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[Hurdity]

Hello GypsyRoseLee! Perhaps the high dose of oestrogel is actually suppressing your cycle. Normally 4 pumps of oestrogen when added to your own cycle would definitely thicken the lining as it is a high dose - so either you're not absorbing it or it is suppressing so keeping your oestrogen levels more constant. However the crash you experienced doesn't bear this out?

I know blood tests are not especially reliable but in view of your situation and the regime you are on - have you had a blood tests or two - might be illuminating?

I agree I could not find any info about Oestrodose on the web - the SPC is not available as a separate product. If you can actually feel the difference in consistency with your fingers (ie if one is runnier than the other) then this could account for absorption differences although you should have reserves in your system to keep levels fairly even?

Thinking aloud here

Hurdity x

[GypsyRoseLee]

Hi Hurdity

I last had bloods done last summer. I'd been on 4 pumps for about a month, but my oestrogen was still only about 604 p/mol, I think? And Prof Studd said he didn't think that particularly high at all, he has patients will oestrogen levels over 1000 p/mol.

It would make sense if the  pumps were mainly suppressing my cycle, and I feel okay, but then occasionally my cycle breaks through and causes these symptoms? The headache, nausea, aching joints, interrupted sleep, diarrhoea etc are all things I associate with hormonal fluctuations. Whether that's too high, or too low, I just don't know? If I knew, I would know whether to lower my pumps for a few days, or increase them.

I applied 4 pumps of oestrogel at about 10.30am this morning, and since lunch I have felt much better, much more calm and clear headed. I just don't know if this is a coincidence?

[Salad]

Hi Salad

How could you tell the oestrodose wasn't as effective?

I'm sure mine isn't as effective. Yesterday afternoon I felt unusually hot and a bit sweaty (never normally have this), and had a headache all day with a touch of diarrhoea. I felt very unfocused and low, and quite panicky at times. These are all symptoms I associate with not enough oestrogen.

When I used the Oestrodose I still had symptoms but using Oestrogel I was symptom free - hope you get sorted soon 

[GypsyRoseLee]

I'll be very interested to hear what you discover Stellajane. I think something odd must be going on. My pump of oestrodose also has a large white sticker on it, saying it's Oestrogel too.

[Liz]

Mine does too!

[GypsyRoseLee]

Right, I have just studied the estrogel pump pack cannister and box, supplied by Prof Studd's pharmacy. The word 'Estrogel' actually has a big loop attached to the left side of the capital letter E, so it looks like it 'could' say OEstrogel. Does that make sense?

But I have found this article http://surmeno.blogspot.co.uk/2014/04/troubleshooting-gel-hrts.html which talks about Estrogel and Oestrogel as two separate products.

I am confused 

[GypsyRoseLee]

It's confusing stella. And I suspect that even if we took it to a pharmacist they would turn their noses up, and insist it's the same product, and we should just put up & shut up.

[Tempest]

When I see Professor Lumsden next, I will speak to her again about this. I spent some time showing her the two different products and she certainly took my concerns on board. I can confirm that the Oestrodose IS runnier in consistency, just as GRL says. I know I certainly didn't feel anywhere near the same on the Oestrodose and couldn't secure a further supply of the Oestrogel despite phoning a good number of pharmacies.

[dangermouse]

17b estradiol is the full chemical name of the hormone but it's often shortened to estradiol (and it's paired with other chemical absorbers like valerate in pill forms).

Oestrogel is a brand of estradiol and is more expensive if bought privately (I tried it when thought I needed it and still have the pump).

The main difference with brands is the carrier and, from what I know of progesterone cream, the better absorbed carriers like Versabase mean the product is more expensive.

As the (probably) cheaper one is runnier then it will evaporate on the skin more quickly and you will absorb less. The thicker carriers will hold it there for longer before the alcohol dries it out.

I suspect the 4 pumps were suppressing your own fluctuating oestrogen and the poorer absorber has allowed your own oestrogen to leap about again.

[GypsyRoseLee]

Well, we certainly can't all be imagining it? If you ever decide to try Estrogel again, I can give you the contact details of the pharmacy in London who supply Prof Studd. They always have it in stock. Probably because of the high number of private gynaecologists nearby (they only fulfil private prescriptions).

My delivery of Estrogel arrived Thursday mid morning, I applied 4 pumps immediately, and by 2pm I was already feeling much better, which has carried on through today. This surely can't be a coincidence, can it???

I will be very interested if Prof Lumsden could shed any light on the differences between the two. Will you keep us updated 

[GypsyRoseLee]

What you say makes sense dangermouse. I've looked at the ingredients, and they're the same on both products, so does that mean the 'carrier' will be the same, too?

But something certainly changed, and I felt I was rapidly heading back to those awful days of this time last year, when I was waking at 4am filled with dread, and that was happening within only 2-3 days of using Oestrodose. Now, having been back on Estrogel for 2 days, I feel so much better.

This can't, can't be a coincidence???

[dangermouse]

The carrier is often hidden from ingredients as it's a secret formula so that it can't be copied, like KFC...

Besins list them separately here http://www.besins-healthcare.com/index.php?mode=product&submode=2&group=2
and the only detailed ingredients I could find for both are:

Oestrodose:
The drug brand named Oestrodose contains generic salt-Estradiol Hemihydrate and is manufactured by Besins.

Generic Salts
Estradiol Hemihydrate

Available types of drugs
Gel; Topical; Estradiol Hemihydrate 0.06%

Oestrogel:
of gel contains 0.6 mg of estradiol (as estradiol hemihydrate); excipients: carbomer 980, triethanolamine, 96% ethanol, purified water.

I suspect the hemihydrate is the patented ingredient that makes it technically a drug (and thus can be trialled and BMA and FDA approved) and the excipients are the bits that differ.

Besins either made a cheaper and a more expensive version or it's to do with their move to Asia and perhaps different manufacturing plants having access to different ingredients (the oestrodose one seems to be in the U.K. perhaps to avoid import fees?). The original Brussels formula seems to be the 'quality stuff'.

More importantly, this is what Friday night TV has driven me to.

[GypsyRoseLee]

Thank you for finding that out dangermouse. I feel relieved, a bit, that there is actually a chemical difference between the two, and that an informed person like you can spot it.

So if the carrier is different, could that have an effect on how my skin absorbs the oestradiol?

[GypsyRoseLee]

I agree stella, it's hard enough finding the right balance with HRT, without pharmacies muddying the waters with different brands.

I'm happy to swap my oestrodose packs for your estrogel, if you're interested?

[dangermouse]

Yes absorption is all about the carrier! For some like Stellajane, the weaker absorption suits her and so yes it's about consistency in what you're prescribed.

I can understand the pharmacies not being aware of the differences though as the drug companies don't have to disclose non-active ingredients.

The same would apply where generics are prescribed for other oral meds and patients can feel the difference compared to the brands. I could also feel the difference between Brevinor and Ovysmen (2 BCPs which had the same oestrogen and progesterone ingredients and amounts).

Plus some people get allergic reactions to different fillers used in oral meds.