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[chopsuey]

Hi

Just been messing about with scales. By weight consistently 0.78g when it should be 1.25g.

So by weight 40% less. So laying aside formula, I'd need NINE pumps by weight for same dose.

I've just tweeted BMS and Louise Newsom, a doctor needs to speak up.

I'm starting a spreadsheet - batch no and weight by pump.

And yes formula also but this is woeful.

Sooner I'm off this crap the better.

Reb
X

Hi Reb

I previously sent a  record of my pump weights and cannister details to Besins after a previous complaint. They just said they would look into it. But I think the more people that do this, the harder it will be to ignore. Clearly the pump is faulty and should be changed.

As far as the gel is concerned, I wonder if this is how Besins have always made it, as I have read that there have been issues with Oestrodose for several years. This is made for the French market by Besins but was sometimes imported into the UK at times of shortage. People have said it always seemed to be weaker than old Oestrogel, although I've never had it myself. Someone on another forum said that Oestrogel for the UK market was previously made by another company, presumably under license from Besins. This then changed when Besins bought the factory off this company when demand for HRT rocketed in the UK. The intention was to use the whole of this factory in Belgium just for manufacturing HRT to meet this new demand. I have not found any evidence to confirm that another company previously made Oestrogel for the UK but Besins did buy this factory in Belgium in order to ramp up supply: 

https://www.pharmiweb.com/press-release/2022-06-22/besins-healthcare-group-acquires-hormonal-gel-manufacturing-site

If this is the case, it might explain why Besins insist 'nothing has changed' as this is the way they have always made it at other sites. However, this is all just speculation on my part.

I am not on Twitter/X but would be interested to hear if Louise Newson responds. I know she has conducted a poll on whether people are finding the new gel to be effective, which I believe over 2/3 aren't.

[Banjo1973]

UPDATE

Hi,

I switched from useless new oestrogel to Sandrena a few months ago. Although Sandrena has been wonderful compared to new Oestrogel, I never felt as good as I did on 3 pumps of old Oestrogel plus testosterone. I've been tweeking amounts and have been on 2g of Sandrena per day (sometimes a little bit more)

My blood results are: 587 pmol/L

That must mean I'm absorbing well (I think)

Unfortunately my testosterone results are high... I'll start a new thread for that one!

[RebJT]

Hiya

Bango, those are GREAT results, from just 2mg too, that's brilliant, OK that gives me hope!  Great you are feeling better. 

I'm feeling MUCH perkier for 7 pumps, and spreading over a smaller area (takes yonks to dry so I'm swanning about in my undies for ages).  Also to add, if I stand the cannister on a hard surface and prop the scales on a pile of books to just under the spout, and properly press it firmly down, I can just about squeeze out 1.2g of gel, but everyone I know and all demo vids I've seen is a woman holding it in one hand and pumping it into the other.  Holding it tilted in my hand onto the scale, 0.8g every time.  Also, the doses defo get smaller as you get through the bottle, that didn't happen on old oestrogel until right down to the last few bits.

Chopsuey (great name, makes me think of Hong Kong Phoeey's side kick!) yes, from a profit point of view, it makes sense they'd do this, and use the most inexpensive packaging, and also given the uptick in women asking for HRT, use the most cost effective way of producing it, and cut out any third parties if return made it worthwhile.  I've never tried Oestrodose but I know some women had a miserable time when switched over.

On Louise Newsom, I'm not a massive fan of hers, she's done a lot on education but strikes me as a bit of a one trick pony, who is a bit cavalier (and charging consultant gynae prices for a GP practice!) - heard a few horror stories.  She's ticked off breast cancer docs today, I appreciate HRT post BC is controverial and do think there's a convo to be hard re risk vs quality of life for some women (my mum had a horrible horrible time on tamoxifen and into meno with no HRT, inc quite serious health consequences now she's elderly) but she isn't a specialist and I think is about to be told to stay in her lane.  However, she is high profile, so if she said something about gel, it would get attention.

Testing on 20th, and still mulling my options.

Cheers

Reb
x

[chopsuey]

I found this whilst I was looking for info on the use of Oestrogel:

https://www.instagram.com/p/COilhbUM7sw/?utm_medium=copy_link&img_index=1

It describes how the oestrogen is absorbed into the skin and advises against rubbing it in, which causes the alcohol to evaporate too quickly before the oestrogen can sink into the skin. I wonder if spreading the gel over too big an area has a similar effect, as the alcohol would also evaporate more quickly this way. I might contact Besins and see what they have to say about this. Certainly, I do find the new gel seems to dry more quickly. The old stuff used to stay a bit tacky for a good 10 mins. Yes, it's a pain to wait longer for the new stuff to dry if you apply it over a smaller area but worth it if it helps. I just use the time to do my teeth, hair and makeup, whilst I'm still in my underwear.

