Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Bobidy on February 22, 2019, 10:00:03 AM
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Hi ladies
Can I check with Oestrogel users whether I need to really rub in the gel or just sort of smooth it onto the inner thigh and wait until it dries?
Also do you put all pumps on one inner thigh and alternate daily or put it on both inner thighs?
Apologies if I'm asking daft questions, I'm just trying to get everything straight in my head before I start.
Thanks x
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Hi there's been lots of debate about this and I'm not sure there's a right answer. I rub in till almost dry then wait a few minutes. I put 2 pimps on each shoulder/outer arm each morning x
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No question is daft on here - well....within reason ::) !
The rubbing of gel....
Well - that is one gel I haven't used - but I have used Sandrena, Testogel and Testim.
It is an interesting question. The instructions for Oestrogel ( as for Testogel) say to spread the gel onto the right area of skin and leave to dry, whereas for Sandrena and Testim they say to rub it in. The gels are all formulated differently - with Testogel and Oestrogel both made by Besins and exactly the same fillers. The others are different. Testogel ( as I presume as Oestrogel) just dries and soaks in, but Sandrena and Testim leave a sticky residue after the initial evaporation which takes somewhat longer to dry.
There is no problem with rubbing in - but it will be that the instructions on dosage will be based on a consistent method of application which in the case of Oestrogel and Testogel is by spreading, and studies looking at oestrogen levels.
I gather some gynaes do suggest rubbing it in like Sandrena and although the Oestrogel is much more slippery - it may be that higher concentrations are attained by doing it this way? I haven't come across research into this, only about the area the gel is spread onto. The most important thing is that the oestrogen needs to be absorbed before it dries so if it dries too quickly more of the active ingredient will remain on the surface, as I understand.
Women are so variable in how much oestrogen they absorb from the different methods that as Stellajane says - you have to do what's best for you - but if more is absorbed by rubbing I would be tempted to start off gentle and slow in your case (ie spread), as you said your periods were still very regular so you may well still be producing a lot of oestrogen - unless the aim in your case is to suppress ovulation and hence the dramatic hormonal fluctuations with a high oestrogen dose (after your op)?
The other thing is, whatever you decide ( rubbing or spreading) to use the same part of the body (left and right) as absorption will differ depending on your skin in different areas.
Hurdity x
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I just do as I'm told in this regard, the instructions say.
Oestrogel leaflet states:
"Spread the gel over a large area of skin on each shoulder, outer arm or mid-inner thigh."
EstroGel leaflet states:
"Spread the gel as thinly as possible from your wrist to your shoulder.
Do not massage or rub in EstroGel."
So I'm a spreader and get great/enough absorption from 1 pump every other day.
Think you can do it whichever way though it seems without any issue.
TD
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I have been spreading it on the front of my thighs. No wonder it's not working.veryvwell. for an intelligent girl I can be a real numpty at times!!
I have been wondering about something though, and maybe hurdity you might have a thought on this:
're rubbing it in, which I have been doing.
I was once told by a dermatologist to not use hands/fingers to rub in cream as a good proportion of it will be absorbed by your hands, especially if they are dry. That's why expensive face creams come with a little applicator.
With face cream it doesn't matter realy as it just means you're wasting an expensive face cream on your hands but.....
What about with the eastrogel? It's being rubbed into your hand at the same time as your arm/leg but unlike the application site (which you mustnt wash for an hour)its being washed off immediately.
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Interesting to read this thread. I'm on 6 pumps of oestrogel which is A LOT to just leave to dry. I used to spread it thinly on my legs and leave it to dry (with that much gel it takes more than a few minutes). After a failed attempt at patches I'm now rubbing the gel into my buttocks until dry and haven't noticed any difference in absorption so far.
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Interesting woodpecker. I'm on 4 pumps and have also wondered whether it's better to do 1 pump on each leg. And then another pump on each leg or to just pump out 2 doses at a time.
