Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Pippa52 on November 22, 2022, 10:25:04 AM
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Hi All, I have been struggling for ages to try and get my HRT levels to even out. I am post meno, surgical menopause many years ago and aged 70. Been on oestrogen only HRT since I was 42. Was absolutely fine HRT wise till last year when oestrogel became unavailable and then was put on Lenzetto and then two different patches which I never levelled out on. Started back on Oestrogel in July and just can't get level. Had loads of blood tests in Sept like thyroid etc all came back normal. My oestrogen blood level however was low in July at 69 and Meno consultant told me to work up to 3 pumps of Oestrogel (which I was originally on). Have been trying to work up over the months as have to take it slowly as am super sensitive to any level change but every time I went up (got up to 2 1/2) it made me feel dreadful to be honest its been horrendous with cracking headaches, dizziness, huge anxiety, feel wired and jittery all the time, insomnia and episodes of palpitations which are all supposed I thought to be signs of too little oestrogen but the higher up I went the worse I felt. Hence over the past 2 weeks I have come down on the dose and am now on 1 1/2 pumps. I notice the oestrogen in Oestrogel which used to be Estradiol 17b changed last year to Estradiol hemihydrate and I am wondering if it is maybe a bit stronger. I did write to the manufacturer but they told me nothing has changed which is odd as the main ingredient has for sure. I just wondered if anyone else suffered from too high a dose of their HRT and if so did they have similar symptoms. I had a spell of really bad muscle pain as well but that seems to have got better since I decreased the dose. My blood oestrogen levels were low in July but I felt a lot better then than I do now so maybe I should be going on symptoms and not blood levels which is what the Meno consultant seems to want me to do? I have a follow up telephone appt on 1st Dec but really am finding it hard to function at any level right now. I realise it will take time to level out on the lower dose too. Any input would be very much appreciated - thanks so much xxx
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Hello, I don’t have specific experience but it does sound like you are on too much gel. Maybe your body is ready for less oestrogen now that you are older ? Have you tried going below the 1.5 pumps and see if that helps at all?
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Hi Pippa52
Yes I’ve had the exact same experience as you since the changes to the gel earlier in the year.
I’ve also wondered if the green squared bottle was too strong also? I do think that I could have settled on the Amber squared bottles, but they became unavailable.
I’m still trying to find the balance, but I’ve decided to stop with oestrogel for the timebeing as I feel it’s like starting a new product each time I get a different bottle. I have wondered if it changes the absorption depending on how you apply it, so rather than rubbing in, you could spread it and leave to dry!
Not sure if you are aware of this, but Sandrena is also 17b oestrogen.
Sorry I can’t help but I do know exactly how you are feeling.
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MIS71MUM I'm so sorry to hear you have suffered too regarding Oestrogel. Really interested though to hear that you found the strength different too. I think that is what has really messed me up as was told to return to my original dose of 3 pumps but of course now that is way too much. I have gone down to 1 1/2 pumps today as have been decreasing slowly over the past 3 weeks or so. Its really not great of the drug company who make it to keep varying the strength of the product as it makes it really hard to stay level on it. Having been on 3 different types of HRT over the past year before Oestrogel became available again I am a bit loathe to change yet again but thank you for letting me know about the Sandrena gel and if I don't get some sort of normality back soon I will have to think of that before I end up being carted off by men in white coats :) I was told to apply the Oestrogel a different way to what I used to originally and the consultant said that would save between 20 - 30% for each pump worth so again I have probably been getting a lot more from each dollop worth that I used to just to compound the problem of it being stronger. I have some amber bottles which I am on at the moment but my next prescription is green ones so I dread to think what will happen when I have to change to them :( Thanks so much for your post really appreciate it. I do hope that you start to feel better soon and you have helped honestly just by letting me know I am not alone xx
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VanillaLover - thanks so much for your reply. The 1 1/2 dosage I went down to today will be the lowest I have ever been on Oestrogel so will be interesting to see what happens. I know it will take time to bed in properly but I hope very much the lower dose will make life a bit more normal again. I so agree being older I should in theory need less oestrogen too so fingers crossed. Thanks again so much for your post x
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Hi Pippa52
Just to let you know that I’ve done exactly the same as you! Sometimes applied so there’s hardly any left on my hands to wash off! Like you say, that combined with the different strengths in the gels!!!
