Advice re HRT…too high a dose?

[TinySpark]

Looking for some advice re Oestrogel/Utrogestan. My sister has been moved to this from Evorel conti 50mg but her GP has prescribed 6 pumps of Oestrogel (3 pumps twice daily) and 2 Utrogestan tabs per night. Looking online it seems that 2 pumps would be equivalent to her 50mg patch so I’m a bit concerned she has been advised to take too much?

GP was going to prescribe 100mg patch to manage her symptoms a little better but surely equivalent Oestrogel would be 4 pumps? Also, isn’t it 1 Utrogestan tablet per night once for post menopausal women?
Any advice would be appreciated, thanks.

2 utrogestan tablets is recommended with higher doses of gel now.

Hi @MassiveOvaryaction thanks for your reply. So is this considered safe? I’ve really only read 4 pumps max so was a bit concerned. Also thinking she should be gradually increased as jumping straight to 6 pumps means she would be on 3 times the dose her patch currently provides.

I'm on three utogetran tablets and a one sandrinw gel pack

As I adjusted my dose I was prescribed up to 6 pumps. I found 3 optimum but it was good to be able to trial doses until I felt well

Four pumps is the typical high-end dose, but some women are prescribed more. Lots of women have absorption problems, so will need a higher dose.

Oh god I'm so sorry I didn't mean to send that first bit. But people have been saying helpful I hope that the OP won't mind me jumping on too.
I'm on three tablets (prescribed by the consultant) to stop intermittent bleeding for 21 days which seems to be good but only one sachet of sandrina gel each day and that doesn't feel anywhere enough. Bladder weakness and not sleeping at all well. Does anyone know if I can just increase the sandrina? I'm waiting for biopsy results so following up in a week or so but in the meantime ....?

I’m on the same dose. I need it. Not all GPs will prescribe over 4 pumps but mine do.

I'm on the same dose of both.

This webinar explains a bit about the huge differences in absorption between women.

That’s a big jump up from a 50mg patch to 6 pumps, which is broadly equivalent to 150mcg.

She may not need that much and may get side effects such as sore boobs and headaches. I’d have suggested going from a 50 patch to say 3 pumps, then up from there as needed.

2 utrogestan nightly would be suggested for more than 100mcgs/4 pumps daily.

Thanks everyone, this is all really helpful.

Thanks also @SwishMyCape I’ll take a look at this and forward to my sister. You can’t have enough info!

I would imagine it is safe if the British Menopause Society recommends it (no personal experience as I have a Mirena coil for the progesterone part of my HRT). 6 pumps does sound a lot to me (I'm on 4 and that's the max my GP said he was allowed to prescribe).

Yeah this is what I thought but it seems some GP’s are happy to prescribe it. She has been advised to take 2 Utrogestan tablets to offset the higher dose.

I take 2 tablets and 4 pumps and it seems fine

Hope your sister feels better soon