I will be having a blood test on the 26th but definitely feeling a lot better for applying over a small area. I am progesterone intolerant and it took ages, plus a small fortune spent on an expensive private gynae to get a bespoke HRT regime that worked for me. I am not in a position to do that again so have to try and make this new Oestrogel work.

Reb - glad to hear you are feeling better on your new regime. I would think 7 pumps per day probably isn't sustainable in the long term, although you'll be helping to keep Besins in business with that amount!

[RebJT]

Hi

Thanks, yes I'm now applying over a smaller area and leaving to dry, that seems to be helping.  I'm testing on 20th, perhaps we can compare notes when we get our results?

I'm also P intolerant - I have histamine intolerance so I have to be super careful with E and P - and it's taken me YEARS to get steady and feel well and I really resent this upset, because I've also spent a fortune on a private gynae and scripts to get here.  Cost of living rises are kicking my butt and I can't really afford to be faffing about either. 

Saw my sis in law last night, she's post hyst and takes 2 x estradot 100 patches changed a day early, although she has a massive stash of evorel 100s she doesn't need (prescribed during estradot shortage, but she's allergic to the adhesive) - my gynae ages ago prescribed me Evorel that in the end I didn't use, so what with SiL's stash too I do have a plan B up my sleeve if my results are terrible.  I also have a three month supply of Sandrena (from my eight day failed attempt recently).  So I've got choices.  I just don't really want to rock the boat unless I absolutely have to, simply because getting here has been so painstaking, and I have such a bloody awful time with fluctuations and instability that completely derails my life.  I freelance for work, no sick pay, so I can't afford time off and underperforming again.

Fingers crossed we're both absorbing these increased doses.

Reb
x

[chopsuey]

Hi

Happy to post results when I get them. I was allergic to the glue in Evorel and was put on Oestrogel, which, once the progesterone issues were sorted, worked really well with the old stuff. My gynae also tried me on Lenzetto, as that is her preferred option but like many women, I found it really weak. I think the response to transdermal medication can vary so much from person to person. I apply mine straight after a bath/shower, so my skin is really clear of any oils and also warm, to maximise absorption. I have read that having well hydrated skin helps too.

I have not tried Estradot ( is there still a supply issue?)  or Sandrena. I would have to go through a specialst though, as my GP would not authorise any change to my regime due to taking minimal progesterone ( I take one x 100 mg Utrogestan, vaginally for 14 days). I just can't afford to do that though.

Feeling more achy today but still no headache and my skin is looking better, which had got very dry. 

[RebJT]

Hey

Yes my skin is better.  GPs are a pain aren't they, 14 x utro vaginally isn't 'minimal' as you can take half the dose vag for the same effect as 200 oral, many women only take it for 12 days (I take it for 10 min, and try and get to 14, but was so sensitive started off on 5, one every three days) but totally understand if the GP won't budge, then you are stuck. No idea what the Nice guidelines and NHS meno guidelines are, but might be worth checking.  My sis in law is under Nick Pannay himself, privately, he wrote the meno guidelines, but her Gp has refused to keep prescribing his recommendations (she doesn't have a uterus!) unless she is seen in an NHS meno clinic, and when she says 'but Nick Pannay wrote the NHS meno clinic guidelines' he literally just starts shouting.  It's bonkers.

Due to histamine issues I'm worried about glue in patches too as I react to certain surgical dressings, which is why, like you, I was happy on gel.  I'm also gutted about needing more consultations and scripts as things are really very tight at the moment and I could do without it.  It was bad enough just paying for my HRT.

Fingers crossed on our results, I defo feel and look better so I'm hoping my levels are rising.

Reb
x

[chopsuey]

Hi Reb

It's all bit crazy isn't it?

BMS currently recommend 200mg  for 12-14 days for sequential oral use and same for vaginal. They also suggest you may need more if on a high dose of oestrogen. But surely that all depends whether you are absorbing it well, not just the dose? As you say, some specialists are happy with using less, as mine was.  However, I saw an NHS gynae recently (for another matter) and he was really not happy with my regime. My GPs are sadly clueless and didn't even understand the difference between topical oestrogen for internal use and Oestrogel!

I am getting my blood test done through Medichecks. I want to stay under the radar with GP but also my local NHS blood labs wrote a snotty note on my results when I first had my levels checked, when I was struggling with symptom control, saying it wasn't necessary! They also refused the request to test my free testosterone & SHBG levels. It really makes me mad that women's health is treated in this way.

 Hope you and everyone else in this situation finds a satisfactory solution soon.  I will post results when I get them.

x

[Hurdity]

GPs are a pain aren't they, 14 x utro vaginally isn't 'minimal' as you can take half the dose vag for the same effect as 200 oral, many women only take it for 12 days (I take it for 10 min, and try and get to 14, but was so sensitive started off on 5, one every three days) but totally understand if the GP won't budge, then you are stuck.

