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

@OtterInDisgrace I've used gel for 15 years. The container has changed several times.

The old version which went out of production around 8 years ago was a cylinder pump in white and gold. This was replaced with a white and blue version.
At the same time, there was a shortage, partly to do with the packaging, and the Oestrodose version was used to fill the gap.

Oestrodose is what they call a parallel import. This means it's the name of the gel imported from another country. In France, women get Oestrodose (not Oestrogel.)
The sticker is to replace the French name for the gel, with the UK version - Oestrogel.
There should be no difference in the gel because it's just the name/carton that's different. It's a flagon shape, not a cylinder.

A couple of years ago, there was a huge shortage of gel because of the increased demand.

Besins, the manufacturers, procured another manufacturer of the pumps and this time they are a cylinder with a white top.

They also increased production across two sites- France and Belgium.

Some women have said they feel there is a difference with the latest style pumps- the cylinder type.

The MHRA contacted Besins after a lot of complaints from women and Besins have reassured them that the actual product is no different.

It would be illegal and unethical to change a pharma product from what is shown as the active ingredients. Quality control has several stages and although thee may be a very rare different batch, it couldn't continue long term, because of the quality control processes. (I know someone who does this for a job in pharma- not with Besins.)

Some women think the new cylinder pump (white cap) is not as strong or gives out a smaller quantity. Others, posting on forums, say they can't see any difference.

If it did give a smaller quantity, there would be more than 64 applications in the pump - so it's best to count them and if it's giving a lot more, contact Besins.

I have just started on a new supply and am finding myself suddenly so much better! I am making sure I am pressing down firmly on the pump to ensure I get the full dose. I use 4 pumps. Still the odd headache but think that is sugar detoxing after Christmas. Whispering the awful night sweats have receded for now. Fingers crossed.

@JinglingSpringbells there is no way the nozzle cap is for security as I can fully depress the nozzle without unattaching it from where it is clipped on (and there it a good few mm distance still between it and the rim as I tried it with my new bottle last night). The instructions also changed when the bottle shape changed to say it was important to always replace the little nozzle cap after use. So I would think that it is indeed to stop the premeasured/prepumped dose, that is waiting in the nozzle, from drying out between uses.

As an extra twist to this all, I have now started to get printed cylinder bottles with a tear tab on the box, rather than a label stuck onto the cylinder and a plastic sticker sealing the box. I actually think that this gel is thicker than the one from the other bottle I have just finished. I don’t want to get my hopes up, in case it is wishful thinking but that is just my observation so far. 🤞

Anyone else get this type of packaging yet? If so, what are your thoughts?

@ConfusedEasily I've just got one bottle of the new type and the tab to cover the pump is almost impossible to replace once it's been used once (to open the pump for the first time.) It's very short.

The original pumps, 15 years ago, had the same tab but it was much longer. It was there as an additional way of ensuring that the pump wasn't depressed and released accidentally. I never ever used, it in years.

When there was a huge shortage of gel, many years ago, some of us took the bottle apart, to extract the tiny bit of gel left in the vacuum packed plastic bag inside. Desperate measures!
The top of the plastic inner bag is tightly sealed except where the pump nozzle is attached and it would be pretty impossible for the gel to evaporate in my opinion. I accept others may think differently.

@JinglingSpringbells I don’t need to remove the nozzle tab from anywhere on the new bottle to use it though. That is what I am saying. It is attached in such a way that I can use my bottle perfectly fine without even touching the nozzle cap. I mean, I do remove it from where it is, after I have used it for the first time, because I want to cover my nozzle as I don’t want to risk my gel drying out. And you are completely right, it cannot be reattached after that point because it is held to the lid button by tiny plastic tabs that you have to break to unattach it in order to cover the spout. However, if I believed that it served no purpose other than to be a security tag, then I wouldn’t need to break those tabs to use my bottle at all and would just leave it attached just like it is when new and unused. It doesn’t cover or obstruct the dispensing mechanism in any way.

