sed I think Louise Newson recommends splitting the dose for more stable oestrogen levels but I'm not sure of the basis for this?
Also there is research to show that spreading the gel on the largest possible area is not recommended as it can dry too quickly so I wouldn't spread it all down your arm from shoulder to wrist at all. I realise the area is not very precise though, but just to be careful about spreading it too thinly.
Also I do know that many women apply to outer arms and indeed some are recommended to do so by their docs, and on the instructions, but of all the transdermal HRT (patches and gel) oestrogel is the ony one that says you can apply to upper body, the idea being that it should be applied as far from breasts as possible. Not saying its dangerous to do so, but personally I would not ( and did not when I used gel) apply to shoulders or upper body.
The other exception is Lenzetto which can be sprayed onto the forearm - but that is some distance from shoulder/upper arm.
I'm probably just being over-cautious but have always applied my oestrogen to lower torso.
Any changes to dose should ideally be discussed with your doctor unless you have been given free reign to tweak yourself?
I agree with sheila99 - if you are feeling awful it may well be the Mirena causing this and hopefully will settle. Maybe not adjust the gel dose until youve had the Mirena for a while longer, unless you are still getting flushes or sweats?
I do hope it all settles for you soon
Hurdity x