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

Hi, I've just been put on oestrogel and progesterone tablets due to postmenopausal bleeding on evorel patches. I can't seem to get the dose of the gel the same! Some days it looks like twice the amount. Should I invest in some scales like PP?

I have decided to come off it completely. I have had so many problems since the gel change. I have tried patches etc.
I am also getting my mirena removed not fun as the strings can't be found so a trip to the hospital in January!

I feel OK. I have been on HRT for 5 years and was bloated and just not tolerating it as well. I have lost 5 lbs in 4 weeks which just wasn't budging so that is a bonus. My breasts are now not sore and I don't feel bloated. I mediate for anxiety and my joints have improved with bodyweight fitness.

Anyone else struggling with poor skin on the 'new' bottles? My terrible acne has returned with a vengeance in recent months. It has completely gone away when I was on the 'old' conical bottle and even the 'old' cylindrical bottle. Not sure what's going on any more. Thinking of change - what's the next best alternative?

@SoftPillowAllNight i switched fo Sandrena sachets it’s not quite the same but it’s a hell of a lot better than the crappy gel. For context I was very happy on the old gel for five years before it got changed.,

@LeafDancing - thank you. Is Sandrena a gel or spray? Is the spray any good?

It’s gel in individual sachets I use the 1mg ones.

I find my skin has gone quite dry didn’t consider it could be the gel.

What is going on, again. I got settled on the new packaging Oestrogel (bottle with label as part of the bottle, not stuck on). I bought some more after my 2 bottles ran out and ALL my symptoms are back. It's like theres no Oestrogen in the gel at all?!
This is getting so stressful and boring. How are they allowed to mess about like this?
Anyone else noticing symptoms again between same bottle style and batches?
Indeed no idea what to do.
Also, do the patches vary, as I tried one and I felt horrible on it, is Estrodot the better one?
Thanks

Hi Muttley47

I have the exact same experience, I recoded the batch number and sent a complaint to Besins, they have responded by they want my endocrinologist to fill in the form. However, she isn't interested and was a bit blasé about it all, she just wants to change product. My blood test show that I am absorbing estrogen with the "bad bottle" but the levels were down about 25%, however if I increased my dose I could get my E2 levels up but I found that it still wasn't as effect. My doctor thinks I am having an allergic reaction to some of the ingredients in the gel. It is currently being supplied to the UK and Ireland from multiple sources whereas it was previously a single source supply. I am assuming that there is a slight difference in the other ingredients in the bottle coming from the different manufacturing plants. I would think this is entirely possible as the regulations and controls are probably mainly on the active ingredient rather than the carrier gel.

I'm not sure what to do myself as a lot of the patches are not effective for me. Evorel used to be excellent until they sold it to Theramex and now it doesn't work the same, I actually find it pretty useless. The old Evorel used to irritate my skin a lot but I found it very effective, with the new patch my skin would look like I never put on a patch. The new one looks the same, and is in the same package but it is basically a generic patch that is rebranded. Nothing wrong with generic per se, it just doesn't suit me; it is not the same Evorel. I found Estradot ok, but I need to take a very high dose in order to get the appropriate E2 levels, I have the same issue with other patches. My biggest issue with Estradot was the small patches didn't stay on if I was exercising a lot.

As I said I sent in a complaint which they did respond to. I am going to fill it in instead of my doctor as I have a good knowledge of my hormone levels etc anyway. I think everybody experiencing this issue should make a complaint and keep a record of which batch is good and which is bad so that it can be documented. If enough people do it, maybe it might get some action.

Hi@Muttley47

So sorry to hear that you are having issues, even after managing to settle on the newest type of gel. It sucks and is really annoying that we have to keep going through this.

I just have a quick question though. Are you weighing out your gel, as I have found that the pumps can be pretty inaccurate, some more than others, and could be why you might be getting issues with some bottles? Even the smallest difference in dose makes my symptoms come back as I am super sensitive to fluctuations it seems. Maybe gives you something else to try, if you want to try and persevere with Oestrogel and you’re not already weighing it.