Just to let you know when I recently ordered the gel, it was Amber bottles again with newer expiry dates! And……one bottle was the shape of the old slimline canister!!
Sorry you are struggling too. Hope you feel better soon, you are definitely not alone. Take care xxx
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Hi Pippa
I'm not an expert on this but estradiol hemihydrate is two molecules of 17B estradiol joined together with a water molecule. Because it is readily converted into 17B estradiol in the body it's considered the same active ingredient. In terms of using one form or another in different HRT products - I Have no idea whether companies have changed from using the single molecule 17 B estradiol to the hemihydrate - or whether it is just a difference in labelling. Either way the amount of estradiol in any product will be exactly the same so the same concentration (and the biochemistry of it all is beyond me - long time since my degree!).
Here is what it says on Wikipedia:
"Hemihydrate
A hemihydrate form of estradiol, estradiol hemihydrate, is widely used medically under a large number of brand names similarly to estradiol.[166] In terms of activity and bioequivalence, estradiol and its hemihydrate are identical, with the only disparities being an approximate 3% difference in potency by weight (due to the presence of water molecules in the hemihydrate form of the substance) and a slower rate of release with certain formulations of the hemihydrate.[169][170] This is because estradiol hemihydrate is more hydrated than anhydrous estradiol, and for this reason, is more insoluble in water in comparison, which results in slower absorption rates with specific formulations of the drug such as vaginal tablets.[170] Estradiol hemihydrate has also been shown to result in less systemic absorption as a vaginal tablet formulation relative to other topical estradiol formulations such as vaginal creams.[171] Estradiol hemihydrate is used in place of estradiol in some estradiol products."
I'm wondering if as you say, your oestrogen dose is too high - as you are 70 you should be able to function on far less than someone younger and ideally be flush and sweat free from a much lower dose. Certainly I wouldn't want to have high blood oestrogen levels at 70 only because there hasn't been much research I don't think in long term use in older women? Just realised I might have misunderstood your post - when you said you oestrogen level was low at 69, I thoigh you meant age 69 - maybe you meant pmol/l, ie the actual oestrogen reading? That would be low - but a one off result doesn't necessarily mean it's correct...
Having said that - it is much harder if you have had surgical menopause with no ovaries. Do you or have you taken any testosterone or not felt you needed it?
Have you thought of patches - I feel these may give you a more stable dose than chopping and changing with different gels and Lenzetto - all of those types of HRT are far more likely to be variable because of rubbing or spreading the gel on your body and the area covered may vary and the amount absorbed dependent also on your skin, thickness and temperature....?
Sorry I can't really help and hope all goes well with your consultation appt
Hurdity x
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Hi pippa52, I feel exactly the same but I’m on 2mg tablet age 61. My levels are over 400 and I have tried lowering but I’m a mess. I just can’t get balanced either, it’s so hard so I feel for you. I can feel wired, anxious or tearful.
I too wonder as Hurdity mentioned about a patch to give a more consistent level. I have had total hyster too. Your levels are low though so you can’t be absorbing too well?
Hope we can find a solution soon xx
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Hurdity - thank you so much for your incredibly informative post I really appreciate it. My oestrogen level in my last blood test in July was 69pmol which the consultant said was far too low but I had another test last week so will be interested to see what that is now. I totally agree with you that at age 70 I should need less oestrogen and have absolutely no wish to be on a high dose but was told to go up to 3 pumps a day - well 2 is proving too much let alone 3 so I am now on 1 1/2 pumps. I did try patches (Evorel and Estradot afterwards) but sadly re-acted really badly to the adhesive. I have found with the gel now I put on 3/4 of my dose in the morning then top it up with the remaining 1/4 in the evening - I find for me that seems to work best. I do weigh the gel out as I am so ridiculously sensitive to dose changes and this way I know I always get an accurate dose as the pump system on Oestrogel can vary the amounts quite a bit from each dose. I've not taken testosterone but do feel it might help with muscle pain and energy etc so I will discuss with the Meno consultant. Thank you again so very much for your help xx
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MIS71MUM - thanks so much for your reply x Really good to know you were given amber bottles again so fingers crossed maybe they are still being manufactured. Thanks also for your kind words. I am starting to improve a bit on the lower dose so am keeping everything crossed that if I stay exactly on this dose things will improve long term. You are so right we are not alone in the quandry. xxx
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Mollydolly many thanks for your message. Unfortunately I did try two different types of patch but the adhesive on both I reacted really badly do with hives etc so was advised not to use them :( xx
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sweettooth - oh goodness it's such a nightmare isn't it. I am a few days in on the lower dose and am starting to improve but the proof will be if it stays levelled out further down the line. I am keeping everything crossed but the anxiety, headache and insomnia are improving a bit so far. Hope so much you will start to feel a bit better soon. What a total roller coaster this all is. xxx
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It sure is a pain this whole balancing act! Sounding good for you so far🤞glad the horrid anx is!!
