Oestrogel: new packaging (yet again)? - Thread 2

[ConfusedEasily]

Carrying on from a previous thread by Cosmetichamster which can be found here:

https://www.mumsnet.com/talk/menopause/4696464-oestrogel-new-packaging-yet-again

@abdnhiker - do you mind sharing a photo of your old and new bottles please?

These were the 2 new type bottles I got. One shiny label the other matte. My old bottles were conical shaped (ones i didnt have an issue with).

I’ve had both of those, the shiny label was terrible for me and I sent it back to Besins (still no request for GP access for them though) but I seem okish on the matt. I did find a half conical one at my parents that I’d left for emergencies when I visited at the weekend but was too scared to use it in case it stops the matt one working. I’m feeling angry that we are having to put up with these inconsistencies.

@Chrisg79 - thank you. You mentioned your latest bottle is working well and you are back to 1 pump. Which bottle is that?

I've been using the new bottle now for 4 days. So far, I've not noticed any difference. In fact, I've felt slightly better (sleepwise) than on the Oestrodose bottle which I was given before (along with the usual Oestrogel bottles.)

The only think I'd say about the new bottle is that the pump sometimes seems to vary in how it works. I've found you need to really press it very hard, in one firm 'press' so that enough gel comes out.

I doubt very much that the label makes any difference. The will be down to the label supplier (all these things like packaging are sourced from suppliers and aren't connected to the contents.)

One thing I'd mention is that it's almost impossible to request a certain type of bottle. My HRT is a private prescription which I sometimes collect from a large private hospital. Even they have to take what their supplier has (and gave me the new pump type a while ago.)

I am using 3 - I have been told I can use 4 (which is above the licensed amount) but haven't needed to. I hope it works for you too.

I have changed onto sandrena gel now, 2 x 1mg sachets instead of 4 pumps of oestrogel. Let's hope this works!!!

Sorry for the delay - here’s the photos of the old conical and new one with French label that I’ve just been given (same shape I think as the ones I used to get). It was me who said I’m back to my original dose on the new bottle.

@JinglingSpringbells I did measure the weight from the conical bottle with a very fine scale when I first got it and it was exactly 1.24 or 1.25g when pressed. I probably was pushing it carefully - so I’m not discounting that there could be less accuracy with the dosing, but I’m confident that isn’t the difference in strength I observed when I switched bottles.

Sorry for the delay - here’s the photos of the old conical and new one with French label that I’ve just been given (same shape I think as the ones I used to get)
@abdnhiker Thanks for posting the weight of the gel. The bottle on the right in your photo- Oestrodose- has been around for some years. It's a parallel import and is what's used in France, but imported to the UK with an English-speaking label over the French.

I've had it many times and although I ask for the UK version, (as I'm paying for it on a private prescription) sometimes it's been all that is available and more so now because of the increase in demand. I've had a bottle recently but the latest batch are the new conical bottles.

Personally, I've not noticed any difference with the new bottles (and I'd be very worried if there was as I'm using HRT for bone health as much as anything which I have monitored.) I think the pump is different and it doesn't allow for half a pump very easily.

From the 2 bottles pictured below I went from the bottle on the left (first bottle of gel after moving from patches, started with several side effects then went from 2 pumps to 3 after reading this thread and things settled down) to the bottle on the right. I had a severe allergic reaction and came out in hives from head to toe. Also had a panic attack. I was in agony for 48 hours. I'm now off HRT to allow my body to settle, and it will be reviewed in a few weeks. It is very interesting what pp have said about histamines. If I do go back to the gel I will ask my GP about taking a daily antihistamine. I've gotten around to writing to Bessins yet but will do.

Which bottle were you allergic to? Trying to make sense of the posts here. I was terribly allergic to the one on the left.

I always have anti histamines anyway and they did not touch the sides of my allergy to the gel. I was also allergic to the patches the second time I used them and get some itching on tablets . Also feel itchy off HRT so I can't win really!

GPs are extraordinarily clueless about all of this must say and never want to give reasons for the porblem, just treat the symptoms.

Meanwhile I'm bored of feeling itchy and being allergic to life.

Just for information - In pharma there are very stringent quality controls.

It's not possible for the gel to contain less estrogen or be totally different.

There are layers of checks, with quality control of raw materials, final products, batches, all with large teams of scientists double checking.

The overall responsibility is someone called a Qualified Person who has trained to a very high level (post grad) and who is only awarded the title by a panel including the Royal Society of Chemistry. Their role has legal implications.

If a QP makes errors with signing off batches of drugs that are not fit for purpose, or overlooks something, they can be prosecuted and imprisoned. This is the same in the UK and the EU.

So, drugs being made across different sites etc is not relevant.

Fully aware of that (have a science PhD myself and have always worked in science and technical roles) and my initial view was the same as yours that there couldn’t be differences in the gel. But - that’s not the experience I had when I switched back to the teardrop bottle and as I wasn’t expecting any difference I don’t think it’s a case of placebo effect.

This is one of those things where it doesn’t make immediate sense but there’s enough people impacted that there’s almost certainly something different. I can’t rule out it’s just the volume from the different pumps as didn’t measure the weight of every pump, but again, I’ve a science background and I was definitely using more volume of the conical gel than I am using from the teardrop bottle. And of course we all have different reactions to HRT so it will be different for different people - perhaps most people will see no difference between bottles. For me, I’ll know if I go back to the conical bottle to consider if I need to increase my dose (and will try to do that on a weekend when if I have a rubbish night it’s not before a big day at work).