You'd think someone the manufacturers maybe, they're making enough money from it, would do some clinical trials about all these questions we are raising and come up with a more definitive answer on how to use their product for maximum efficacy.
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I wondered that too, is it being rubbed into hands as opposed to thighs?!
I always wash my hands after applying but there must be some getting absorbed
Don't know what we can do about it
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Well I've been rubbing it into the front of thighs 1 pump at a time. Before I started my E was 129pmol. I've just had a blood test which I get results on Monday
So we shall see....
I'll let you all know.
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Can anyone see a reason why you couldn't use some sort of spatula to spread it?
If your getting through bucket loads of it bcz not absorbing it properly could be worth a go.
Though no mention of it in the manufacturers patient info leaflet.
TD
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TC re your earlier point - yes I have thought that and intuitively I would never use (and never have used) whole hands (so perhaps not the window-cleaner approach ::) ) but a finger.
In terms of application area - this is given in the leaflet but actually the very detailed product info I read ( from the company that first produced the gel) did some trials to show that absorption was reduced if the gel was spread as thinly as possible over a wide area but on medium areas and below there wasn't much difference. I can;t remember the exact areas - but eg the whole of the inside leg (from top of thigh to ankle) was a no-no re absorption. Also will depend on the size of the women and amount of fat (girth) of legs etc!
However whatever works for you. I would started by spreading with one finger on medium sized area as per instructions and if after a given time symptoms return then perhaps try rubbing first - rather than increase the dose?
Another point is that Oestrogel is the only trandermal oestrogen that suggests applying to upper area of body and I see several of you put it on shoulders. Sandrena gel and all the patches say apply on lower abdomen below waist. I don't know why there is this discrepancy unless being ultra-cautious in case women misinterpret and put on upper inner arms etc which could be too close to armpit - breast?
I'm sure spatula would be OK if you could be bothered!
Hurdity x
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Hurdity thanks for the info about absorption trial.
My thighs are quite generous shall we say but then so are my upper arms.
My gynae originally told me to rub it in my forearm (less fat) but the instructions say upper arm. I chose legs for the same reason as you as I too was worried about transferring to breasts/armpits.
I do wish they would give an indication of area I.e. square inch or say size of a digestive buiscuit or a saucer or something like that.
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Hurdity thanks for the info about absorption trial.
My thighs are quite generous shall we say but then so are my upper arms.
My gynae originally told me to rub it in my forearm (less fat) but the instructions say upper arm. I chose legs for the same reason as you as I too was worried about transferring to breasts/armpits.
I do wish they would give an indication of area I.e. square inch or say size of a digestive buiscuit or a saucer or something like that.
Skin area to apply each pump of Oestrogel should be about the size of a sheet of A5. I read this on here somewhere but can't remember where. I think it might have been in one of Conolly's posts. When I used it I was a spreader rather than a rubber (as per instructions at the time). I used to use the back of a tablespoon to spread. It took at least 15 minutes to dry this way. I didn't absorb well though, but perhaps that was just me.
JP x
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It's not about it being absorbed into the hands, at least it would be getting into the system somehow and that would be fine with me . But we wash the hands straight after to stop transfer. However we are told not to wash the application site for an hour presumably because it would interfere with absorption. Therefore we are not getting any benefit from the gel on our hands.
When you're struggling to get your e levels up on 4 pumps you have to consider why.
JP thanks. For that. A5 is roughly what I have been doing
Maybe I just don't absorb well either.
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My gyn was very clear about where I ought to apply it, which was below the abdomen.
I'm a size 16, my inner thigh which is where I spread the gel is in no way thin or void of fat, but not huge either. I still get great absorption from one pump.
