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[Bring me Sunshine]

Just to add my pennys worth I had read everything about oestradose v estrogel at length.  I fell ill again the end of December and noticed I had been on oestradose for 6 weeks.  I looked at the ingredients and both the same although the oestradose smelt more alcholy.  I went to the drs and took them both in and she said a number of women had said it wasnt as effective.  I then went to the pharmacy with them both and he told me that when he worked in Oxford and now where I live women kept coming in saying their symptons returned on oestradose.  I reported it to the yellow card and also sent an email to Besins.  I got an email back from India where my oestradose had been tracked back to and they were looking into it.  I havent heard back as I would have reported the findings here if anything concrete was found.  I could see that a lot of women are fine on the oestradose.  I changed to patches and recently had to add in some gel but estrogel.  Still not found  a stable balance as yet.  So im a bit on the fence between the 2. What hurdity has written in length makes perfect sense but I suppose you have to go on how you are feeling.

[Bobidy]

Yes I can see it from all viewpoints and personally too.

I'm hoping Dr Zoe etc can get to the bottom of it.

I emailed Besins at the beginning of the year and had the standard reply that they are all the same. But I know that the round canister/clear top was super effective and the shaped turquoise one wasn't for me only at double the dose.

I'm very happy with the patches now but for other ladies I'd like this sorting out.

[Bobidy]

Hi all

Quick update, Dr Zoe has just posted this advice on Menopause Doctor, I've not found the link yet but this might be useful to print out and take to the doctor. I hope this helps x


Oestrodose
Did you know that there are two different versions of Estradiol gel on the market, Oestrogel and Oestradose?

Oestradose is a parallel import, and although both are manufactured by Besins, Oestradose is supplied to pharmacies from other companies and therefore does not stay under Besins' strict control.

We have had many reports from women who say that they experience a return of symptoms when using Oestradose, so if you would prefer to always use Oestrogel then here are a few things that may help to keep continuity of supply:

Ask your GP to put the word ?Oestrogel? on the prescription rather than 0.06% Estradiol. This is known as a ?named prescription? which entitles you to request the specific version that you wish to have dispensed.
The pharmacy can order Oestrogel from several suppliers including AAH, Alliance and Phoenix by entering the ?PIP code? 217-1775. At the time of writing there is plenty of stock in the UK.
It can be helpful to take an old bottle of whichever gel suits you to check the new prescription against, as the parallel import products are over-labelled with a sticker saying ?Oestrogel?.
Make sure you check the product whilst still in the pharmacy. If you have been given the wrong version, then as long as you haven't left the pharmacy, you are entitled to ask for a return of your paper prescription.
If you had an electronic prescription and the pharmacist is unable to dispense the version that you have requested, they can send the prescription back to 'the spine? and give you a token code. This can be taken to a different pharmacy to request a new order.
The findapharma.co.uk service may be able to help you locate a pharmacy that can order the version you prefer.
If you find that Oestrodose is effective for symptom relief then we would advise continuing with it.

If you have experienced side effects with either versions you should report these via the Yellow Card Scheme. You will need to enter the batch number of the product as well as other details such as duration of use and side effects experienced.

[lillith112]

I've just reported mine under Yellow Card, I put it under the 'defective ' category.  Had a confirmation email back, see what happens.

Lillith.

[Bobidy]

Hi all

Another quick update on this.

Liz Earle has done a quick podcast which includes Dr Zoe in which they discuss this issue in detail which is worth a listen https://lizearlewellbeing.com/friday-five-hrt-scandal-and-gut-health/

I've found the leaflet you might want to take with you to the gp/pharmacy which explains the problem https://www.menopausedoctor.co.uk/menopause/oestrodose

There is a yellow card app that you can download to report if the product is not working.

You can ask your gp to put 'no PI' on your prescription. This means you won't get the parallel import inferior product.

Again, if you have no problems with Oestrodose don't worry about it.

It sounds like this is going to be an ongoing investigation now for Liz and Dr Zoe which is fantastic to finally have some umph behind it, so I'll keep you updated on any progress x

[Hurdity]

I listened to thepodcast and looked at the leaflet. I'm afraid I find Liz Earle very annoying and actually quite irresponsible the way she talks about it as an HRT scandal. Get real FFS!  it's not a scandal, it's a parallel import ie PI per se is not scandalous.  People dying in care homes from Covid  19 is a scandal.  Care assistants having to go to work with Covid due to lack of sick pay is a scandal. What would be scandalous would be if the company responsible for the parallel imports were pulling a fast one and eg re-labelling old stock?  She starts off the podcast by saying the scandal is that it does not work which is absolute rubbish.  There will be thousands of women out there perfectly happy with it. it's estradiol  0.06% gel manufactured and put in sealed  pouches by Besins and their stability studies have been conducted at high temperatures: ?However, the stability studies are made on products not leaving the factory and stored in the optimum conditions for the complete shelf-life period, although we have stability studies for the following conditions: 25℃ & 30℃ for 36 months and 40℃ for 6 months.?

