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.

Hi, I’ve posted on this thread before but have had a long period with the green top bottles & hoped the problem was behind me.
Latest prescription though I received white top bottles- despite doubling the dose (2 to 4 pumps) am now getting terrible hot flushes, within 2 weeks of starting white pump (and despite pressing pump hard, etc.)
2 questions.

1. Basically, what is the problem now thought to be? I want to explain it to my gp & there’s so much information here I can’t work out what the issue is thought to be.
2. I’m going to ask to be moved to a different product (despite years on oestrogel). Are there any recommendations? (Ie for a topical oestrogen.) in particular has anyone managed to get Lenzetto on the NHS, & if so what has their experience been?

I’ll do the yellow card, but last time I complained to Besins I heard nothing back from them after an an initial acknowledgement. I don’t think they are fit to produce pharmaceuticals. thank you!

@Newyorkdollmama reading your post was as if I'd written it! I felt rotten on Sandrena (bad headache, angry, flushed , eyes finding everything bright and stale feeling). This is all so as annoying and potentially fixable if Besin actually do something.

I had awful results with the new bottles and tried patches again and they just weren't as good as gel.
So I spoke to my doctor and got swapped to sandrena gel. She put me on 2 sachets a day. Symptoms were still there so I checked the equivalent of 4 pumps of the oestrogel was actually 3 sachets of sandrena. I upped my dose an went through sone awful days of headaches and feeling a bit woozy. But now a few weeks in I feel a lot better. Sleep is back to normal and symptoms are finally gone.
So don't give up trying something new as the first few days I felt awful, but now it's settled down I'm glad I stuck it out.

Glad it worked for you, any changes can take up to 3 months to work.

Have any of the people with these symptoms had bloods run to see what levels are and to compare them to levels before on the old gel? Especially people post meno without their own fluctuations to confuse things…?

I think this sort of approach is so unhelpful.

Women have been told that things are ‘in their head’ for centuries (ref. the mesh scandal for a recent abomination).

How do you explain the sheer numbers involved in this on this forum alone? How do you explain the fact that I had returning symptoms before I was even aware of a change in packaging?

A friend recently told me that she’d been really struggling with symptoms for the last 3 weeks (already on HRT). I asked if, by any chance, she’d been given a different bottle of gel. She checked - yes she had.

This is not psychological.

This gives me hope. I’m trying to get a prescription for Sandrena (GP being difficult and asking me to come in for a consultation but none are available until December 😩).

When I do get it I will start immediately on 3 sachets.

I totally agree! The poster says she didn't suggest we were imagining the symptoms! Actually yes she did suggest that. If not I don't know what point then she was trying to make. I certainly read from it that it was psychological. Posts like this REALLY UPSET me. The same old song it's all in your head. Does the tune ever change?

Interestingly I’ve had an issue with a recent bottle of oestrogel (white cap) where the pump isn’t working properly at all. It alternate between giving me one pump and then “splats” the next couple before behaving again. Like it does when it’s empty but it’s a relatively new bottle.

I’ve rung Besins and they’re passing it on to their product quality team - the person I spoke to offered me a swap out with a new bottle, so we’ll see how that goes. Luckily I’ve got a couple of other bottles (different batch) so it’s not left me short.

I’ve recently moved from Everel Conti topped up with gel to utrogestan tablets and gel. I was getting unexpected bleeding on the patches and gel - that’s been investigated, I’m fine and it was put down to insufficient progesterone. While it was being investigated I had been told to reduce my gel use which I did but it was horrible with symptoms coming back. Now I’m stable on the utrogestan tablets I’m gradually increasing my gel. I’m feeling ok on 3 pumps (white cap) at the moment. Fingers crossed it stays that way.

@funnelfan Thanks for sharing your experience. Let us know what Besins

@funnelfan sorry, hit post before finishing the sentence and can't edit it on the app.

Let us know what Besins says (if they do) and good luck 🤞🏻

Will do! The former analytical chemist part of me wants to rip the bottle apart to see what is going on (as I would have done myself when dealing with product complaints!). However I think it’s far more important that Besin gets some useful data from it - they’re not going to take the word of a random customer doing kitchen experiments, even if I did attach my cv to it.

How exciting 😊 It's great to have a former analytical chemist on board.

haha, I’ve posted a couple of times already.

troubleshooting manufacturing issues is a fascinating and frustrating part of the job. Especially when transferring manufacturing to another site - you can do everything exactly the same as the original place and yet still have issues. It can be really random things like the new factory has two bends in the pipework whereas the original one has only one, and no one would ever have predicted that would cause a problem. Throw in packaging changes at the same time makes the multi factorial analysis a massive job. Lots of different experiments needed to pin down the issue(s). You need a good team working on it!

i think the main job we have as patients is convincing Besins there is a real product issue to start with, and it’s not patient variability or “psychological”. Which is why I fully support everyone reporting their problems, whether via the yellow card scheme or directly to Besins.

😂 Menobrain here!

That's exactly what I think it's happening, but coming from an analytical chemist mouth it sounds so much better 😁

I saw my gynaecologist yesterday and for the first time I heard a health professional tell me that several patients are complaining about the change of oestrogen packaging and the resulting ineffectiveness. I almost couldn't believe it. He knew all about the lower quantity being dispensed by the new pump and the fiddly stopper etc. I was thrilled. Felt like there is some hope!

Great news that you were not gaslight!

@funnelfan I know what you mean by the splats!

