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.

In the instructions on the new bottles, it says to remove the little cap before use. However the bottles I have, the cap is attached by the plastic cord to the back of the nozzle when they are first opened (see pic). Are they all like this or is it just the batch that I have? Should they be sealed up when supplied? I have started to use the cap in case it makes a difference but I figure if they have sat around for months without it on then it probably makes little difference.

@Amireallyhere You have to use the stopper AFTER priming the pump. If the pump hasn't been used the stopper can sit there until the expiry date of the gel.

Thanks Azalea, that's not clear from the instructions. They say you need to remove the stopper from the spout in order to prepare the new pump pack.

@Amireallyhere I was a bit confused by the wording when I first got the new bottles with that instruction, but all of mine have come with the stopper attached like yours so I am guessing it’s just poor wording on their part.

@Amireallyhere Yes, I agree with @ConfusedEasily Poor wording. We need to detach the stopper from the spout otherwise it won't reach the nozzle. It doesn't always work though. On an Instagram video by rockmidlife the stopper gets in the way when she's pumping the gel and it doesn't stay on the nozzle., What's happened to quality control? 🙄

Thanks for this thread, I started a new shaped straight bottle with clear lid bottle a few weeks ago and have been wondering why I’ve had a headache and various symptoms returning.
I’ve filled in the yellow card so Thankyou to the person who linked to that.

Oh no....I've been given oestrodose this time, after refusing the dreaded cylindrical bottles from numerous pharmacies 🤦‍♀️ I didn't realise there had been issues with that one as well.

@dicedicebaby Some women feel fine on Oestrodose. Fingers crossed for you 🤞🏻

I just wanted to say I'm so impressed with the efforts to track down the problem with all this Oestrogel stuff. Well done everyone :)

I started on blue lid/green square and then was switched to cylindrical white lid. I can't say I've noticed any probs because I was still all in flux and trying to sort out the right dose for me anyway. But on 4 pumps of Oestrogel (new cylindrical) I only had 283pmol of estrogen and I'm in peri so some of that is my own... is it doing anything.....!?!?! I'm now on 5 pumps of it...

During perimenopause oestrogen levels fluctuate a lot so one blood test snapshot doesn't mean anything, but this reading is consistent to what is expected for postmenopausal women on 4 pumps of Oestrogel. I struggle to understand how HRT works for some women in perimenopause, it did nothing for me!

Well, it's not quite true that it doesn't mean anything. If you get a high result, it doesn't mean anything - because a day later whatever your own ovaries are contributing can drop to almost nothing.

But if you get a low result, it definitely means something - your ovaries can't take away from what the exogenous HRT is providing, so you know that you aren't getting much from the HRT.

I'm with Newson Health for menopause stuff and my dr there says that most women feel best and don't have symptoms when their estrogen is between 400-600 although some do need it to be higher. And that this is indeed a low result for 4 pumps of gel, corresponding to 2 pumps for most women.

@everythingyouneedtoknow This is from Oestrogel PIL:

"Distribution

Daily application of 2.5 g or 5 g Oestrogel over a surface area of 400-750 cm2 results in a gradual increase in oestrogen blood levels to steady state after approximately 3-5 days and provides circulating levels of both oestradiol and estrone equivalent in absolute concentrations and in their respective ratio to those obtained during the early mid follicular phase of the menstrual cycle.

Oestrogel was administered to 17 postmenopausal women once daily on the posterior surface of one arm from wrist to shoulder for 14 consecutive days.
Maximum serum concentrations (Cmax) of oestradiol and estrone on Day 12 were 117 pg/ml and 128 pg/ml, respectively.

The time-averaged serum oestradiol and estrone concentrations (Caverage) over the 24hour dose interval after administration of 2.5 g of Oestrogel on Day 12 were 76.8 pg/ml and 95.7 pg/ml, respectively."

The time-averaged serum oestradiol on Day 12, 76.8 pg/ml = 279 pmol/l, is very similar to your blood test result. The study only considered the 2.5 g dose (2 pumps), it can't be extrapolated that 4 pumps will provide you 2x oestradiol, because the absorption rate and the steady levels will achieve a maximum concentration after some time (time-average).

In most laboratories, serum oestradiol levels range from 73.42 to 293.68 pmol/l during the early to midfollicular phase of the menstrual cycle.

I just wanted to come back and say that I am utterly fed up with how I feel. I’ve spoken to my GP and the pharmacist, contacted Besins etc. to no avail.

The pharmacist (male) was just starting to tell me that it might be psychological etc when a female pharmacist popped her head up from behind the counter and said she couldn’t believe what she was hearing - she too has been suffering terribly lately after changing bottles and has been back to the GP for blood tests. Now it all made sense to her.