I hope you manage to find something that works for you x

Hi @Jeneh1976 , I have a ton of experience with how products are licensed in the UK. Let me help on how manufacturers are bound. It’s not just the active ingredient (known as API - active pharmaceutical ingredient) that is regulated, the carrier gel is also governed because the delivery of the API is directly influenced by the gel formulation and the pump construction, so the medicines regulator in the UK - the MHRA - has control over both elements.

The bottle change may or may not coincide with a change in the product formulation - you can do either or both but you must get approval from MHRA to vary either part. From your post and others, it’s clear that there’s suspicion that the product has had a formulation change and a suggestion that there may not be enough API in the gel. If you - and everyone else - raise an ‘Adverse Event’ complaint to MHRA, it will be looked into. It’s called the Yellow Card scheme. Note that manufacturers are not obliged to tell patients that they’ve made a change because the assumption is that the MHRA will only have approved the variation if they consider it to have no clinical impact on the patient (otherwise they’d ask for more data or just reject the change).

When the MHRA get involved, they have to take it up with the manufacturer and indeed, may go and inspect the manufacturing plant(s) that they have registered to make this for the UK market. They have the power to test products and recall them if they are shown to be substandard.

This is the link for you to submit your AE reports here: (you can describe your AE as ‘lack of efficacy’ which is a fancier way of saying it doesn’t work!) yellowcard.mhra.gov.uk/how-to-report

All the best with this

the last 2 cylindrical bottles I’ve had with the Matt label seem back to the old formulation to me! Hooray!

@SaltySeaCat

I had the same experience for a while. Definitely had a difference between the bottles with the glossy sticker packaging and the matt printed bottle. I recorded the batch number of the ones the worked and didn't work and raised it as an issue with Besins. However, I found that all recent bottles have the same printed matt packaging and I can still have an issue with some batches. Going to continue recording which ones give me a problem

The problem of underdosing has been solved, for me, by weighing my dose using a sensitive weighing scale. I found that the bottles underdose frequently at the beginning and end of the bottle.

I think the problems are caused by erratic dosing, not the formulation.

The issue of the pump delivering slightly less as the bottle comes to an end is long-standing- it's always been like that for years long before this thread was started. I've experienced something like 4 changes of bottle shape and labels.

I can see the difference in the size of the 'blob'. I just press the plunger down lightly and use a little more.

Do you 'prime' the pump as the start, as per the instructions? The first couple of pumps aren't accurate so they say 'discard' but that's a waste (IMO!).

For most women this tiny amount shouldn't make any difference but it depends how sensitive they are.

Any quality control issues should show up as every batch is tested before it leaves production.

I also using a weighing scales to get the correct dosage, I still find a difference between different bottles. It is not just a case of how it makes me feel rather I get reactions to some bottles in the form of skin rashes etc. if I switch to a known 'good' bottle then the skin issues disappear

Found this thread to say it must have changed again? I started on the cylinder bottle, picked up my prescription today and got this

I’m on Oestrogel the cap doesn’t go back on the besins cylindrical bottles. Always been like this once I open it it doesn’t stay on again…anyone else have this issue?

I got the new (old) shaped bottle in my last prescription.
merry-go-round again!!

Return it to the pharmacy and ask them to contact the manufacturer.

I’ve been on Oestrogel for years and am new to this thread. I’m postmeno and also take one Utrogestan tablet at night and 3 pumps of the gel. My current bottle is the same
as this one - is this now the new shape? I’m so confused 😵‍💫
For some reason I’ve been getting some breakthrough symptoms - mainly night sweats and vivid dreams.
My GP is happy to increase my HrT but I’m now wondering if it could be the change in the Oestrogel?

I’m sad to report that I’m once again waking up with a racing heart; probably the new bottle? 🙄

I’ve had a couple of the new bottles and it’s like being back on the original for me. I love it. Hate the cylinder that has the glossy label, does nothing for me and just about cope with the cylinder with the matt label - thankfully I have a brilliant pharmacist who works with me to order in the bottles I like and saves them for me.
I think the texture in the conical bottles is thicker and less watery so it absorbs better for me.