Thank you Abdnhiker! I have been experimenting and documenting my experiences with the 2 bottles for 13 months now. I have sent 2 bottles back for testing and both reports came back as no issues. YET when I fully read the reports neither of my bottles were actually sampled and tested, they just a general quality control " investigation ". But here is the zinger...my post menopausal bloods are consistently in the 300 to 350 range on 3 pumps for the last 4 years. When I changed last December 2022 to the cylindrical shape bottles my physical amd severe neurological symptoms returned within days. I upped my dosage to 4 pumps and felt even worse. I went to dr and he documented the return to symptoms especially the burning feet and uti. Bloods taken. ..guess what estrogen down to under 100. Managed to buy a few older shaped bottles....bloods taken next month....back to 350. So when I ran out again of the old bottles i had to use the new and decided to take off licence 5 pumps! YET again bloods taken same issue..a huge drop down to 100. Bought 2 bottles of old off Facebook marketplace and a lovely lady here sent me an old bottle...Guess what bloods taken and estrogen levels back at 350. Can someone please explain that?

I'm so sorry, I completely missed your question last week.

I had the severe reaction to the bottle on the right. Not sure whether it was the brand change, the dose (I got a lot more gel per pump with that bottle) or the fact that I changed medication a few times in a short period of time and my body just didn't know what was going on.

Thank you @abdnhiker for the photos

Has anyone here encountered the old style bottle which was working for everyone? None of my pharmacies have it and the very last bottle I own was purchased a year ago🥲.
Is there any hope at all?

I was on 3 pumps of old shaped bottle and felt great. I didn't know anything about problems with cylindrical shaped bottles so when I got them from the pharmacy last October I thought nothing of it. Until gradually I started feeling rubbish again. Mainly stopped sleeping and brain fog returned with a vengeance plus mood swings. I upped the dose to 4 pumps with no effect. GP put me on patches equivalent to 4 pumps of gel and it felt awful. I then moved onto Sandrena 1.5 mg which is equivalent to 2 pumps of old gel and now feel fine. I tried upping it to 2 mg as that was closer to 3 pumps but it wasn't great. I might still try and up the dose a bit again now that I settled to see if it will make a difference because when I was on 3 pumps of old Oestrogel (2.25 mg) it was great. My GP said she heard about the issues with Oestrogel and her theory is that it's the so called base ingredient in the gel which aids absorption that is affected. Perhaps Besins somehow changed the base which now means a lot of women don't absorb the Oestrogel from cylindrical bottles. It's not an active ingredient so perhaps doesn't get tested as much as hormonal make-up does. Perhaps they didn't even change the chemical formula of the base gel but the source supply and/or the quality of ingredients. There was a similar problem with one of the contraceptive pills years ago that I read about. Lots of women were fine until pharmacies started dispensing 'exactly the same' pill made in Bangladesh rather than France and many women started having severe side effects like bleeding, acne, etc. Nobody believed them either because the preparation was 'identical' to old more expensive pill made in Europe.

@Lollipopsnet I changed to sandrena too in December . After swapping to the new style bottles in September I felt terrible .. was waking every half an hour in the night .. racing heart .. felt terrible .. I’m in 1.5 sachets of sandrena and am feeling much better and more human plus I only wake about once in the night . My menopause specialist said the same that she wondered if oestrogel wasn’t being absorbed as well

@Rockschooldropout are you on the same equivalent dose of Sandrena that you were on Oestrogel? My GP just let me choose the dose, she thought it was ok to be on 2.5 mg of Sandrena even though 1.5 mg is the maximum dose.

@Lollipopsnet I’m on 1.5 sachets (1mg sachets ) which is equivalent to two pumps I think ? I was on 3 pumps .. she said I couid up it to two sachets but it made me feel jittery

@Rockschooldropout Yes I thought 1.5 mg is equivalent to 2 pumps. I was also jittery on 2 mg. Interesting. I think Sandrena has better absorption especially if you don't spread it much. It says in Sandrena leaflet that rubbing it over wider area than 2 widths of one's hand reduces absorption. Btw you can get 0.5 sachets too, I got prescribed both dosages so use 1 mg sachet and 0.5 mg sachet to get 1.5 mg.

Interesting chat. I’ve tried 1mg sandrena then used some of the new style oestrogel and noticed feeling very anxiety odd mood brain fog again there’s definitely something going on with absorption or strength?! I’ll persist again with Sandrena I need to order more as that bought my symptoms back under control again!

Oh that’s worth knowing on the sachet size .. defin agree re absorption.. I feel I’m absorbing the sandrena much better , certainly than the new style oestrogel

i was in the last thread chatting in general because my background is in pharmaceutical r&d (not Besins!) and I was interested in the patient experiences, as well as taking oestrogel myself. My theory is similar to that of a pp that there is an unmeasured change in the other ingredients in the gel (“excipients”) that is causing the gel to be not as well absorbed in some, but not all, patients. Probably the polymer that forms the gel.

And now it is happening to me too with my latest prescription! Over the last couple of weeks I’ve noticed all my menopause symptoms returning - brain fog, anxiety, muscle stiffness and pain, constipation, night sweats, crappy sleep, just generally feeling old. The medics still haven’t got my progesterone dose right as I’m back to suffering from bleeding (I’m post menopausal, investigated all ok, consultant said not enough progesterone). I’m on 3 pumps to 100mg utrogestan. I thought my symptoms were related to my current “period” as it felt like PMT to start with but it’s gone on so long I’m recognising it as menopause.

Aaargh!