I too would like to reduce but from my experience after 2 weeks I was in a right old pickle but then I wonder wud it settle🤷♀️
Hope we get feeling better whatever we do xx
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Hi.
I’m also struggling with high estrogen symptoms severe anxiety. The original symptoms Fo on this 100 and blood count is 414. If I reduce it from 100 to 75 my original severe muscle spasms and back and rib pain come back with in a week or so.
Weirdly I was prescribe amitriptyline 6 days ago. After 5 days my original symptoms are back with vengeance also itch skin. Read an article that antidepressant can affect hormones.
Cant tolerate testosterone either
Hope we can all get through this x
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Hi Pippa52,
your comment about muscle pain and increase in estrogen interested me , as I have the same problem. Every time I try to increase, I get aches and muscle pain. Once i drop, it goes away. So i can only stay on a low dose. I am still trying to find out why this happens - there must be a scientific reason.
I hope you feel better soon
PMXX
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Hi.
I’m also struggling with high estrogen symptoms severe anxiety. The original symptoms Fo on this 100 and blood count is 414. If I reduce it from 100 to 75 my original severe muscle spasms and back and rib pain come back with in a week or so.
Weirdly I was prescribe amitriptyline 6 days ago. After 5 days my original symptoms are back with vengeance also itch skin. Read an article that antidepressant can affect hormones.
Cant tolerate testosterone either
Hope we can all get through this x
Hi AliP,
Just noticed your post, so hope you don't mind me cutting in.
I'm on amitry and have been since february, I'm only on 10mg though. You're quite right in the study that was done, it was shown that amitry can decrease estrogen and progesterone, however I believe this is only on higher doses of amitry 50mg, 75mg and 100mg xx
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Hello ladies.
Pippa 52 - Your post resonated with me as I am experiencing all the symptoms that you describe ie anxiety, headaches, jitters etc. I am 66 and post meno and I have been guilty of tweaking my HRT over the years. My latest experiment has been to apply the 'less is more' philosophy and I am now using half a sachet of Sandrena gel which I think equates to 50mcg. Most of my physical meno symptoms have resolved over time but just recently I tried a quarter of a sachet and low and behold the physical symptoms of muscle aches, flushes, night sweats and vaginal dryness also joined the party! I assume this all points to a sensitivity to changing hormone levels.
Ali P and discogirl - I have been taking the AD Venlafaxine since 2013 which is the same time that I was prescribed HRT. I wonder if this AD has always affected my hormones and this explains why the HRT has not been totally effective?
Wishing you all well ladies.
K.
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Hello ladies.
Pippa 52 - Your post resonated with me as I am experiencing all the symptoms that you describe ie anxiety, headaches, jitters etc. I am 66 and post meno and I have been guilty of tweaking my HRT over the years. My latest experiment has been to apply the 'less is more' philosophy and I am now using half a sachet of Sandrena gel which I think equates to 50mcg. Most of my physical meno symptoms have resolved over time but just recently I tried a quarter of a sachet and low and behold the physical symptoms of muscle aches, flushes, night sweats and vaginal dryness also joined the party! I assume this all points to a sensitivity to changing hormone levels.
Ali P and discogirl - I have been taking the AD Venlafaxine since 2013 which is the same time that I was prescribed HRT. I wonder if this AD has always affected my hormones and this explains why the HRT has not been totally effective?
Wishing you all well ladies.
K.
Hi Kathleen,
I think you would have to be on a high dosage of amitry for it to affect hormones. The study said anything from 50mg to 100mg. I'm only on 10mg of amity so not enough for it to really affect hormones.
I don't know about other AD's x
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Hello discogirl
Thank you for your reply.
I will see what I can find out about which ADs may affect hormones.
