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[ellmcdee]

Hello there
I posted a while back when i just started on (sept 2016) oestrogel ( 2 pumps) and utrogestan (2 tabs orally days 15-26) and things seemed to be ok until end of last year - more hot flushes in the day, bad nights sleep, hot, grumpy etc. Upped my gel to 3 pumps but this past 6 months just feeling more and more tired, grumpy, fatigued etc. The bleeds on utro were a bit hit and miss, sometimes get them, sometimes not, sometimes heavy sometimes not, and all usually 3 days before i actually finish the tabs.

Via HRT review with GP in March where she didnt really know what i should be getting re bleeds she sent me to gynaecologist.

Recently have had pelvic ultrasound, trans vaginal scope and blood test for oestradiol. Results show low oestrogen 253pmol/L, 2mm thick lining, and numerous small fibroids and cysts, with a fibroid probably pressing into endometrium causing bleeding as with that oestrogen level and womb lining Gynae says i shouldnt be having a bleed and thinks i'm not absorbing the oestrogel.

she wants to do a hysteroscopy, look at fibroids and possibly fit a Mirena coil and put me on Zumenon tablets for oestrogen part.

Couple of questions - has anyone else stopped absorbing the gel ( or patches)? I'm now trying different sites. previously was putting on outer thighs only. until hysteroscopy later next month i'm now using inner thighs, inner lower arm and shoulder. 3 pumps is a lot of gel to dispose of!

and is anyone else on this potential new regime - coil and zumenon? wasnt keen on coil and tabs but current regime doesnt seem to be working.

any thoughts/advice gratefully received from this excellent forum.

Ell
P.s. was peri at 43, struggled with symptoms, trying to treat with natural remedies, jan 2016 last period, sept 2016 started HRT as on my knees with insomnia and night sweats.

[Dancinggirl]

Hi ellmcdee

The Mirena would be a good idea if you have fibroids and problematic bleeding.   Unfortunately Utrogestan isn't a stable progesterone type and many women, like myself , find it causes erratic bleeding.
Your oestrogen levels are not bad but I am surprised it is so low on 3 pumps of gel per day.  Do you divide the doses to morning and evening? Do you apply it over a good area on inner thighs and allow to dry for at least 10 mins? before covering? If you use outer thighs or use any type of moisturiser on the area you use for application, then it won't absorb. If I were you I'd do one dose on each inner thigh at night after a shower and then in the morning wash your inners thighs and apply one dose.  You could try the oestrogen pills but maybe you need to be more specific with application with the gel - although pills are easier to manage.
I also found that Utrogestan gave me flushes and quite bad ones!!!!

In my 50s, I had the Mirena and used 2 pumps of Oestrogel for 4 years in post meno and found this the best HRT option at that time. The Mirena will protect the womb lining better and will usually shrink fibroids.  Dg x

[ellmcdee]

Thanks Dancinggirl

 i think i'm pretty good at letting gel dry since i started using it, occasionally would feel it stick to clothing.
since upping to 3 pumps in Dec 2017 i have put it all on in the morning. at night not sure if that would be good idea as i think it says no close skin contact with partner for up to an hour afterwards, not sure that would go down well!

do you think outer thigh is not a good area?
i always apply to clean skin.
i'm now being really careful with application and drying and will see how i feel come 17 July when have hysteroscopy.

thanks

[Tinkerbell]

I have always applied my estrogel across my shoulders and absorb it very well.
How much of any area are you spreading it over?

[Optimist]

Hi ellcdee, I trialled the gel for 5 months and was on 4 pumps and still wasn't feeling like I was absorbing. My gp wouldn't do a blood test so I asked for 100mcg everol patches (I have the Mirena also) and my god I feel so much better! 2 weeks in, so fit me same as you I reckon although no blood test to back it up. There was also a supply issue half way through my using the gel and I was given oestrodose as a substitute, god it was awful, chronic headaches had to stop all hrt for 3 days doctors orders! So for me the patches are the best. I would try those and you may need a high dose to start to get some oestrogen in your body or try tablets. It's your body and we're all different. Good luck and let us know how you get on 😊 x

[Tinkerbell]

It's funny how we are all different, I didn't absorb enough from patches but the estrogel has been life changing!

[Nikkisyard]

It would be interesting to do trials with patches and gel... with regular and consistent blood tests to see if there is anything that makes the difference with absorption... perhaps there is one?

[Joaniepat]

ellmcdee, they told me at the meno clinic that they recommend Oestrogel be applied to outer thighs. I doubt there's any consensus amongst the medics as to where it is best applied. Application site for gel has often been discussed on the Forum, and it seems to be a matter of personal preference.

Dancinggirl, is this something new, that gel applied to outer thigh won't be absorbed?

JP x

[Dancinggirl]

 When I used Oestrogel (I first used Oestrogel in the early 1990s), it clearly stated in the instructions to apply to inner thighs or upper arms, on clean, dry skin. I didn't like to apply it to upper body as I didn't want it anywhere near my breasts, so I just applied it to inner thighs.  I got a level of between 500-600pmol/L on just 2 pumps per day.  I simply assumed the skin is thinner on the inner thigh and upper arm areas so absorption would be better.  The skin on the outer thigh tends to get more friction so the skin is tougher??!!
It really does seem to vary very greatly as to how well women absorb this gel!!!!

Here are the instructions I have found on the net:
6. Apply the gel to either:
- the outer arm and shoulder of both arms,
or
- the mid-inner thigh of both legs.
7. Do not apply on or near the breasts, or near the genital area.
8. Spread the gel over a large area of skin on each shoulder, outer arm or mid-inner thigh.
9. If your doctor has prescribed 2 measures of gel, spread 1 measure over each outer arm and
shoulder, or each mid-inner thigh. If 4 measures of gel have been prescribed, spread 2
measures over each outer arm and shoulder or each mid-inner thigh. (See steps 4-8).
10. Cover the spout using the attached stopper.
11. Replace the cap.
12. Leave to dry for 5 minutes before covering with clothes.
13. Wash hands with soap and water after applying the gel.

Another set of instructions I found also said that you only need to allow one hour after application before close contact with someone else.

I always allowed at least 10 mins for the gel to dry as well - just to make sure it had absorbed.

I don't think it has ever been right to apply this gel to outer thighs.  I'm afraid doctors don't always read instructions fro medication!!!!!

I hope that helps. DG x

[ellmcdee]

Thanks ladies for all the advice.
it is amazing how different we all are and how 1 size definitely doesnt fit all!
I'm about to go on holiday ( sunscreen needed), and have been reading about timing etc. of gel application. Will be careful to make sure clean skin and max time to absorb before lathering up with sun lotion!

Ell.

[Daisydot]

Hi elimcdee I'm just back from holiday and I found the best plan was to shower after I'd done my sunbathing and before gettin* ready for dinner and apply my oestrogel then,that worked very nicely for me so I could apply my suntan lotion and not worry about getting burnt.
Have a fab holiday x