You could have just asked "The poster". The point was that Besins need to stop dicking around with the packaging. They've left the problem unaddressed for too long. I've been consistently using Oestrodose - which has been an issue for some UK women who were were switched onto it from Oestrogel - without problem. Consistent product AND consistent packaging, and that has helped also because I know there is a problem going on with different product AND different packaging, as do many women who have read this thread or seen the posts on other forms of social media and who would then not be able to receive a change in packaging neutrally because they know so many women have had a poor experience with such a change. We are human beings, and that's the way it goes. I have not said it's all 'in your head'. I'm going to unfollow the thread but I wish you all well.

@Mayflier please don't go! I'm sure it's just a misunderstanding. Your input from France is really important for this thread.

But (as I tried to explain) a VAST number of women have only ended up at threads like these because they have been having problems for weeks/months and thought it was them. They haven’t read about a change in packaging causing issues and thought ‘Ooh, come to think of it, I don’t feel quite right lately’.

It’s really dismissive.

What you’re saying is that they’ve perceived the new packaging as a problem and the issues have stemmed from there.

In the vast majority of cases that simply isn’t true.

Some of the returning symptoms we’re talking about here aren’t vague things like brain fog and low mood, or palpitations that can come from an anxiety loop. In my case it is muscle pain so bad I need to take ibuprofen. Other people have had a frozen shoulder return.

How on earth can you imagine that due to concerns about packaging?

@Cherryann I switched to Lenzetto after the new bottles came out due to the same problems reporting here. I had no problem getting Lenzetto on NHS and I find it so much better - one quick spray (equivalent of two pumps), nothing on your hands and less than a minute drying time. It is important to get the angle right to keep the dosage consistent, but that's just a matter of positioning your arm so the bit of skin you're applying it to is vertical. There are some interactions with suncream so I put it on my hip in the summer to avoid this. But generally it's been a revelation and I wouldn't go back.

I was on 4 pumps of gel but have switched to 100mg patch due to my symptoms returning. I still have dreadful back pain in bed. Do you think I could switch to Lenzetto? I’m not sure 3 pumps of spray would be enough.

@jocushion one lenzetto spray = two estrogel pumps so you should be fine on two sprays of lenzetto. It's weird as lenzetto seems so much less stuff that you're applying but it seems to work; I'm doing as well on 1 spray as I did on 2 pumps of the old gel.

@Namddf My understanding of what @Mayfliersaid is that the psychological effects of this never-ending packaging changes can add up to to the fact (real, not imagined or nocebo effect) that women are having menopause symptoms on the dose that used to work for them.

Although this can be explained by perimenopausal hormone fluctuations in some cases, it doesn't seem to be a coincidence or an effect of mass hysteria that many postmenopausal women feel like the consistency of the gel is fluctuating as much as their own hormones used to.

And by 'consistency' I think both meanings apply here: consistency of the gel itself (different manufacturers, different raw materials suppliers, different pump suppliers) and consistency of packaging (which can lead to psychological effects).

These psychological effects can often be unconscious, so not all people are prepared to accept them, but they're REAL, not 'imagined'.

If our brains can 'create' menopause symptoms, I think researchers are missing the vital clue that we can control them as well. If only...

I have been puzzled by Besins products for a while now. I have started investigating them back in 2016 when I was in late stage perimenopause and tried Oestrogel for 3 months.

I had friends using Besins gel in other countries (which were supposed to be exactly the same, only different packaging and sometimes different brand names), but over the next couple of years all my friends living in the UK started complaining about their symptoms returning, while friends living overseas were fine.

Many of the UK users didn't even notice the Oestrogel label stuck to the Oestrodose bottle until they read about it on menopause forums, so I continued investigating even after things seemed to have resolved themselves. (As I have already emphasized a few times in this topic, it takes time for the body to reach a steady-state level of estradiol in the blood and tissues when absorption of the product is different from before).

I think the orange-green squares on the label might illustrate what I'm trying to say:

When my UK friends started complaining about their symptoms returning in 2020-21, they didn't notice the coloured squares. I asked them if they knew what the squares were supposed to mean and they all said 'Which squares?!'

I have been looking into this for almost a year and concluded that they meant different manufacturing locations, but I could be wrong and Besins said they were just printer codes.

Looking back, maybe they are just printer codes. I have been looking for printer codes on other product labels and have found them. They usually have the same colours as the bottles and cartons, but I recently found one that has a blue square and that colour is not on the carton (Italian Barilla Integrale Penne Rigate, lol).

I was intrigued because dark green had never been used on Oestrogel bottles, but then I realised that the Besins logo on Oestrodose bottles is/was dark green (and coincidentally looks like a square).

So yes, it could just be printer codes, but coincidentally (or not), patient information leaflets in the UK (and other countries) changed a few months after the squares appeared on the bottles.

They changed the manufacturer from Delpharm, Drogenbos Belgium to Besins Manufacturing Belgium, Drogenbos Belgium OR Laboratoires Besins International, Montrouge France.

It is therefore obvious that the changes to the packaging existed before the changes to the leaflet (probably because it takes time for changes to the leaflet to be authorised by the MHRA, although I think it's unacceptable to have a product with an old PIL).

Sorry for the long post, but it makes me sad when we can't look at these issues from a neutral perspective because we all struggle with a lot of things at this time in our lives and we certainly don't need to stress about pharmaceutical or medical technical stuff but, if necessary, we need to keep investigating.

As invaluable as personal experiences and opinions are, they are as different and virtually infinite as the number of individuals on the planet, and when it comes to menopause, they can change radically, not only between individuals, but within a single soul.

I hope this topic can be useful for all women who need help. It certainly helped me, after I had to leave a menopause forum for discussing the findings of my investigation, rather than just accepting what a 'knowledgeable' user had implied that it was 'all in our heads'.