TD
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Here is the information on size of area from the Summary of product Charatceristics for oestrogel:
https://www.medicines.org.uk/emc/medicine/19898/SPC#POSOLOGY
4.2 Posology and method of administration
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Method of Administration
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The correct dose of gel should be dispensed and applied to clean, dry, intact areas of skin e.g. on the arms and shoulders, or inner thighs. The area of application should be as large as possible at least 750 cm2. One pump actuation from the dispenser, or half the prescribed dose, should be applied to each arm/shoulder (or thigh). Oestrogel should NOT be applied on or near the breasts or on the vulval region.
Oestrogel should be allowed to dry for 5 minutes before covering the skin with clothing.
The gel should be applied by the patient herself, not by anyone else, and skin contact, particularly with a male partner, should be avoided for one hour after application. Wash hands with soap and water after applying the gel. Washing the skin or contact with other skin products should be avoided until at least one hour after application of Oestrogel.
For initiation and continuation of treatment of postmenopausal symptoms, the lowest effective dose for the shortest duration (see also section 4.4) should be used.
For people not being treated with Oestrogel:
In the event of contact with an application area, which has not been washed or is not covered with clothing, wash the area of skin onto which Oestrogel may have been transferred as soon as possible, using soap and water.
Unfortunately the patient leaflet - which is what patients are given - is vague and just says "over a large area"
Hurdity x
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Hi girls!
Been thinking about what TC said re wasting gel bcz of using your hand to apply, then having to wash off the gel from them bcz of contact issues.
Got me thinking what I could use instead of my hand and came up with those silicone make up applicators...genius right!
Gonna get me some asap from Primark where there pretty inexpensive.
Can have one for testogel too. I'm thinking pink for oestrogel and blue sillcone for testogel.....I know...I really need to get out more!
Here's a couple of links to some
https://www.revolutionbeauty.com/en/gb/Revolution-Ultimate-Silicone-Sponge-Set/m-2457.aspx?utm_source:UK_PPC_SHG&gclid=CjwKCAiAqt7jBRAcEiwAof2uKx8Ou_g9RVUGly3ZmilLDF6tbhiDs9MesRisH7UQBAoZWtbhIqKlZBoCRKgQAvD_BwE#fo_c=2784&fo_k=b12cce0ef05008646111c84e507a4d7f&fo_s=gplauk
Wow that ones a mega link lol
https://www.superdrug.com/Make-Up/Makeup-Application-Tools/Make-Up-Sponges/Superdrug-Spaa-Silicone-Mask-Applicator/p/747117?gclid=CjwKCAiAqt7jBRAcEiwAof2uK8WOWMM3uWuxdUWv1_AWt9L9cNoAR4vU0F9x7mf7vwq8f4_Pi4Xr8RoCJBcQAvD_BwE&gclsrc=aw.ds
TD
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A blood test showed I wasnt absorbing it.
My level hadn't increased at all. I dont think that can be purely down to application technique. I think it must come down to how well you personally absorb.
I've changed to estradot yesterday 75mg. Its leas than 4 pumps gel but if I absorb it better might not need the 100 dose.
Must say Ive been sweating continuously for 24 hours solid but I have picked up a horrible virus so that might be why.
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After reading another thread I've just realised eastrogel and eastrodose are slightly different. I had just thought eastradose was a brand name for the same product. Apparently it's not. So all this time I've been saying I was using eastrogel I have been using eastradose.
Just wanted to clear that up case anyone searching for info sees that ive posted about not absorbing eastrogel when in fact it was eastradose.
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Hi Tc - do not fret - they are not different at all! I wrote to the manufacturer and they are the same gel made by Besins in Belgium or France but packaged differently. If you check the leaflet with yours it should say where it was made. It is still oestrogel because that is what it is known as in this country. Exactly the same ingredients, same gel made in the same factory (or whatever you call it!).
Any issues you have with absorption will be to do with you individual differences. Absoprtion of different types of hRT varies hugely.
I hope you manage to absorb the estradiol better from the patches :)
Hurdity x
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Thanks for clearing that up hurdity. Keeping my fingers crossed for the estradot