As chopsuey says - the Guidelines are to take the same amount vaginally as orally if you are intolerant to oral intake and this is the same as the manufacturer ( Besins) recommends (taken from the French product info where the same product can be used either vaginally or orally - and this is the same product as Utrogestan).

"you can take half the dose vag for the same effect as 200 oral," - that's a sweeping statement put across by some gynaes but the fact is there were some very small studies that did indeed demonstrate this, but they were very small ie trials with only a few women, and as far as I recall were only carried out using small to medium doses of oestrogen - so for higher doses of oestrogen more progestogen would be needed, and in any case not all women would be OK even on this depending on how well they absorb both the oestrogen and the progesterone, so always best to follow guidelines unless under medical supervision and monitored with scans etc

Re spreading out the gel. The original product info monograph or a paper on it described how it was important not to spread it too thinly ie over as wide an area as possible as this caused the alcohol to evaporate too quickly before the oestrogen was absorbed so the area to which is applied is a crucial factor in response.

I would suggest anyone who is bothered by dodgy pump mehcanisms and sensitive to slightly inconsistent doses would be better off using Sandrena (though still have the issue of what size area of skin not to mention products on skin, temeperature of skin etc) as it comes in ready portioned sachets ( yay!), or patches - exactly the same size - though I realise these are ot for everyone, but estrogel seems to be one of the most widespread oestrogens being prescribed. I just wouldn't want to waste my time worrying about what was right or wrong or different about it, and try something else that at least from the dosage point of view starts off as being more  consistent!!

" My GPs are sadly clueless and didn't even understand the difference between topical oestrogen for internal use and Oestrogel!"

That resonates with how my GP was a few years ago - who thought I might be overdosing on oestrogen (as the cause of some spotting) because I was on systemic HRT ( 50 mcg oestrogen patches!) and vaginal oestrogen and sent me off for blood tests! Needless to say my levels were not too high and only around 200 pmol/l or so maybe a bit more!

Hurdity x

[Christine79]

There has been a couple of estrogel batch recalls. Finally some acceptance there is a problem

https://www.gov.uk/drug-device-alerts/class-3-medicines-recall-besins-healthcare-uk-ltd-oestrogel-pump-pack-750-micrograms-slash-actuation-gel-estradiol-el-24-a-slash-09#:~:text=Besins%20Healthcare%20(UK)%20Ltd%20has,Pack%20750%20micrograms%2Factuation%20Gel.

[joziel]

Can anyone advise me... I'm currently on 9 pumps of Oestrogel (I know...!). 4 pumps in the AM and 5 at night.

I'm probably going to get switched to Sandrena because this is ridiculous, but...

How many sachets of Sandrena am I going to try to extract from my Newson GP to equate 9 pumps of Oestrogel....?!?

[chopsuey]

Hi Joziel

According to the BMS, 1 x 1mg sachet of Sandrena is equivalent to 2 pumps of Oestrogel, which on that basis would make 4.5 sachets of 1 mg Sandrena but that would be a ridiculous amount and way above the guidelines. According to the patient's leaflet, the manufacturer recommends a maximium of 1.5 mg a day.

Have you had your oestradial levels checked on 9 pumps?

I don't think the two products can be compared really, especially in view of all the issues so many people are having with the new shape Oestrogel. Did you ever use the old shape version?  Sandrena is clearly a very different product anyway, in terms of it's concentration and the exipients which enable it to be absorbed. People respond very differently to how they absorb drugs and chemicals. I think you will have to leave it to your Newson GP to figure out what dose you should start on, based on your response so far. 

[chopsuey]

There has been a couple of estrogel batch recalls. Finally some acceptance there is a problem

https://www.gov.uk/drug-device-alerts/class-3-medicines-recall-besins-healthcare-uk-ltd-oestrogel-pump-pack-750-micrograms-slash-actuation-gel-estradiol-el-24-a-slash-09#:~:text=Besins%20Healthcare%20(UK)%20Ltd%20has,Pack%20750%20micrograms%2Factuation%20Gel.

Interesting... I don't know which batches I have reported but I never sent any back, just batch numbers and the weights of each pump. As far as I am concerned though, all the new dispensers are defective - they just cannot be relied upon to deliver a consistent and adequate amount

[Tynkabelle]

I have sent back batches with earlier numbers ie 745** and 747** - will be interesting to see if they add more batch numbers 🤔

[MrsMitch]

I wonder if my symptoms of poor sleep and flushes,  night sweats, have returned very slightly? I think this is since I have the new design pump bottle from Besins. It is definitely a smaller dose. I think I will add an extra pump,  to 5 a day and see if that helps.