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[Butterfly22]

Hi ladies, been through themill with hrt, just need a couple of questions about my new hrt.
I started the Estradiol gel last week (was on sandra gel last year) and this seems very different, dries quicker and put on different.

The sandrena gel was rubbed on my thigh on a size about same as my hand and took ages to dry, this new gel is on your inner thigh, arm or shoulder and seems you can spread it out a bit more? is this corect?

Second thing i wanted to know is there only two progesterone tablets? i was on utrogestan last year but thought it made me tired so now on provera, are these the only two?
Last thing i want to no is i cant stop crying, i just feel so low and down, i have chopped and changed hrt so much last few months, may this be why?

sorry for all the questions, i was seeing someone at the gyno clinic for last 12 years as started menapause age 25 but just moved and no clinics ect so just see doctor x x

[meno lesley]

Hi

Do feel for you, is horrible when you cannot stop crying, I sometimes wondered where all the tears were coming from, a secret supply of water?

I have floundered around on different hrts but have been using estradiol gel and utrogestan for a few months now. I put the gel on each shoulder and it does take about 5 mins to dry. I take the utrogestan before bed, some ladies take it vaginally, but haven't plucked up courage to try it so far, it helps alleviate some of the side symptoms of progesterone.

Most hrt they say to try for at least 3 months in order to let the side effects settle down. I know this is hard and have thrown in the towel on several occasions before the 3 months.

I do think gel and utrogestan has worked the best for me. I am not symptom free but am in a much better place than I was.

I hope this helps you in some way. Things will get better, just try to take one day at a time.

Lesley

[Butterfly22]

Thanks so much for the reply, yes i really must give this a good go, im wondering if i should of taking the utrogen again as did make me sleep ok, maybe the other gel made me tired!
What is the size of skin you cover when rubbing in? id say mine is just over the size of my hand?
Glad its working for you, gives me hope  :)xx

[Gig]

Hi

I've been using Oestrogel for 4 years.

I divide the dose so apply one pump measure in the morning and the second just before bed.
This also makes it less messy to apply- as it's over a smaller area.  This is fine to do and some drs think it's actually better.

I apply it to my upper arms, mainly on the outside edge from shoulder to elbow.  I do this after my morning shower and same in the evening.  While it dries I clean my teeth and put on /take off my make up in the bathroom.

I take norethisterone as a progesterone and find it okay.  I struggle with progestins anyway because I have ahealth condition called PBS- painful bladder syndrome- and any progestins make this worse, but I find with noreths. i can take at least 4 -5 dyas before I notice the side effects.

I got on very well with the gel- it's the only HRT I've tried and it worked well within days.

You do need to give any HRT 3 months before you give up unless the side effects are unbearable.

Good luck!

xx

[Hurdity]

Hi lila

Sorry to hear you are still feeling rough.

I think I have spoken to you before on your other thread a couple of weeks ago?

I have never used gel but I have read about it. The instructions do say that the size of area you spread it on is important:

For Oestrogel it is 400 – 750 square cm (2- 4 measures of gel). This area is critical for mximum absorption according to the Sandrena leaflet – and I presume is the same for oestrogel. This is what the Sandrena leaflet says:
“Application of Sandrena on area of 200-400 cm2 (size of one to two hands) does not affect the amount of estradiol absorbed. However, if Sandrena is applied to larger area absorption decreases significantly. To some extent, however, the estradiol is stored in the subcutaneous tissue from where it is released gradually into circulation.”

Is there a template that comes with it to give you an idea of the size? Otherwise then I presume it is the size of 2-4 hands going on the above.

I also understand it should not be rubbed in but just spread out and will absorb into the body before it dries.

Yes there are only two types of progesterone tablet licensed for general use although as mentioned some gynaes prescribe norethisterone but I seem to remember you have tried this in pills and didn;t get on with it. There used to be the one in Femoston - dydrogesterone - fairly similar to our own progesterone - can't remember if you've tried that but you can't get it on its own now - only in Femoston tablets.

How many pumps of gel are you using per day and are you taking the Provera continuously? As Lesley says you won't be able to tell immediately what is causing you to be tearful and unhappy until your body has got used to the gel and the Provera. I can't remember if you have just changed from tablets - and if so it will definitely take your body a while to adjust.

Finally have you been advised to continue with taking progesterone continuously? If you are somewhat intolerant it will be difficult and it might be a matter of choosing the least worst.

Have you been tested for testosterone too? With your circumstances you should ask to be referred to a meno clinic if you can - you can find the nearest one to you on the main website here:
http://www.menopausematters.co.uk/clinicfinder.php

Hope this helps and do hope you begin to feel better soon.

Hurdity x

[Gig]

Hurdity- in the pack of Oestrogel there is a leaflet and it shows you which areas to apply to- a diagram of the body. The shaded areas show upper arms, front of upper thighs, and it says avoid anywhere near genitals and breasts.

  There is no text about the area to be covered in terms of cms2 etc etc.

Similarly there is nothing about absorption being affected.  What it does advise is to avoid skin to skin contact with another person for 1 hour after applicaiton to prevent transfer, and to avoid bathing etc for 1 hr after application.

[Hurdity]

Hi Gig

Thanks
However this is what I found in the SPC on the web:

How to apply Oestrogel:

Each measure from the dispenser is 1.25g of Oestrogel.

