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Author Topic: Just started HRT 0.5 Estrogen only Sandrena - When to adjust dose?  (Read 8062 times)

anni291

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Hi all,
This is my first post, but I've been here reading for a while now.
I'm 55, had a hysterectomy in my early 40's but kept my ovaries. I have had night sweats on and off since my late 30's, but didn't experience a daytime flush til january 2016. Since then, I have increased to between 10 and 30 (yes 30!) hot flashes a day. I have terrible mood swings and irritability mixed with anxiety and paranoia.
I work fulltime in a pretty stressful job which doesn't help and up until recently had been determined never ever to start HRT.
The heatwave of last summer was a nightmare (and yet I've always worshipped the sun). I sleep with windows open even in the winter and my husband now delays coming to bed until the earliy hours because it's freezing in our bedroom!
I tried various natural remedies with varying and temporary success,
Then one weekend recently I had a day of such intense hot flushes that it became the day that broke my determination not to try HRT.
The Dr recommended I self adjust my dosage starting at the lowest dose to find the lowest effective dose for me. She described a pump gel for this purpose and it sounded ideal. I was surprised then that when I had the prescription made up, I had only been given 0.5 sachets of Sandrena gel x 28.

That said I thought I'd give it a try and started using it that same day. within 3/4 days, my brain fog irritability and mood swings seemed to have all but completely vanished. Which surprised me as reading up on here it seems that most of you have had to wait months for these symptoms to improve.

But 10 days in and my hot flushes are still here! They may have slightly reduced, but still between 10 and 15 a day.
I love the fact that the other symptoms have vanished but really want the same for the hot flushes. They are really affecting me. I feel like I should be on a very slightly higher dose but with only 28 sachets in the pack I'm not sure what to do. my instinct tells me I should try doubling the dose, what do you all think? Should I just go for it as the Dr did tell me to self adjust upwards as needed, or should I contact her and ask? If I do increase the dose, then I'll need the next prescription sooner  as there's no leeway in what I've been given.

Sorry for the long post! And thanks in advance for your help and advice.

Anni
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Joaniepat

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Re: Just started HRT 0.5 Estrogen only Sandrena - When to adjust dose?
« Reply #1 on: March 11, 2020, 11:45:39 AM »

Hi all,
This is my first post, but I've been here reading for a while now.
I'm 55, had a hysterectomy in my early 40's but kept my ovaries. I have had night sweats on and off since my late 30's, but didn't experience a daytime flush til january 2016. Since then, I have increased to between 10 and 30 (yes 30!) hot flashes a day. I have terrible mood swings and irritability mixed with anxiety and paranoia.
I work fulltime in a pretty stressful job which doesn't help and up until recently had been determined never ever to start HRT.
The heatwave of last summer was a nightmare (and yet I've always worshipped the sun). I sleep with windows open even in the winter and my husband now delays coming to bed until the earliy hours because it's freezing in our bedroom!
I tried various natural remedies with varying and temporary success,
Then one weekend recently I had a day of such intense hot flushes that it became the day that broke my determination not to try HRT.
The Dr recommended I self adjust my dosage starting at the lowest dose to find the lowest effective dose for me. She described a pump gel for this purpose and it sounded ideal. I was surprised then that when I had the prescription made up, I had only been given 0.5 sachets of Sandrena gel x 28.

That said I thought I'd give it a try and started using it that same day. within 3/4 days, my brain fog irritability and mood swings seemed to have all but completely vanished. Which surprised me as reading up on here it seems that most of you have had to wait months for these symptoms to improve.

But 10 days in and my hot flushes are still here! They may have slightly reduced, but still between 10 and 15 a day.
I love the fact that the other symptoms have vanished but really want the same for the hot flushes. They are really affecting me. I feel like I should be on a very slightly higher dose but with only 28 sachets in the pack I'm not sure what to do. my instinct tells me I should try doubling the dose, what do you all think? Should I just go for it as the Dr did tell me to self adjust upwards as needed, or should I contact her and ask? If I do increase the dose, then I'll need the next prescription sooner  as there's no leeway in what I've been given.

Sorry for the long post! And thanks in advance for your help and advice.

Anni

Hi anni291, welcome to the forum!

Great that the Sandrena is controlling some of your symptoms already, although 10 days is not long and maybe your flushes will improve further. If your GP wants you to titrate the dose and mentioned a pump pack, she must have been referring to Oestrogel, so I wonder if she prescribed Sandrena in error. Might be worth asking for a telephone appointment to check.

If the flushes don't reduce soon, I would say you are not getting enough oestrogen from the 0.5 sachets. That dosage is roughly the equivalent of 2 pumps of Oestrogel, and had you been using that, you would probably have been told to increase to 3 pumps after a couple of weeks if symptoms are not controlled. You can even do half pumps with Oestrogel to fine tune the dosage. Perhaps you can try one and a half sachets of Sandrena, but I wouldn't advise doubling the dose just yet as you don't want too much too soon.

