Side effects from changing from patches to gel

[Annoyingsquirrels]

I have been taking evorel 50mg plus utrogestan for 3 years. I was ok on it but getting irritation from the patches so asked to switch to the gel.

I took off my 1st patch yesterday and tried 1 pump at bedtime (was planning to split my 2 doses am and pm) but feel really dizzy and spaced out today.

I am wondering if I should just try 1 pump for now to get used to the gel or if it would be better to do the 2nd pump this morning to match my previous 50mg dose? Any ideas?

Morning, have you read the information sheet supplied with the gel? Try that first and see what guidance it gives. Then check with a pharmacist at your local chemist and if neither helps contact your doctor on Monday. Good luck

Many thanks however there is no detailed guidance in the leaflet. I could try a pharmacist but was wondering if others had a similar experience and if anything helped.

I doubt a pharmacist (good as some are) can help unless they're trained in menopause.

@Annoyingsquirrels 1 pump of gel is the same as a 25mgs patch so it's half of what you were using.

Was it time to change your patch yesterday? Would it have run out?

If not, you've added more estrogen to your system because of what was already there from the patch. That's the likely reason for side effects.

Patches are slow release, which is why you change them 2 x week, rather than daily. You'd still have a lot of estrogen from it in your body.

So it would be like using a 75mcg patch.

Maybe don't use any gel for a few days because otherwise you're doubling up.
And when you do, use 1 pump only for a week or so, before you move up to 2.

My personal experience has been that I absorb the oestrogen from the gel much more efficiently than the patches. I had worked up to 100 patch and was really struggling with breakthrough symptoms as they just didn’t seem to be working any more. Before referring me to the specialist (with a long waiting list!) my GP suggested switching to the gel to see if it made a difference. I started on two pumps a day, and very quickly felt an improvement. One isn’t enough and three I started to feel was too much.

Thanks both. @JinglingSpringbells I don't think I was doubling up, my patch was due to be changed the day before and I left it in a day longer. I am also not sure that my 1st pump was a full one.

@queenrollo it is interesting you absorbed more from the gel. I am wondering if I am the same. I am thinking I will just continue with 1 pump at night for now and see how I feel. Do you do you do 2 pumps at the same time each day? I was not sure how long they stay in the system and if splitting them would make a more consistant dose.

When I moved to gel I went to just one pump even though 2 was the same as my patches. I defo absorb gel better. It's actually been great as I needed to rebalanced my estrogen and progesterone levels (based on a series of private tests) so I have stayed on one pump. When I did 2 pumps I felt queezy and weird like you.

The advice is if you're using a high dose (like 4 pumps) split the application timings.

2 pumps you don't need to do this unless you choose to for a reason.
I do because when I started HRT, many years ago, 2 pumps at once made me feel sick.

The info on the leaflet mentions what to do if you miss a dose, which is counted as 24 hours. So the level won't fall for at least that time.

I have a friend who did this the other way round - patches to gel- and she is absorbing very little from gel.

Everyone's skin is different.

I have been on the gel 6 days now and still feel buzzy and weird. I just can't work out the dosing and whether I need more or less.

Yesterday I did 1 pump at 9pm before bed and was going to wait to the same time today. Started feeling a bit woozy at 1pm today so I decided it wasn't enough so did a dose at 2pm but still feel weird now.

Any idea if this means I need 1 pump or 2? I am really not sure what I am doing at the moment.

Everyday this week I feel a bit funny in the afternoon. Would this be the oestrogen wearing off as one dose is insufficient or maybe I just need to stick to one consistent dose? Any idea?

I started on Oestrogel and went to evorel patches when they messed with the gel formula, even though they swear they didn’t! changed the bottles
I get slightly wired if I have too much oestrogen, as I found out when I went from evorel patches to estradot patches.

BTW, I have had to go back to Evorel patches temporarily as there are supply issues with Estradot, and am getting an allergic reaction to them that I didn't get before. Maybe you could try Estradots?

My GP will not prescribe estradot for some reason (probably more expensive). Did you find you needed a higher dose of evorel than oestrogel?

I was on 100mcg of oestrogel (4 pumps) and went onto the 100mcg patches when I started getting peri symptoms again. The GP wouldn't prescribe an increased dose as it has only been licensed for doses up to 100mcg. I changed to Evorel patches as I got tired of the faff with applying gel - on both arms, both thighs, stand nearly naked in the freezing morning while it dries.

As far as I can remember, I had to cut the patches down for a while and work back up to 100mcg. I could tell when it wasn't enough when night sweats returned. I then changed to Estradot as the Evorels kept coming off when I got sweaty during exercise, and again had to cut the patches down and work back up to 100mcg. The Estradots are so much smaller than the Evorels and stay stuck on.

Estradots aren't available at the moment due to supply issues but are supposed to be back on the 4th April (hooray!) TBh, I was probably using twice as many evorels as you are supposed to because they kept coming off.