Oestrogel: new packaging (yet again)?

[Cosmetichamster]

Hi ladies,

Just got this month's prescription for Oestrogel, and I have been issued with a bottle that is new (to me at least). Have a look at the photo: left is what I have known and used since June this year, on the right is the new bottle, also from Besins, same labels, same ingredients, and long use by date (07/25). Obtained from a reputable pharmacy, which has filled all my previous HRT prescriptions.

Has anyone seen this sort of thing? Slightly freaked out here.

Just because one person doesn’t personally notice the change does not mean that the next person won’t either! I have only been on oestrogel as no need to try any other types of hrt as it works for me, however lots of symptoms are returning since I started the new bottle which may be just coincidence but also worth discussing as others have noticed a change too. We are not all stupid but all deserve to have a rational conversation about it, just in case there is any truth in our findings. Same with any medication..

Dh is on lots of meds for his arthritis, some of which he has noticed a drop in effectiveness with new packaging or manufacturing, others he has not had any problems with the change. Everybody reacts differently to meds all the time.

Hi all, I’ve just signed up as I was desperate to find out if others had shared my experience. I received the changed oestrogel packaging just before Christmas and shortly started having symptoms again. Terrible nights not sleeping and burning up. Also hot flushes during the day. I’m due to see my GP on Tuesday so will tell her. Forgive me, I haven’t read the whole if the thread so might have missed something but I feel so relieved to know I’m not alone!

You are certainly not alone! I’ve increased mine a tiny bit and it seems to have helped as my symptoms are now under control. The amount coming out per pump does not seem as much as with the original packaging, no idea how that can be but that is my experience.

Hope it goes well with your appt.

Hi, this has absolutely nothing to do with shortage of bottles (the conical ones). It's just that Besins has bought back from Delpharm its manufacturing plant in Dogenbros, Belgium and their bottle supplier is Lablabo (the cylindrical bottles). The previous conical bottles were Oestrogel manufactured in Montrouge, Paris, France at LBI (Laboratoires Besins International) and the bottles were supplied by Nemera. Different manufacturing sites, slight differences in the gel. Simples. Some women are sensitive enough to feel the difference. It's not about quality control, etc, it's about really small amounts of estradiol that are hard to control, something that is not a problem with the higher estradiol doses in contraceptives. Our bodies take some time to get adjusted. By the way, I think all of them will come from the same place now, unless you get the parallel import ones.

Oh and the inner pouch is not the same, JinglingXmasBells... you can check them out at the respective manufacturers websites, Lablabo and Nemera. One is LDPE, a sort of plastic, and the other is aluminium.

Are you in the pharma industry @Azaleah How do you know all of this about who is making what now?

Are you using gel?

I think it's nigh impossible to get exactly the same amount of gel on your skin every time it's used. I know from my own experience that sometimes I spread it slightly further down my arms or thighs (not supposedly so good for absorption as it likes fat cells) and sometimes a little bit more is left on my palms, regardless of how I spread it.

I've never taken more than 1 bottle apart- never had the need to and not worth the effort!

I don't think anyone said it was about a shortage of bottles. Besins said they were now using another supplier for bottles in order to meet increased demand (there was a shortage of the actual product as they couldn't keep up with the increase in demand.) That's not the same thing.

@Azaleah I really don't understand your post. Sorry. You say it's about the actual amount of estrogen in the gel and that they are different, depending on who is making it. Well, that is quality control because the active ingredient ought to be the same whoever makes it.

Are you in pharma quality assurance out of interest?

Hiya, no I'm not in the pharma industry, but I have done my research when I used the gel. If you search Lablabo and Nemera you will be able to see how the bottle, pouch and pump are assembled and the available materials. The supplier for the Oestrodose bottle used to be Rexam which was sold and now is called Nemera and it's the main supplier for Besins in France. The other one, Lablabo, was the original supplier in Belgium and still is, hence the 'new' bottles are the same as the 'old' bottles (cylindrical shaped). It's all on the internet. Besins owned the Dogenbros manufacturing site until 2012 when it was acquired by Delpharm. Now Besins has bought it back.

You said there was a shortage of 'packaging' previously. I assumed you meant bottles, since cartons are easily manufactured.

JinglingXmasbells · 12/12/2022 12:15
This was mentioned either on the BMS website under the availability of HRT, or on a pharmaceutical website, a couple of weeks ago. Besins issued a statement about it.

