Oestrogen gel application - explain like I'm 12 please!

[QuickBrown]

I have a mirena coil which I've had for 8 years as contraception and to manage PMDD. Last year I started with the oestrogen patches as HRT. The lower dose did nothing, but the higher dose was amazing, it relieved so much achiness! Then I developed a reaction to the patches, like insect bites, itchy and swollen. I tried a few different things but had to stop the patches. I was eventually prescribed the gel and told to use 2 pumps before bed.

Why before bed? How long does it take to get into the body? I shower every morning, am I losing some of the medication and would be better applying after my shower? That would be an easier time to remember too! Does anyone know how the drug gets through the skin? Could I do one pump in the morning and one in the evening to make it more level? What might be the issue with that?
Thank you

You can have a shower 2 hours after application. Not sure about splitting it, you have to take the progesterone before bed but you might not be on that.

I do one pump in the evening and one at night. Not sure why you’d only have to do it at night. My doctor told me consistency mattered more than a particular time. I was also told to spread it thinly and let it dry but not aggressively rub it in. I use the lid of my bottle so I don’t get it on my hands.

I do mine in the morning after a shower, just a faff waiting for it to dry.

I just checked the pack. It says to avoid close skin contact with your partner for an hour after, avoid skin care etc for an hour after and to apply morning or evening.
also says to apply as per GP instructions - was there a reason your said night?

I apply Sandrena gel in the morning (inner thigh), about half an hour after showering.

I find Sandrena more convenient than Oestrogel as it comes in pre-measured, single-dose foil sachets, the dose is much smaller in volume as it's thicker, and more concentrated.

I appy it to the inner thighs after a shower to give it time to dry before I get dressed. If it isnt dry in time I blast it with the hairdryer 🤣

I was told not to use a hairdryer as the body needs to absorb the gel.

@QuickBrown I don't know who told you 'before bed' but that's not right. It's nonsense (and there is nothing on the leaflet about it.)
I've used gel for over 15 years with a consultant.

You can apply it any time you like. Yes, you can split the dose morning and evening.

It won't make any difference to the amount in your body over 24 hours, but it does mean you can get spread it more thinly (1/2 a pump per arm or leg) if you prefer and it dries faster.

Just pump 1 pump into your palm then apply half to each upper arm or inner thigh.

I wonder if the dr who told you was getting mixed up with micronised progesterone? That's taken before bed as it's a sedative and can cause some slight dizziness.

Don't apply it over body lotion or fake sun tan lotions (because fake tan can stop it being absorbed so well.)

You should also avoid skin to skin contact with another person (only the area where the gel is applied) for an hour as it can transfer to their skin.

I do mine when I’m in bed. I do one pump and usually slap it on a bum cheek. I don’t use the lid, nor wash my hands afterwards.

I apply in the morning after a shower. Always have.

Interesting.
Why bum cheeks when it's not on the leaflet as an option?

You should wash your hands simply because it can transfer to another person (if they are in contact with you.)

Does it dry when you apply it in bed? How does that work if you're lying down?

I have the spray rather than gel. Same principle though. I apply in morning. It doesn't matter what time of day as long as you are consistent. No shower or getting it wet for two hours, no suncream moisturiser etc on top of it for 2 hours ( or just beforehand). No need for separate progesterone if you have a hormonal coil as that provides the dose.

I do mine in the morning after my shower and it dries whilst I blow dry and straighten my hair. Seems to be working well and I never forget it as it’s part of my routine now

My consultant told me to do it at night too. I was seeing consultant for post menopausal bleeding. I think it was because I take progesterone tablets and I take them at night and it's better to take both at same time.

I tried the lid approach but didn't get on with it.

You are meant to apply to clean dry skin and not directly after a hot shower or bath. Something to do with skin temp.

Consistency is important. There may be a reason your doc said nighttime so stick to that.

I don’t know, bum cheek is convenient and I’m not sure I’ve ever read the leaflet. 😬 I do only one pump so it dries quickly. Sometimes I put in on my thigh. I avoid the arm area in general as a gynaecologist friend told me to due to proximity to boobs. My husband does maintain my slatternly approach is the reason for his moobs, but I think that’s just an excuse for not losing 1/2 a stone.

Re bum cheeks probably not recommended as skin is thicker there so harder to absorb. I was told inner thighs where skin is thinnest or inner arms.

Arms are fine as long as it's outer upper arms not the inside near your boobs.
It's if it actually gets onto your boobs that would be an issue.
Once it's in your blood stream it reaches all areas anyway.

I started getting really stressed about it when I did my outer arms, in case my hair brushed it and transferred to my boobs.
i have ocd so have found inner thighs less stress inducing.

The 'use both at the same time of day/night' is a new thing and it's not scientifically relevant as far as I know.

Progesterone isn't any less effective if it's taken at a different time to applying estrogen gel. If that was the case, women using patches would have a problem as the patch gives a constant level over 24 hours.

The relevant part is to use gel or progesterone at a regular time.
The leaflet covers all of this. It mentions 'late application' being 12 hours or more after you'd normally apply it.
So if you apply at 9am, a 'late' application would be more than 36 hours later ( 24 hours +12 or more.)

I apply mine on my inner thighs in the morning after my shower.

I was told arms or hips for application in the morning. If I put it on and then brush my teeth it usually dry.

The consultant thought it might be relevant to my post menopausal bleeding. He expressed surprise at me doing oestrogen in morning and progesterone at night. And since I moved to nighttime alignment I have not had a bleed. I guess a gynaecology consultant is influenced by anecdotes they observe?

I always apply gel on thighs and not arms. My reasoning is that if I apply to arms, it is too close to my breasts which is a higher risk. I was worried about accidentally brushing some gel on my breasts.

The gel is applied by hand and I put the dose on one leg one night, and then the next night on the other leg! I'm just wary about reacting to the gel if I applied it to the same area every day as I have sensitive skin.

It takes probably less than a minute to absorb and then I wash my hands afterwards.

That probably explains why my moods are so sporadic

So apply to lower body. I applied at bedtime but even then still had night sweats hence switched to patches. You can do one morning and one evening

re: bum cheeks. If you have lower bodyfat and apply to legs it can get absorbed and processes too quickly. Applying to an area with fat can help to slow this down.