How much oestrogen?

[DustyLee123]

So the Panorama programme said women should be on 100 mcg a day, yet there’s 75 mcg in a pump of oestrogen, so two pumps is 150 mcg.
Or am I reading it wrong?

Anyone?

I would like to know too

My patches are 50. They work for me. They used to be 25, and they worked for about 6 years. Surely one size does not fit all?

No, it said the maximum licenced dose is 100 mcg, not that woman should be on that. 25/ 50/75 is absolutely fine

Patches are in micrograms.
That's lower than gel which is measured in grams.

1 pump of gel (it's on the side of the cardboard carton) is 0.75gms.
2 pumps is 1.5 gms

https://www.medicines.org.uk/emc/product/353/smpc#about-medicine

One gram of gel contains 0.6 mg of the active ingredient, Estradiol (0.06% w/w).

Each pump actuation delivers 1.25 g of gel which contains 0.75 mg of Estradiol.

A 50mcg patch is roughly the same as 2 pumps of gel.
75 patch- 3 pumps
100 patch- 4 pumps

You can find this online if you search HRT and equivalent doses.

I’m getting confused. It said 100mcg is the licenced maximum, so how many mcg in one pump of Oestrogel?

One pump of oestrogel is equivalent to a 25mcg patch, so 2 pumps are the same as a 50mcg patch, 3 pumps = 75mcg patch and 4pumps = 100mcg patch

You can't compare patches and gel.

The measures are different. One is micrograms the other is milligrams.

Patches last over several days and are totally different.

The dose for gel is 2 pumps rising up to 4.
2 pumps is the same as a 50mcg patch.

Each pump actuation delivers 1.25 g of gel which contains 0.75 mg of Estradiol.

The Panorama programme didn't say women had to be on 100mcgs.
They said no women should be using more than a 100mcg patch unless it was off-label for special reasons.

I’m not comparing patches and gel, I never asked about patches!
And I didnt hear the programme didn’t mention patches in relation to the 100mcg, I thought it was talking about all methods.

But the programme as referring to patches when they talked about doses. That's where the 100mcgs was discussed.

If you are using gel, the licensed dose is anything from 1 to 4 pumps a day.
2 pumps is 1.5mgs. This is the same as a 50mcg patch.

So unless you're using more than 4 pumps a day, don't worry.
You won't be getting too much.

Maybe we need to roll this back! What was it that was concerning you DustyLee123?

Is it whether you ought to be on a higher leben of oestrogen?

As an aside to this, the 75mg dose patches that I use aren't actually 75 overall. Reading the leaflet that comes with them, the patches contain 225mg in total, supposedly delivering 75mg a day - that's three day's dosage, not three and a half as it is supposed to be.

Thanks for explaining....

I'm on 2 pumps of oestrogel and suddenly thought this was too much after watching the panorama show..

So 2 pumps is equivalent to 50 then?

I didn’t want to be taking more than the 100mcg equivalent in gel.

My pump states 75mcg per pump of gel

I had brief confusion about dosage after Panorama until googled. I am on Femoston 1/10 which for oral hrt considered low dose. Realise cannot compare dosage from different types of hrt as are taken by the body differently.

@DustyLee123 Look back to the post I wrote last night where I quoted the info (copy and pasted) from the info online about gel.

One gram of gel contains 0.6 mg of the active ingredient, Estradiol (0.06% w/w).
Each pump actuation delivers 1.25 g of gel which contains 0.75 mg of Estradiol.

0.75mgs is the same as 750mcgs.

You can't compare it with a patch which releases the estrogen slowly and continuously over days.

If you're worried you're on too much then every woman using gel would be too!

I also had a panic after the Panorama programme and looked at my Oestrogel label which appeared to suggest I was on a 300 dose by using 4 pumps. Phew.

I think that programme could cause some worry for people who are on a normal dose. It really wasn’t at all clear.

The problem is that without tests being done how does anyone know what your oestrogen levels are at in order to prescribe the correct amount of oestrogen hrt to bring you back up to what you 'should' be.

And even that 'should be' level isn't fully worked out.

I always think about when we don't feel well and go for blood tests which show say iron levels are down. We get given a prescription for iron tablets. Based on the evidence of the blood tests.

So why don't we get a test for our hormones? It's very important. Yet it's ignored. Bizarre.

And to those who say blood oestrogen tests are unreliable unless repeated at various times of day etc, there is the option of saliva tests.

I think that in this case there is confusion on Panorama about Dose ie how much is delivered in each pump is not the same as the dosage which us how much a person should take.
Each paracetamol tablet as an example contains 500mg but you take 2 of them.

@DeliciousApples the unreliability of blood tests is the one thing that doctors actually agree on. Levels in the blood can fluctuate hourly so that's why they don't recommend blood tests for women 40+. And they'd only be reliable in women post menopause. There's lots of information online about this: www.mymenopausecentre.com/gp-resources/oestrogens-and-blood-testing/

I think the panorama programme was most unhelpful and has caused even more confusion and panic. Disappointed at Kirsty Wark for fronting it. She did a fantastic programme many years ago debunking myths around HRT. The fact that 45,000 women have sought help from a private clinic because the NHS is not supporting them is the bigger story here.

Well said. Women are peddled birth control, no problem. When it comes to managing sometimes debilitating physical and mental symptoms at the other end of our reproductive ‘usefulness’ — forget it.

If men’s dicks shrivelled in the same way women suffer Genitourinary Syndrome of Menopause they’d ensure HRT was available like candy.

@BedBathAndBeyonce yes they do say blood tests are unreliable. Which is why I mentioned saliva tests in my final paragraph. These are widely used/bought outside the U.K. apparently but we don't use them here.

Another thing that they don't even attempt to deal with in the nhs, preferring to throw patches and gels at us indiscriminately like sweeties.

@DeliciousApples there’s certainly a trial and error element in finding the right dosage; everyone’s physiology is unique. We are happy to take ownership of things like finding the right diet to work for us personally – I suppose HRT can be a little like that, particularly as hormonal tests aren’t very useful for women in their 40s and up .

What we need is more information, less preaching, scaremongering and gatekeeping, and HCPs who are willing to work with women to find the right formulations, dosages and combinations for them personally. If, indeed, HRT is what the woman herself chooses.

But again, women of a certain age aren’t deemed particularly useful – so why bother?

Panorama obviously didn't give Louise Newson a right of reply at the time. Here she is today trying to explain dosage and individualised care: www.instagram.com/reel/DAxls8sOo9H/?igsh=MzB1Z2Vianpna3M2

@BedBathAndBeyonce I agree, GPs were very keen to let us take the contraceptive pill for decades but in my experience they baulk at the idea of HRT. I had to do my own research and debate to get it - they kept suggesting anti-depressants even though all my symptoms: extremely heavy periods, debilitating headaches, lack of sleep, forgetting words, tinnitus, all pointed to perimenopause. And these are female GPs (all in their mid 30s, will be interesting to chart their attitudes as they experience it themselves).