The correct dose of gel should be dispensed and applied to clean, dry, intact areas of skin e.g. on the arms and shoulders, or inner thighs. The area of application should be at least 750cm2, twice the area of the template provided. One measure from the dispenser, or half the prescribed dose, should be applied to each arm/shoulder (or thigh). Oestrogel should NOT be applied on or near the breasts or on the vulval region.

The absoprtion of gel for Sandrena and Oestrogel appears quite complex and depends to some extent on whether application of gel is to the same or different areas, and to the area of skin applied.

Anyone who has trouble getting relief from symptoms from gel should seek expert advice as to whether it is being applied correctly.

This is from a paper in Climacteric:
The application of a hydro-alco-holic gel containing estradiol results in a rapid penetration of the estrogens into the stratum corneum; this stops after drying of the gel on the skin. As the absorption is proportional to the surface of application, deviations from the instructions may cause variations in the estrogen level and clinical efficacy. About 10% of the dose is absorbed by the skin during the 2 min until drying. The estradiol is stored in the stratum corneum and permeates through the epidermis into the dermal capillaries according to the concentration gradient between the stratum corneum and blood. This diffusion lasts for 2–14 h. The two available gel preparations differ in their concentration and mode of application

This is the reference although it is very technical:
http://www.cenegenicsfoundation.org/library/library_files/Pharmacology_of_estrogens_and_progestogens___influence_of_different_routes_of_administration.pdf

As lila is young I imagine she is trying to achieve a higher serum oestradiol level than those who are late 50's post meno so this information does become important, in my opinion.

lila - hope this is helpful?

Hurdity x

[Gig]

If you think about the area they suggest -750cms2- that is a HUGE area- it's 12 inches by 10 inches. My upper arms aren't that big!!!

This is partly why I use only 1 pump ( although 2 made me feel sick) because to cover 750cms2 would involve applying to legs AND arms!

[Cassie]

Been using it for years, use 2 pumps at the mo, sometimes one and a half, always use it on my legs, inside of thighs, outside of calves, on my cellulite lol, actually anywhere and I find that 2 pumps will cover one section of my leg, such as the thigh totally fine, I wouldnt stress too much, it gets absorbed no matter how you use it, just keep away from your breast area.

Its great stuff, I couldnt live without it x

Oh and meant to say am using the Utrogestan 200mg vaginally it also seems to work really well, I only use it for 8 days pm

[Butterfly22]

Thanks for replys ladies, Yes Hurdity you helped me other week too, i just seem to be in a pickle at the moment.
Just been to doctors and got the ustrogen to try again with this new gel and i do feel it will work this time, I asked about the rubbing in as completly different to the sandrena gel, ill do it as picture shows on the arm as much better as other gel had to be on your hip in a very small patch.
Thanks so much for your help both of you and fingers crossed x x x

[Butterfly22]

Been using it for years, use 2 pumps at the mo, sometimes one and a half, always use it on my legs, inside of thighs, outside of calves, on my cellulite lol, actually anywhere and I find that 2 pumps will cover one section of my leg, such as the thigh totally fine, I wouldnt stress too much, it gets absorbed no matter how you use it, just keep away from your breast area.

Its great stuff, I couldnt live without it x

Oh and meant to say am using the Utrogestan 200mg vaginally it also seems to work really well, I only use it for 8 days pm

hi thanks for reply,
Im on the 100mg utrogesten for ten days! how come you take for 8? Is it the tablet ? x x

[Butterfly22]

Good luck with trying the new regime. Its a long period of trial and error for so many of us until we get it right!

I personally have tried both estrogel and sandrena and prefer the former. The sandrena didn't suit me - it sounds mad but I actually had an increase in hot flushes when using it.

With Utrogestan the usual course seems to be 10 - 12 days but some GPs do appear to prescribe for a shorter period if someone has particular problems with progesterone. I found it very very difficult to tolerate orally (dizziness, sleepiness, spots and general feeling of wanting to scream - all very familiar PMT symptoms from the past!).

Vaginally its totally different and I've found there are no side effects at all. The only downside I find is that its a bit messy. Inevitably there's a bit of melt-out so I find I need to wear a pantyliner - may not be the same for everyone though. Both methods produce an effective bleed although with the oral method I never got past day 10 before the bleed started wherease vaginally its a fews days after finishing the course. No idea why! All down to your own personal preference really.

Wow you sound like me! haha, thats for sharing your routine, im so sensitive to chemicals as i also have ME and taking the tablet vaginally sounds it may be great for me! is it the same tablet you take orally?
I have also been on Hrt which brings on night sweats! crazy!!
I may give taking it orally a go then i always have the chance to change to the other way, which i had been told this.
Oh and Hurdity i forgot to say i do one pump in morning and one at night, im feeling so much more positive about it all so thanks ladies you have all been so helpful x x x

[Butterfly22]

Thanks for your help x x

[Cassie]

Same tablet yes and I was actually prescribed if for 10 days but I cheat
I used to use 100mg for 7 days and he then upped it to 200mg for 10 days but I figured that it was double what I was getting so I would do 8 days, naughty I know, I will see how my lining looks and whether I get any more breakthrough bleeding and can then adjust up to 10 days again. So far, so good! I prefer the vaginal method, works better for me. I finish the course and wait at least 5 days before the bleed.

All the best, hope that this regime works well for you x

[Butterfly22]

So if im on 100mg for ten days orally (this is what my doctor advised) would i just do the same but vaginal method?
Sorry if i sound silly but this is all new to me, i was on nuvelle hrt for ten years (started menapause age 25) but they stopped it so last couple of years been trying to find something sutible and dont really understand it all. Well ill blame it on the menapause x x