So, if I don’t have to touch the nozzle cap or break those tabs in any way, and can still use my bottle exactly as intended, it doesn’t make a very good tamperproof security because they are still left exactly as they were when the bottle was unused.

I have no clue how your nozzle cap is attached that you need to remove it to use it, but none of mine have been that way - even though the instructions are worded like I should have needed to, as it says the cap will be covering the spout - but it isn’t. 🤷‍♀️

As for the mechanism, doesn’t the pump prepare the next dose by sucking it up into the inside of the lid button, ready to be dispensed out when the button is next depressed? (That is what I always assumed as to why the button sometimes takes a while to return to full height sometimes, especially near the end of the bottle, and why it needs discarding once the button doesn’t come up fully as the dose will be wrong). If so, it is that next dose that I assumed the cap was to protect, because the nozzle is larger than it was on the old conical bottles, it will naturally let more air in and be at risk of drying the gel inside/clogging if not protected with a nozzle cover. And is the reason the bottle doesn’t need to be dispatched with the nozzle cover over the spout, as there is no gel inside the lid button until it has been used for the first time.

Maybe I’ve misunderstood how the mechanism works though as thankfully I haven’t had to dismantle one for myself…… Yet. 😬

I really don't know!
It's a while since I first opened the new design and I was pretty sure (but could be wrong) that I had to remove the little plastic 'cap' in order to depress the plunger and release the gel. It was certainly the case with the older bottles (years back) that you couldn't use it without taking that small cap off first.

Maybe Besins can explain?

I've used some cosmetic and body care products that have the same (I assume) pump mechanism except the outer bottle is see-through, so it's possible to see the mechanism of the inner bag contracting when the spout is pressed down.

Who knows?!

@JinglingSpringbells That is extremely helpful, thank you. I think I’ll continue with the cylinder for at least another few days to see if there really is any difference (and count the pumps) because once the other two gels have gone out of production it’ll be the only one left anyway, so I’d like to tell if there is any difference for me.

My own issue is further confused by my recent progesterone mix up, but even that - now that I’m back on the Utrogestan - doesn’t seem to be working as it used to. Which may be because the Oestrogel isn’t working and I’m attributing my increased symptoms to the progesterone. And thank you @LittleMissSunshiner for confirming it’s the progesterone that aids sleep. The first night I took it I found I was sleepier than usual.

Reading this thread hasn’t made me hopeful because I’m going to run out of the old style bottles of Oestrogel pretty soon.

@OtterInDisgrace I originally attributed my increased symptoms to the Progesterone, even though I hadn’t changed it. I have had issues with Progesterone containing products in the past, and so I was more willing to believe it was that, than thinking my Oestrogen had suddenly stopped working. Plus, despite my symptoms having increased over all, my anxiety was really spiking during my Progesterone weeks. So I started taking the Progesterone vaginally, and that did help me a little, I no longer have such a big spike during my Progesterone weeks, but if this new printed bottle doesn’t have better results I think I’m going to have to go back to the GP and ask to try something else. I really don’t want to though.

@whiteshutters are you please able to share the good batch number / expiry date? Awake since 3.30 today on the new style packaging and couldn’t drop off the night before so will be upping my dose on this batch. I have also reported to yellow card, and will be doing every one that doesn’t work. I agree the amount that comes out feels much less.

Besins new international website has videos about the gel manufacturing (and Utrogestan in Muel, Spain).

Drogenbos, Belgium

https://www.besins-healthcare.com/commitment/production-manufacturing/drogenbos

Montrouge, France

https://www.besins-healthcare.com/commitment/production-manufacturing/montrouge

Having compared two pumps side by side tonight: one from the Oestrodose flagon/inverted funnel-shaped bottle, and one from the new cylindrical Oestrogel bottle, I’m certain there is more gel from one pump of the former. It also comes out kind of ripply which makes the gel apoear thicker. The pump from the Oestrogel cylinder is smooth. I tested them with my fingers for thickness and they felt about the same.

