Oestrogel - 1 pump or 2?

[countrytweed]

I'm 43 with many (mainly mood-related) peri symptoms and I've just been prescribed Oestrogel + Utrogestan. Female GP not v clued up on dosage ("2 pumps sounds fine" )... my question is, should I start for a few weeks on 1 pump daily or go in with 2 from the start? What are your experiences, please?

Start with one. Are you taking the utrogestan cyclically?

I've just started the same regime with a doctor who didn't tell me how to use everything. Reading the instruction manual it does say 2 or 4 doses. So I've been taking 2 pumps each day, one pump on the underside of each arm. And then 2 tablets for half my cycle. So I work out the dates of my cycle and then set a phone alarm for when to start the progesterone and when to stop. You could also take 1 tablet per day for your whole cycle by the looks of it.

No idea if this is right!

@Apileofballyhoo I'm going to take the tablets from the 15th of every month for 12 days (GP was more confident on Utrogestan dosage...)

Start with one pump and see how it goes and build up gradually if the symptoms don’t subside. I’ve been on 4 for a while but my level is a bit high so going to drop down to 3. I hope it helps!

How can you tell if the dose is too high? What should we look out for?

I only know because I had a blood test done as asked to be referred to a menopause clinic for testosterone. My estrogen level was over 500 and the dr at the clinic said around 300 was optimal in a woman my age (48). But she also said if symptoms return to up it again. I think it’s all a balancing act. About to throw testosterone into the mix….

I've had different opinions on this. I started on 25mcg ( 1 pump) and didn't increase and crashed and burned after 3 months as was out of balance with the progesterone. My friends had started on 2 pumps ( 50mcg) which they said was typical starting dose.
I ended up speaking to a menopause specialist who suggested oestrogen starts on 25mcg ( 1 pump) then increase to 2 pumps after 2 to 3 weeks. She then suggested for me that I'd need to increase to 75mcg ( 3 pumps) then 4 pumps if still not stabilised.
If I was doing it from scratch with what I know now I'd start on 25mcg for 3 weeks, then increase to 50mcg and monitor

Should be on your outer arms.

I started on 25 patch which is the equivalent of one pump, and also crashed on the progesterone weeks, so much so that after the second fortnight of it I went back to the GP, who upped me to a 50 patch. I'd still start on one pump though because it's easier to increase if needed than to think hrt is some kind of terrible disaster because 2 pumps was too much.

apileofballyhoo could you clarify why outer arms? I was never told this and have been merrily slapping it on my thighs 🤪

Oh no why!! Rats!! I've been doing inner arm for weeks. So complicated.

Yes I started on 25mcg patch also. The pharmacist via my GP did not know why I had crashed and burned and was querying a progesterone sensitivity. She suggested increasing oestrogen also but wasn't sure. I switched to the gel as felt this would give more control - however I don't think the gel absorbs very well with me, and the specialist suggested moving to patches ( 50mcg) which was better for me as it gives a slower , continuous dose.
How did you feel on the 50mcg patch increase? Did it sort you out?

I guessed it was low oestrogen rather than the progesterone itself as I still felt rubbish for the first week after taking it, when oestrogen is quite low, and I didn't feel too bad for the first week of taking it when oestrogen is still a bit higher. Felt fine actually the first couple of days when ovulating. It wasn't until I got a couple of months in on 100 patch that all my symptoms went away (stuff I just assumed was ageing really) though I'd had steady improvement and some had disappeared with the first 25 patch (night sweats). Anyway GP asked a few questions and then just increased it.

Inner thighs are grand. Inner arms are too close to the breast I think.

@meemeemammy I forgot to say I think patches suit me better too, I feel like gel is in and out too quickly. Like a sugar rush and crash nearly.

I put mine on the front of my thighs.

You can do thighs or upper arms, but not inner arms. I think adsorption us better on inner thighs and other parts of the thigh.

This is reassuring thank you.
I've just increased to 75mcg and am so dizzy- waiting for it to settle down. I'm thinking I'll need 100 too.

Yes, I'm unsure about the gel as I don't seem to get much relief with it. I was on 50mcg patches and then topped up with X1 pump of gel while waiting my 75mcg for a week but didn't feel any different really. Now I've switched to the 75mcg patch it feels really strong and I'm dizzy and nauseous 2 days after increasing so it feels more powerful to me. I'm just waiting for the start up effects to settle down. Any idea how long I'll be nauseated and dizzy for?

Pretty sure the patient leaflet in the box says how to apply it. I know it's like a novel, but the info is there.
It says upper outer arms and inner thighs.

The reason for outer arms is so that none is accidently transferred to your breasts. It needs an hour to be absorbed (even when it's dried) so your need to be sure none gets on your breasts or anyone else's skin.

*JinglingSpringbells *i see a private meno consultant who was the one who advised thighs. as she has such a great reputation and seems to know her stuff i too her word and didn't read all the small print in the leaflet - my bad.

Thighs are fine, I think it just absorbs better on the inner thighs rather than the front. Anyway I just went by the leaflet.

Would you consider cutting the patch in half (diagonally) and see how you are with that much?

I've always gotten the start up effects since the first 25 patch. I'm hoping it'll settle. If it doesn't settle after a few days I'll consider trying this, but I'm hoping it'll settle and I'm likely going to need it when I'm back on the progesterone

Thanks all for the info... I'm going to see how I go with one pump for a few weeks, then up it to two after that (possibly doing one pump in morning and one in evening) 👍🏼