Over time my dose of Venlafaxine has been increased and I am now taking a 115 mcg tablet nightly. I know many ladies who are on higher doses of this and equivalent ADs. If there is a problem with taking both medications we need to know about it.
From my own experience I don't think that ADs reduce absorption of transdermal HRT as my blood tests record reasonable levels. Indeed my highest level was 600pmol/L which my clinic doctor said was good and that I should have been feeling great!?.
Take care.
K.
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Hello discogirl
Thank you for your reply.
I will see what I can find out about which ADs may affect hormones.
Over time my dose of Venlafaxine has been increased and I am now taking a 115 mcg tablet nightly. I know many ladies who are on higher doses of this and equivalent ADs. If there is a problem with taking both medications we need to know about it.
From my own experience I don't think that ADs reduce absorption of transdermal HRT as my blood tests record reasonable levels. Indeed my highest level was 600pmol/L which my clinic doctor said was good and that I should have been feeling great!?.
Take care.
K.
Hi Kathleen,
You're quite correct, I don't think the results regarding the amity study anyway were significant; and indeed it is quite safe to take amity with hrt.
Thanks for replying and take care xx
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pepperminty and kathleen - honestly it truly is a nightmare isn't it. I have been on the lower dose for 9 days and was doing better then for some reason last night started getting a lot of hot flushes and some anxiety and just could not sleep properly grrr. I am guessing the lower dose has now properly kicked in. I have my video consultation tomorrow wit the Meno consultant and the oestrogen blood level result so I will ask her many questions. :) I don't want to go back up on the dose again as felt far more ill on the higher doses and being 70 I honestly don't think I should need that much anyway. I guess it might be a question of toughing it out and my body adjusting to a lower dose and being on the same type of HRT for longer as I have been switched about so often over the past year I think it's really confused my system totally. Do hope you both are ok? xxxx
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Hello again ladies.
Pippa52 - When I'm feeling a bit better I think I should try and tough out the rubbish times but when the low mood and tearfulness strike I desperately want relief.
I moved to a quarter of a Sandrena gel sachet on the 9th of November and since this weekend I have observed more and more symptoms. The amount of VA type dryness that I experienced on Sunday reminded me of the sensations I had at the end of 2019 when I had been off all HRT for two weeks. Other mood stuff is also happening and I nearly cried in Sainsbury's this morning because I felt so low. Why can't we live with low Oestrogen levels when so many other women can? I despair at times like this.
Wishing you well despite it all!
K.
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Sorry to hear you’re struggling Kathleen. I know from previous posts you’ve had a tough time.
Hopefully an increase in Sandrena will give you a boost.
I don’t think this time of year helps either!
Take care
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Ali P so sorry you are suffering too. Like I have said many times I am most definitely coming back as a man!!! xx
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Ali P so sorry you are suffering too. Like I have said many times I am most definitely coming back as a man!!! xx
i second that pippa52!!!
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Discogirl & Pippa, how are you both getting on?
Had a total disaster with patches, gave me migraines, affected my bladder and ended up flushing every 2 hours last night so got no sleep at all!
So in total desperation I’ve applied 3 pumps of gel this morning. And will be staying with it until I see an improvement in symptoms.
Just need some quality sleep.
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Discogirl & Pippa, how are you both getting on?
Had a total disaster with patches, gave me migraines, affected my bladder and ended up flushing every 2 hours last night so got no sleep at all!
So in total desperation I’ve applied 3 pumps of gel this morning. And will be staying with it until I see an improvement in symptoms.
hi MIS71MUM
im ok thanks for asking.
i think ive realised that this is a marathon and not a sprint x
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Morning,
Pippa52 it sounds like you don’t absorb very well as your symptoms are what I have with low Estrogen, perhaps your bloods results will help to fathom it out.
Kathleen, it does sound absorb if you are getting more symptoms since dropping the dose. It is all trial and error.