It's absolutely nothing to worry about and is being done so the gel is available.

The reason for it is because of the shortage of packaging. Besins have reverted to using some older style packaging (no idea if this is a supply issue with the suppliers of the plastic cartons, or what.)

This is due to the very nature of HRT. The amounts of estradiol are so small that the stability of the estradiol molecules is not easily achieved as in formulations with high amounts, so HRT preparations can have fluctuations that are relatively more important than the ones that happen with contraceptives with higher amounts of estradiol. I can try to find a scientific paper and link it here if you like. It also applies to patches using beta-estradiol. The ethyinilestradiol used in other HRT preparations is more stable as well as beta-estradiol in pills, because they have other ingredients to help with its stability.

And just to be clear, I said 'slight' differences. It's not that different manufacturers will use different amounts. It's about the whole manufacturing process, including different suppliers of the API, in this case beta-estradiol hemihydrate, and the inactive ingredients, trolamine, carbomer and alcohol, and even 'purified water'. Tiny differences can influence absorption depending on the type of skin, room temperature and so on.

This article is the first one you need to read to begin to understand how stability is important for bioavailability and its particular difficulties in the case of beta-estradiol.

pubs.rsc.org/en/content/articlehtml/2019/ce/c8ce01874j

@JinglingXmasbells Sorry, I forgot to quote your username! I'm a newbie to forums 😊

No problem. I've been using it for 14 years. I have never noticed any real difference and I've had changes of packaging many times. Maybe I'm just unusual. I'm long beyond peri and think it must be very hard if someone is still in peri and also starting on gel to work out if it's the change in bottle /supplier or their own symptoms fluctuating.
I said I wouldn't keep posting here as I am the only one not noticing any difference, ever, and I know it's annoying when other women think otherwise. I've discussed it with my specialist who prescribes the gel and they don't think there is any variation. But, obviously, other women have different experiences.
Thanks for your input.

Great for someone with a chemistry degree but no use for me :)

@JinglingSpringbells You're welcome if want me to explain it to you! Cheers!

I'm so glad this thread exists! I read it a while ago when I was still using the conical bottles so it was interesting but not relevant to my situation. Then I collected my new prescription and it was the 'new' cylinder bottles. Besins said no difference so I was fine with that. Within a few days, I felt like I was on the verge of a nervous breakdown. Constant tears, anxiety, just absolute misery triggered by the slightest thing. I struggled on and it continued and then I suddenly remembered this thread and it made me wonder. So I upped my dosage from 2 pumps to 3 and hey presto! The tears are gone, the anxiety has gone, I'm no longer feeling like my life is hopeless and what is the fucking point of carrying on. Absolutely nothing has changed in my life except my dosage!!

This is what happened to me too. I started on the new bottle 10 days ago. Never thought much about it. All last week I found I was havinf vertigo and being unusually moody and irritable culminating with a massive anxiety attack on friday night. The worst I ever had. I happened to be on a menopause support page when someone mentioned they had anxiety and dizziness since starting the new bottle. I immediately realized the connection then myself. I found an old bottle and immediately started using it. Today my anxiety is gone, I feel rested and calm again. I went to the chemist and returned the new bottles for old ones. I am sick to my teeth of being medically gaslit by drs and other women! What i experienced was REAL very real and I wouldn't wish it on my worst enemy. There is NO other explanation except the new bottle. I wish they would leave well enough alone and stop changing the formula.

@Kilkennymom I hear you! But they haven't changed the formula, it's just that the ingredients come from different suppliers depending on which manufacturing plant is producing them, and obviously, the manufacturing process itself is peculiar to each manufacturer.

the manufacturing process itself is peculiar to each manufacturer.

No, that's not how it works.

Well whatever way it works...the final answer is the product is NOT the same and I am terrified to go back to that cylinder bottle. It's totally unacceptable.

Yes they are different because they are located in different countries and have suffer suppliers. It's quite naive to think that all products are exactly the same. That's not being realistic.

I happened to have a review with my GP shortly after I posted on here. I got a new prescription and, despite the chemist saying they didn’t have any ‘old’ bottles, that ms what I got! I had been burning-up and not sleeping at night with hot flushes during the day. Having started to use the new prescription, the symptoms have now eased a little so there must be something in it.

What is the lot number on the bottles? I suspect the bottle on the left will start with 1? What does the new bottle start with?

They used to start with 7, the ones made in Belgium. The ones made in France start with 1.