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[Lyndyloo5]

I’m looking for some feedback. I have been on Oestrogel (3 pumps daily) and Ustrogestan (1 capsule daily) for 6 months and have been doing ok. Unfortunately my pharmacy have not got any Estrogel at present and are struggling for supplies so have given me this Lenzetto spray as an alternative for a month saying I should try one to two sprays daily. I’m sure I read somewhere that 3 sprays was equivalent to 2 pumps so I’m a bit concerned but wondered if anyone else has similar and could let me know how they’ve got on? Thank you.

[laszla]

I have no experience of Lenzetto though I am considering trying it - not because of estrogel shortage but because of absorption problem - but I too have read multiple times that 3 sprays is equivalent to 2 pumps estrogel so if it were me I would be taking at least 4 sprays of Lenzetto. Hopefully someone with more specific input will stop by.

[Uptick]

From the 'Treatment' section on MM main menu:

b. Gels - are useful if transdermal treatment is the option preferred but skin irritation occurs with patches.

OESTROGEL   2* measures once daily (1.5mg estradiol) increased if necessary to max 4 daily (3.0mg estradiol)   £4.20 for
64-dose pump
SANDRENA   1 application daily 0.5mg or 1mg -dose range 0.5 to 1.5mg daily.   £5.08 & £5.85

c. Spray

LENZETTO   1.53mg estradiol per spray. Starting dose once daily to forearm. Up to 3 sprays daily   £3.45- £6.90

So, 1 spray of Lenzetto (1.53 mg of estradiol) is equivalent to 2 pumps of Oestrogel (1.5 mg of estradiol).

[laszla]

3 sprays of Lenzetto are equivalent to 2 pumps of estrogel, see the British Menopause Society, eg. pages 4 & 5

https://thebms.org.uk/wp-content/uploads/2021/03/HRT-Equivalent-preparations-28.4.21.pdf

See also Women's Health Concern

https://www.womens-health-concern.org/help-and-advice/factsheets/hrt-types-doses-and-regimens/

and, finally, the MM fact sheet prepared by Women's Health Concern, which is the patient arm of the British Menopause Society

https://www.menopausematters.co.uk/pdf/HRT-Doses-Sep2021.pdf

Therefore, if someone were looking to match 3-4 pumps of estrogel with Lenzetto, the equivalent would be 4.5 - 6 sprays.

[Lyndyloo5]

Thank you all. I have been told that I am only to take 1-2 sprays pf the Lenzetto I'm not sure will be enough, though the chemist advised that 3 sprays is the absolute maximum so the idea of 4 or 5 doesn't make sense. Also I have only got enough for 1 month of 2 sprays per day. I'm very confused. I think I'll be going back to the chemist 

[Uptick]

Thank you for the links. They're all based on this study

https://journals.lww.com/greenjournal/Abstract/2008/06000/Low_Dose_Estradiol_Spray_to_Treat_Vasomotor.15.aspx

They're considering average absorption rates, which seem to be lower (less than 2%) than the 'expected' average absorption rates for Oestrogel, of  'approximately 10%', 'when applied topically to a large area of skin' (Oestrogel, SmPC). If these numbers are to be trusted, the equivalence tables aren't correct.

These studies provide an idea of how the products will behave, but there are many variables as type of skin, fat content, temperature, to name a few.

I would start with the lowest dose and increase gradually based on symptoms, because two different products are never truly equivalent.

[sheila99]

Last time I looked at the newson website that also said 2 pumps = 1 spray but many people do seem to find it weaker than it's supposed to be. You could go for 2 sprays and adjust up or down depending on how you seem to absorb it.

[Uptick]

https://balance-menopause.com/uploads/2021/10/Easy-HRT-prescribing-guide-NHMS.pdf

[Postmeno3]

I've gone from Evorel25 and Estradot37.5 to one pump of gel to two sprays of Lenzetto and would say that, despite the levels changing radically (60 to 265 on the Lenzetto), there is no easing of symptoms that are particularly markedly noticeable. So, I'm guessing the Lenzetto is perhaps more readily absorbed, but weaker in impact? 🤔

[Uptick]

Hi Postmeno3, you're probably right. Apparently the manufacturer has acknowledged that the formulation is weaker than previously thought (which means a lousy job regarding studies, clinical trials and approval by the European Medicines Agency).

[Sazzle42115]

I went up to 6 sprays with no improvement x