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Floo - yes totally agree it should be low oestrogen symptoms but I get them when I am on a higher dose and much much worse. Hopefully I will know more this afternoon when I get my blood test results. Fingers crossed the level has gone up a bit as I feel better on a lower dose than I do on anything higher. Its all so confusing. aaaaagh xx
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Just had my telephone consult with the meno consultant. Pretty disappointing really my blood levels are even lower at 52pmol and that is on 2 pumps of Oestrogel. She said I am clearly not absorbing the gel properly as my level on 2 pumps should be in the region of 170pmol so it looks like I am going to have to change yet again - she would like me to change to a 25mg patch to start with which is a low dose but will be absorbed at a steady rate. Sadly that is not what happened when I was on them before but I have to give them one more try I guess. She said otherwise because I have begun to feel better on the Oestrogel it may be that we have to compromise with a low blood level but she said I will not be getting any bone protection etc which is one of the main reasons for me of being on it. She did also say she felt the gel strength was being rather up and down recently and several of her patients had said the same. Ho hum back to the drawing board but I just don't want to go back to feeling so ill again aaaagh :(
P.S. Having had a bit of time to think about things I have decided that rather than rush into changing medications AGAIN (6th time in under a year) I will ask to be referred to have a DEXA scan to see what shape my bones are in. Quite honestly if that comes back ok I think I would rather feel well and have a low oestrogen level than feel absolutely terrible with a higher one. Quality of life is very important after all and I have only been on the lower dose for 2 weeks so I think it's too soon to give up yet. The Meno consultant did also say if other methods make me feel unwell then staying as I am would be the only option xx
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Hi Pippa
Only just spotted your recent post. Gosh you really don’t absorb we’ll do you?
Also very interesting to hear your menopause consultant mentioning inconsistencies with the gel.
I’ve gone back on it, and apply 2.5 in morning and well rubbed in. 1 pump in the evening on thigh, again well rubbed in.
What’s your plans for the gel?
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MIS71MUM - no clearly I am a total non-absorber although funnily enough I certainly know when I've gone up a dose so I must be absorbing something but clearly not enough. Although advised to go back on patches I am really not keen at all as I felt so ill for the 3 months I was on them. I get a real rush the day I put one one and then the day after it declines rapidly and by the third day it does not seem to work at all plus I got constant migraines on them. I certainly don't want to be feeling that ill over Christmas either so at the moment I am continuing on the gel. Two pumps well rubbed in during the morning same time every day and what I might do is increase it very slightly over the next few weeks and see it that makes a difference. Meno consult has booked me in for a follow up in March with another blood test. In the meantime I have to decide whether to stick with gel and a low blood result or try the patches again but I will make that decision after Christmas :) I like the gel and would prefer to stay on it but it is definitely different from the Oestrogel I used to be on all those years which had Estradiol 17b in it and not the hemihydrate version which I know is only mixed with water but it has never worked as well for me as the old version. :(
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Hi Pippa52,
do you exfoliate? If you have lots of dry skin it may not be getting through? Or ask for no parallel imports with the gel on prescription? Liz Earle does this - so you get the original estrogen gel .
PMXX
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Hi Pippa52,
do you exfoliate? If you have lots of dry skin it may not be getting through? Or ask for no parallel imports with the gel on prescription? Liz Earle does this - so you get the original estrogen gel .
PMXX
hi pepperminty
saw your post and was very interested in what you say about PI.
im on oestrogel how do i know if mine is a PI. it does state oestrogel on the bottle x
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I don’t tend to exfoliate but will start now. I certainly don’t apply any lotions to the application sites as I know they can block absorption.
Discogirl - pi is usually called oestradose. But then there’s the whole other debate of Amber and Green square bottles which come from different countries!
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I don’t tend to exfoliate but will start now. I certainly don’t apply any lotions to the application sites as I know they can block absorption.
Discogirl - pi is usually called oestradose. But then there’s the whole other debate of Amber and Green square bottles which come from different countries!
yes i have amber at the minute and green for when amber runs out.
im dreading tbe green as my amber gel is settling the chronic insomnia and anxiety.
im hoping that i wont notice anything xxx
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pepperminty et all ....Wow that is interesting re dry skin as yes I do have very dry skin. I will definitely exfoliate from now on! I don't apply any moisturisers or lotions to the area either. I don't get the Oestrodose as that never worked for me. Have been on the Amber bottles of Oestrogel since going back on it although I do have 2 green bottles but I don't want to start on them and make things even more complicated - thankfully my monthly repeat script came up last week and they sent 2 amber bottles this time.! Really appreciate the input from everyone its so helpful getting tips and knowledge from everyone thank you all so much. I'm off to exfoliate the areas now!! :)
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Hi Pippa,
give it a go and use a mitt not scrub. Also can you get a blood test yourself for estrogen via medichecks - don't do finger prick as estrogen gel stays on the hands and effects the reading. You can either go to a local clinic for £30 of have a nurse come to your home for £50. It may be worth getting one to see if your measures work after a month or so? Good luck . xx
PMxx
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Hello again ladies.