I just feel totally fed up. I’ve gone from feeling 99% fine 2 months ago to now suffering with debilitating muscle and joint pain, palpitations and dizziness again. Feel like I am almost back where I started 2 years ago.

I’ve just picked up another prescription of the new cylindrical bottle and I don’t know what else to do to make this better.

@Namddf I'm sorry you're feeling like this. I am really struggling too and don't know what to do either.

All that cr@p 'blaming' the shortages on menopause awareness and increased number of prescriptions... it's the same thing that's happening with Estradot shortages. Nothing to do with increased demand, Novartis has divested their marketing to Sandoz, which is now the Marketing Authorisation Holder of the Estradot range of patches. Pharma money-making business as usual.

I totally understand how you feel. After experiencing all my symptoms coming back even when I upped my does I knew I had to look into alternatives, I’ve been
seeing a traditional Chinese doctor now for around 5 weeks and it’s helping greatly. My aim is to come off the gel, I have reduced to just under 2 pumps a day and all my symptoms have stayed away. I have acupuncture and then tablets to deal with any symptoms. I’ve not had any tablets for over a week now and no return of sweats, brain fog etc so I highly recommend if your interested in looking at other options.

I switched to patches a couple of weeks ago (Evorel 75) as the 3 pumps of oestrogel in the new packaging stopped working for me (as stated in previous posts). I’m already starting to sleep better, night sweats have started to subside too. I’d never trust Oestrogel again and didn’t hear anything back from them.

I did have Sandrena for a while about a year ago when there were shortages of oestrogel and I recall being ok on it.

I’m (now) on 5 pumps of oestrogel and still feel awful. Has anyone switched from this high a dose of oestrogel to Sandrena and can you tell me your experiences?

I don’t want to feel even worse!

Please don't shoot me, but I had to say it.

Maybe you should ask pharmacies if they have parallel import Oestrodose?

It sounds bizarre, but the lady who lives in France posted a while ago that Oestrodose hasn't changed and has the same consistency, smell and works well for her.

If you felt bad on Oestrodose in the past, it was probably due to changing products, but if you give it time to take effect, you may feel better.

I am convinced that the only thing that can explain the return of symptoms is that women who used one version of the conical bottle (produced by Delpharm in Belgium) or the other version (produced by Besins in France) received the other version (when they were available) or the version produced by Besins in Belgium (different team after April-June 2022), and now the cylindrical bottle which seems to dispense less than expected.

Two different things are happening here: change of manufacturer and change of bottle/bag/pump supplier.

I feel totally fed up too! I tried sandrena and I could not get the dose right..felt awful. Then tried the patch which did not suit me at all. I now have to go back to the cylindrical bottles and hope this time I can get back to homeostasis. Being a mom with 2 troubled teens and all the stress and strain of rearing a family but no we have nothing better to do than conjure up an issue with our HRT!

@Azaleah I am the one living in France who has been using Oestrodose for 18 months now and have only ever had the same non-cylindrical green top bottle and it's doing well for me. Whenever I've not slept well or felt anxious during the time I've been on HRT it's always largely traceable to an isolated lifestyle factor (an additional espresso too late in the day, that one glass of wine too many at a dinner party, job stress limiting leisure activity time, family - let's not got there - issues etc.) that I've addressed without needing to change HRT dose. I address the lifestyle factor and things improve so it's not the HRT.

I really do think consistency of product must be a key factor in all this. And with that I would include the appearance of the packaging - that's very much NOT saying 'it's all in your head' when the packaging looks different, but to acknowledge the benefit of psychologically always having had the same bottle/label (Oestrodose) and so not having the confounding variable of feeling anxious about being given something different from what I'm used to when I already know that differences in packaging and manufacturing sites seem to be correlated with poor experiences for many women.

Sorry for not mentioning you by name! I agree with you, consistency is very important when we experience a rollercoaster of symptoms.

I’ve bought some jewellery scales yesterday to see if the dose is consistent in the new cylindrical bottle. So not used long enough to tell but one pump was 1.25g and the next was .99g, so 20% less than it should be.

Whenever my hormones are out of whack the first symptom that comes back is the horrendous muscle pain across my shoulders. That’s not something you can imagine.

I first noticed symptoms coming back the first time I was given the new bottle. I don’t actually tend to notice things like packaging as I’m not very visual, so I was none the wiser that it was different at first.

I only put two and two together when my symptoms returned again after switching from the conical to the cylinder bottle for the second time. It was then that I googled it and found a whole load of anecdotal evidence to back up my experience.

I know that in my case there is absolutely no chance of these returning symptoms being psychological.

Now that you are aware that there is a problem, each time you see different packaging your body is already primed for a problem. That is a real and important confounding variable that can also have concrete physiological effects. I was certainly not suggesting that you are imagining your pain.