If there’s just not as much gel from the cylindrical pump it would explain some of the returning symptoms, particularly for women on higher dosages.

As @JinglingSpringbells points out, it would be illegal/unethical for them to say the product is the same if it’s not, so is it just the amount from each pump?

@OtterInDisgrace I haven’t personally upped my dose, some of the previous posters have, and to no effect sadly.

Do you have the cylindrical bottles with the label stuck on, or the one with the details printed straight onto the bottle itself?

It’s not printed on the bottle itself but on a purposely manufactured sticky label all around the bottle. Which is different from the ‘custom’ printed labels on the oestrodose.

Just as well pharmaceutical companies are known for their ethics and sticking closely to the law at all times then...

I mean it's not like they've ever been caught doing wrong and caused an opioid crisis or had to pay huge multi million dollar fines for other wrongdoing.

i’m not denying there may be other problems. I think I’m just trying to alleviate some of my own anxieties surrounding this and it would be a whole lot better if it was simply a matter of the amount of gel being dispensed.

tbh I think I’m going to ask for a different mode of oestrogen because all of this stuff surrounding Oestrogel is too fucking stressful.

Bit gutted because I haven’t actually been on it all that long (around 6 months) and thought things were going well. Then I got prescribed an alternative progesterone and everything’s been out of whack since then.

I was happily on the old bottle and had no symptoms what so ever. I was given the new cylindrical bottle and as soon as I started using it my symptoms came back with a vengeance.

As for not enough per pump I went up to 6 pumps a day (my doctor said to try it) and still had raging symptoms. I was on 4 pumps of the older style bottle.
As for Besins saying there is nothing wrong with the newer bottles, I beg to differ. Just another pharmaceutical company refusing to believe their product is defective.

And the biggest shocker is thousands of women are suffering and i can't believe all the social media menopause advocates have not picked up on this at all.

I am sick to death of switching products and are so fed up with having to deal with debilitating symptoms. It just effects your whole home and work life is so hard trying to keep it together.

Sorry for the long post 😐

This is on the UK website for Besins.

It describes in detail the two packaging options of Oestrogel.
Date of this is Nov 23

https://www.besinshealthcare.co.uk/wp-content/uploads/2023/11/BHUK_2023_777-Product-Supply-Update-In-Stock-10-Nov-23.pdf

Have you noticed in the Drogenbos video that the gel is also packaged in 'sticks' now?

Maybe a clever way to avoid a defective pump until they can sort it out?

I've just got to the end of a bottle (a new one) and I counted how many pumps I got as I've been writing down the pumps each day. I counted 66 but I know I had 2 sort of trial pumps at the beginning that probably accounts for the difference between 64 and 66 so I'm not sure it's the pump mechanism that is at fault.

I'm just preparing to send a bottle back to besins after contacting them via my pharmacy for analysis.

I'd be interested to know if anything in the manufacturing process has changed. Obv we know the bottle - canister has. But has the whole factory changed? Has the supplier of the ingredients changed? Has something in the way the gel is processed been altered?

I imagine that when it comes to chemistry and pharmaceuticals, all sorts of factors could make a difference or cause an unaccounted for chemical reaction that alters the potency of the gel, including the fabric of the canister itself.

I've also noticed that I have 2 different type of new style bottle. One with a shiny label then other with a matte finish label. The matte one wraps fully round but the shiny one there is a slight gap.

@Chrisg79 your matte one looks like the new ones I have just got, except mine doesn’t have a label, it is printed directly onto the bottle. I think the gel is slightly thicker in those compared to the stickered new shape bottles I was getting previously.

Oh god - even the new bottles have differences! Do you think they’re purposely trying to confuse us?!

I emailed Besins about this and they’ve come back to say that they are aware of complaints and the testing for this is ongoing at the manufacturing plants and that their drug safety team will be in touch. They also said that in order to keep supply the cylindrical (new) bottles are the ones they are sending to the UK. At least they seem to be looking in to it.