Best wishes,

JP x
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anni291

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Re: Just started HRT 0.5 Estrogen only Sandrena - When to adjust dose?
« Reply #2 on: March 11, 2020, 09:41:59 PM »

Hi Joaniepat,
Thanks for taking the time to reply. I had picked up from reading on here that Oestrogel sounded much more like the description the Dr gave me. Interesting about the dosage equivalents... I had thought that maybe one pump was 1mg (or should that be mcg or ml, a bit confused as you can probably tell!) as opposed to the.5mg as I couldn't find any posts referring to .5 Sandrena, they all seemed to be 1 or 1.5 or 2.
Now I'm getting good results with the other symptoms on Sandrena, would switching to Oestrogel for the fine tuning potentially work differently or are they essentially identical ingredients with just different branding and packaging?
I will give it the two weeks as you suggest, but like the idea of fine tuning to the lowest effective dose.

Thanks

Anni
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Hurdity

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Re: Just started HRT 0.5 Estrogen only Sandrena - When to adjust dose?
« Reply #3 on: March 12, 2020, 06:33:01 PM »

Hi anni291

First of all  :welcomemm:

Secondly I have to clarify about the dosages:

1 pump of oestrogel contains 0.75 mg estradiol
1 sachet of 0.5 Sandrena contains 0.5 mg estradiol.

Although these are different amounts the BMS equivalence chart puts these both at low dose - and this is probably because the Sandrena is more concentrated (it's 1 % ) and perhpas is absorbed more effectively.

Anyway it is the 1 mg Sandrena sachet (ie 1 mg estradiol) that is apparently approx equivalent to 2 pumps of oestrogel ( 1.5 mg estradiol) although depending on your absorption could be less.

For someone starting on HRT the 0.5 mg Sandrena is a low dose. I would be wanting to start on a 1 mg sachet. yes if your docs said you should adjust upwards then do so - but as you say there isn't much leeway so i would get in touch with the doc anyway. If you're happy with Sandrena then no reason not to continue with it - you just need to have 1 mg sachets and probably 2 or 3 months worth at a time - if you decide that this oestrogen is for you.

Yes oestrogel is different - like I said - different conenctration, different excipients ( carriers) so will be absorbed differently. If you want to change then do so sooner while you are still tweaking.

Best of luck with it all :)

Hurdity x
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anni291

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Re: Just started HRT 0.5 Estrogen only Sandrena - When to adjust dose?
« Reply #4 on: March 12, 2020, 10:36:02 PM »

Hi Hurdity
Thanks that info really helps, I'll contact the Dr tomorrow to see if I can get a 1mg Sandrena prescription for a longer period of time
Anni
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anni291

  • Guest
Re: Just started HRT 0.5 Estrogen only Sandrena - When to adjust dose?
« Reply #5 on: March 17, 2020, 07:29:07 PM »

Hi all, just to update on this, thanks to the advice received I have today collected a new 3 month prescription for Sandrena 1mg. The advice here really helped me with the conversation today with the prescriber and has given me the confidence to start titrating the dose. The prescriber has suggest I don't use the whole 1mg sachet to start with and ease the dose up slowly... so I'll aim for roughly .75mg and see how it goes..

Thanks all
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Hurdity

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Re: Just started HRT 0.5 Estrogen only Sandrena - When to adjust dose?
« Reply #6 on: March 17, 2020, 08:50:43 PM »

Great news anni291 and let us know how you get on with the increased dose! Glad we have been able to help you :)

Hurdity x
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Flan747

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  • Posts: 509
Any good results with Sandrena
« Reply #7 on: August 19, 2020, 07:54:31 PM »

I am due to start Sandrena after I get my blood test results on Friday and speak with my specialist on Saturday. I was wondering if anyone had any good reviews of it? I have read through posts on here and I suppose as always there is mixed reviews! I do not absorb well and have been told that Sandrena is superior to Oestrogel! Any thoughts welcomed
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Brit66

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Re: Just started HRT 0.5 Estrogen only Sandrena - When to adjust dose?
« Reply #8 on: September 07, 2020, 11:56:08 AM »

I've just been prescribed it too, how have you found it? :)
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Flan747

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  • Posts: 509
Re: Just started HRT 0.5 Estrogen only Sandrena - When to adjust dose?
« Reply #9 on: September 20, 2020, 05:53:29 AM »

I am week 4 on 4mg Sandrena and was hoping for better results. I’m sure I am not absorbing this as feel the same as when on Oestrogel. I have had a few good days but nothing exciting! I am due for a blood test this week just to give a comparison to the gel! Having Mirena coil fitted Thursday so no idea what problems that will add to the mix! This really is my last shot as have tried most combinations now! I presume most will say 4 weeks is too early to tell but it seems to be heading the same way as the other HRT with no real changes to how I feel. I do feel like starting all over again but cannot bars the thought of all the awful original symptoms.
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