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

I apply in the morning to inner thighs after I have showered, I just find it easier to remember and also fits in well with getting ready in the morning routine.
I did read somewhere recently that evening is best if you have night sweats etc and morning if issue is brain fog...not sure how true that is.

Wow thank you all for the responses.
It was my GP who said before bed, for no reason I'm aware of.
I'm not on progesterone per se, due to the coil having that covered!

I will better be able to remember to apply it in the morning so going to start doing that as it seems there is no reason why not.

I dont think its that strong that if you touch someone else it will have any affect

I had less night sweats applying at bedtime but try and see.

The coil is only used for 5 years for HRT, 8 years for contraceptive. I've just had my changed and can now stop the progesterone tablets.

@Cheese55 The leaflet in the packaging says wash hands.
It can transfer for up to an hour after application.
That's also why the information says avoid skin-to-skin contact of that area with another person for an hour after application.
For example, if you apply to inner thighs, don't get intimate where your inner thighs are touching someone else's bare skin (same for upper arms .)

pmc.ncbi.nlm.nih.gov/articles/PMC12185294/

The study concludes that physical contact following application of estradiol gel can lead to skin contamination. Therefore, it is recommended that patients avoid skin exposure for at least 60 min after applying estradiol gel and refrain from physical contact with others, especially infants, children, individuals with breast cancer or other sex hormone-dependent tumors, and pets to minimize the risk of estradiol transfer.

I normally put it on my thighs but if I running late or camping I some times put on my calves ( just roll up a trouser leg) much easier when hanging around half naked it's an option. My GP friend says apart from the warning about not on your breasts it really doesn't matter.

I do this but in the evening. I stand there with my legs drying while brushing my teeth. I was told to take progesterone just before bed and to take oestrogen at the same time. Can’t remember if that was the leaflet or the directions on the label from the pharmacy.

can anyone explain the applying with the lid? I don’t understand how you’d do it. I’m on the turquoise pump pack of Oestrogel and the lid is like a whole cup?

As this thread is active can I ask another question? Sorry @QuickBrown hope you’ve had your question answered.

does anyone know if drinking alcohol in the evening affects absorption of the oestrogen gel? I’ve noticed after some evenings where I’ve had (too much) wine, then applied oestrogen gel at bedtime, I’ve been feeling quite low in mood in the morning. It’s not a hangover! It’s an overall increased feeling of dread and anxiety and low mood, that’s similar to how I first felt before I increased from one pump to two.

ive tried looking it up online and nothing very clear. Results are more about how alcohol affects sleep and mood.

I was specifically told not to put it on at night since there's a chance it could transfer during any sexual activity.

Although if youre perimenopausal there's probably little chance of that anyway..

Morning here.
Out the shower, dry, face cream, pants and bra on.
Gel on outer upper arms next.
Deoderant
Then trousers, socks
Take tablets/vitamins
Clean teeth
By the time I've done all this, arms are dry for me to put my top on.

Or post menopausal...!

Well yes . In fact let's face it at the point at which you need HRT transfer to a spouse is not really an issue..

Not likely. More that your body can't handle alcohol as you get older and are menopausal.

Possibly. It’s the change in mood though - I don’t always get that after drinking alcohol so trying to work it out. It’s a dramatic change if that makes sense, not explained (to me) by having had some wine 🤷‍♀️

by ‘can’t handle’ what do you mean? I’ve got friends who no longer drink as they’ve said they no longer enjoy it or get headaches while drinking etc but that isn’t happening for me

I have three pumps, I do one on my outer arm, then one on each inner thigh. I apply it after I come out of the shower, and by the time I have brushed my teeth and put on my moisturiser it's been absorbed and I am ready to go. I take my progesterone capsule just before I brush my teeth before bed, it makes some people sleepy.

I've just seen that some people have been advised not to apply after a hot shower or bath, but I always have a cold blast at the end of my shower.

Not experienced that but maybe try and experiment - drink the alcohol a few hours before you normally do and a few hours before your gel and see if there is any effect. If there is no discernable mood issues then I would think your suspicion is correct. Only problem is you will have to drink early.

Not experienced that but maybe try and experiment - drink the alcohol a few hours before you normally do and a few hours before your gel and see if there is any effect. If there is no discernable mood issues then I would think your suspicion is correct. Only problem is you will have to drink early.

You don't put it into the 'cup'. Pump onto the flat top of the lid and use that to spread it.

I apply two pumps to my thighs in the morning after my shower using my hands, then wipe the excess off on my bum or my outer upper arms.

I apply it to my outer arms after my shower in the morning and by the time I've brushed my teeth it's dry. I take my Ustrogen tablet at night before bed.

This is an interesting thread. I've just switched from Kliofem tablets to Oestrogel pump and a Progesterone tablet and I'm not sure I'm thrilled (or doing it right).

I was asked if I wanted to start with 2, 3 or 4 pumps of gel and said that I wanted whatever the dose was that I'd been on with Kliofem. I was told vaguely 'it doesn't work like that' so I said I'd start with 2.

I rub one pump on each inner thigh before bedtime and then hang around cleaning teeth and washing hands, face etc to let it dry. Then take a progesterone tablet that's like a flaming aniseed ball.

I am currently very hot, particularly at night, but I can't work out if this if because a) it is hot b) I am very fat or c) the hot night sweats are back.

I'm not sure about going up to 3 pumps - I seem to have run out of thigh (despite being enormous) after two pumps, although I guess I could do an arm. I've tried to speak to the nurse practitioner and left messages but no one has come back to me.

Been on this for about 7 weeks now. Any suggestions welcomed. @JinglingSpringbells has been really helpful to me in the past.

You could try splitting the dose, 2 pumps and night and 1 in the morning, if you wanted to stick with legs only.

Kliofem https://www.menopausematters.co.uk/postmeno.php

This says 2mgs of estrogen.
The most common dose for HRT (low to medium dose) is 1mgs but sometimes tablet form is higher because a lot of lost in digestion.

Estrogel does 'equate' but not exactly.
Each pump is 0.75mgs estrogen so 2 pumps is 1.5mgs.

That's almost the same as Kliofem and because it's trandermal (better absorbed usually) you're going to get roughly the same dose as a 2mg tablet.

The guidance is to give each new dose or type 3 months (unless it's Hell in which case change a bit sooner.)

You could try 3 pumps and split it am/pm so 2 in the morning and 1 at night. This is actually guidance on the BMS website for HRT.

However, it can also be the progesterone raising your body temp, so I'd hold off doing anything for a few weeks and see if it improves.

It is known that being overweight can make symptoms worse, so again, that's something to think about.

Thank you @ProfessorBinturong and @JinglingSpringbells

I'll give it another month or two. I'm not struggling really, just finding that I'm a lot hotter than I was and it's mildly annoying but liveable with.

Again, not sure if it's the change in meds or just the weather!