Pippa52 Thank you so much for the update.
I am with Newson Health and they were keen to take blood tests and measure levels but the best I managed was about 600pmol/L and my moods remained changeable with periods of normality but also panic and tearfulness occurring daily. It was lovely when I felt well but distressing when the anxiety etc inevitably reappeared. The doctor at NH said that I should have been feeling great on those levels! I then developed tender breasts and heavy bleeding so I was forced to reduce the dose anyway.
Perhaps too much is made of blood levels and more attention should be focused on how we feel. I accept that bone health is important but surely some non HRT users have healthy bones and low Oestrogen levels?
Having said all of the above my levels were measured using Oestrogel and have not been looked at while I have been using Sandrena gel sachets. Your post has made me wonder if different gels absorb differently just as patches do.
I like your idea of staying with the gel for the time being with only a gentle increase. I have a similar plan until my next clinic appointment in January.
Wishing you well and let us know how you get on.
Take care.
K.
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Hi ladies - well today I have experimented with the Oestrogel application. I have taken up the kind advice given on here and exfoliated the area I apply the gel to and also I have changed the way I apply it. I was told to 'glide and pat' on the gel. Today I have chosen to apply it to a smaller area and simply put it on and let it dry and not even rub it in. I did some research on the internet and it was suggested a smaller area of application can give a more potent absorption and to let it dry naturally not rub in - bit like the patch I guess smaller area albeit only over 24 hours not days. No idea if it will make a difference but thought it was worth a try. Fingers crossed xxx
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Hi ladies - well today I have experimented with the Oestrogel application. I have taken up the kind advice given on here and exfoliated the area I apply the gel to and also I have changed the way I apply it. I was told to 'glide and pat' on the gel. Today I have chosen to apply it to a smaller area and simply put it on and let it dry and not even rub it in. I did some research on the internet and it was suggested a smaller area of application can give a more potent absorption and to let it dry naturally not rub in - bit like the patch I guess smaller area albeit only over 24 hours not days. No idea if it will make a difference but thought it was worth a try. Fingers crossed xxx
Hi Pippa52
Please keep me updated as I am on gel and I have scoured the internet (and on here) regarding the patting and letting dry or rubbing in only to find two opposing opinions.
I spread it on making sure it's even over my inner thighs and on my upper arm.
It will be interesting to know what happens.
I wish you all the very best and take care x
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discogirl - yes of course will definitely keep you informed. I am on 2 pumps which I spread on inner thighs. I had been doing the 'pat and glide' method so as of today have changed to a smaller area, not rubbing it in or pat and gliding just letting it dry naturally. xx
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discogirl - yes of course will definitely keep you informed. I am on 2 pumps which I spread on inner thighs. I had been doing the 'pat and glide' method so as of today have changed to a smaller area, not rubbing it in or pat and gliding just letting it dry naturally. xx
Well it's all a bit of conundrum to me;
I started on gel on 9th nov after trying patches. I'm on 3 and a bit of oestrogel, tried to go up to 4 yesterday but all my old symptoms of anxiety (which had gone!!) sleep issues (which were getting better) came back last night.
I've been having palpitations and strong hearbeats all day, so I went back down to 3 and a bit pumps this morning.
xxx
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Hello again ladies.
Regarding the area to cover with gel, when I was using pumps of Oestrogel/ Oestrodose the patient leaflet said something like ' for the area of skin to be covered see enclosed template ' however a template was never included.
When I began using Sandrena gel the PIL stated that the area to be covered was ' two palm widths '. I have been using this measurement ever since and this may be a useful guide for all gel products.
I hope this helps ladies.
K
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Hello again ladies.
Regarding the area to cover with gel, when I was using pumps of Oestrogel/ Oestrodose the patient leaflet said something like ' for the area of skin to be covered see enclosed template ' however a template was never included.
When I began using Sandrena gel the PIL stated that the area to be covered was ' two palm widths '. I have been using this measurement ever since and this may be a useful guide for all gel products.
I hope this helps ladies.
K
thats really helpful kathleen.
thank you x
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Kathleen - thanks so much that information is so helpful xxx