If the PI company (eg Chemilines) is storing it somewhere at temperatures higher than this then the product could deteriorate, or if using old stock obviously this would be illegal.

There are also other PI companies and there are equally large numbers of women who have not and do not notice any difference ? but of course like on this forum, we would not hear from them.

Like I said pretty much all of what she reports and Dr Zoe,  is what I found out two years ago and you can read about on the long (meandering)thread but you?ll need to ignore some of the conspiracy theory stuff and inaccuracies on there re carbomers or something can't remember now! 

Dr Zoe also was a bit confusing in the podcast because towards the end she said that Besins dealt with Oestrogel and the PI companies with Oestrodose which is not the case as you will see from my extract.  Just to remind you Oestrodose is produced by Besins for other EU countries. The PI companies buy that (presumably there is more of it so it's cheaper?) and repackage it. If you had estradiol 0.06% gel prescribed in France you would get Oestrodose because they don't call it Oestrogel there. it's not a different product. Again it is not a generic.

They talk about having personalised letters from Besins rather than standardised responses ? but in fact all of my responses were personalised detailed responses to individual queries I posed in e-mails to them and were sent by named individuals. This is because it was before everyone started writing. Right early on we suggested that anyone who had problems needed to report the product under the yellow card scheme along with the batch numbers so that the product could be tested. If it was found to be  either old or stored at too high a temperature for too long then it would be important to know this and as I said Besins would want to know.

Anyway it's good that people report under the yellow card scheme but not sure whether that does lead to testing? Personally I would also copy the info including the batch number and the PI company, to Besins itself so they can maybe do their own investigation.

Much of this was advised two years ago. A few of us back then did try to contact Chemilines (admittedly not by phone) but never received a reply so we were also looking to investigate this as a potential issue.

However it would be utterly wrong for anyone to listen to those podcasts and to think that they are not getting Besins 0.06% estradiol gel.  The important thing for women who are sensitive to minute changes, is to stay with whatever you have been using and the advice on how to get whatever you need is helpful.

Patches will be less prone to leading to fluctuations although as already said, temperature of the skin, ambient temperature  and a host of other factors will all affect how well gel is absorbed.

Dr Zoe and Liz Earle also conflated the issue of parallel imports with that of generics, which is a totally different issue. Oestrodose is not a generic.

OK that was a bit of a rant but this is not a new issue!  I feel it's a bit of a bandwagon - Liz Earle's podcasts - and can get women worried when they needn't be. Hopefully we will hear if Chemilines is not storing the product as it should be stored.

Anyway enjoy your weekend girls with whatever easing of the lockdown brings for you, in terms of family and friends!

Hurdity x

[lillith112]

I've had a reply back from my yellowcard report, they will conduct an investigation to be passed onto Besins or somewhere else can't remember the name. I'm to hold onto my bottle of gel in case they want it for testing etc.

I also e-mailed Besins, but e-mail bounced back undelivered for some reason.

Lillith.

[GypsyRoseLee]

This is a subject I have followed with great interest. I have used both products and I know that gel from an Oestrodose bottle is slightly thinner and runnier than gel from an Estrogel bottle. If the carrier gel is thinner and more watery then this will affect how it's active ingredient is absorbed. And, with gel, consistent absorption is absolutely key to controlling symptoms.

The only reason that other companies want to distribute Estrogel as a parallel import is in order to make money from distributing it. So, I suspect that these other importers might cut corners to maximise their profits. So, it could well be that their storage and transport facilities are insufficient for purpose?

When I was a patient of Prof Studd I used the private pharmacy he recommended, just off Harley Street. The pharmacists were incredibly helpful and knowledgeable. They told me that they never even stock Oestrodose because the private doctors they supplied considered it inferior to Estrogel.

[GypsyRoseLee]

I do know there is a definite difference in the consistency of the gel between the two products. Oestrodose is definitely thinner and runnier.

[DS68]

I watched the you tube video and gosh what an eye opener, I also did what she suggested by pealing the label the pharmacy put on the gel  and it revealed that the oestrogel was actually ostrodose  😳

Shocking that pharmacies are allowed to do that.

I have made notes and will be mentioning it next time I put on prescription (if I don't forget ofcourse  )

[Tinkerbell]

Everytime i have used the estradose i have got a spotty itchy skin rash on my shoulders , something i never get with Estrogel, but i have been told on more than one occassion on this site that there is no difference. I have fortunately found an independent chemist who are happy to order Estrogel in so i go there now.

[Bobidy]

I think for those of us that re maybe more sensitive to hormones any change to our hrt has real symptoms. Some ladies are maybe not as sensitive and therefore the Oestrodose / Estrogel thing is not a problem, which is great.

It's good to have the info and tools to get what we want though x

[Hurdity]

Everytime i have used the estradose i have got a spotty itchy skin rash on my shoulders , something i never get with Estrogel, but i have been told on more than one occassion on this site that there is no difference. I have fortunately found an independent chemist who are happy to order Estrogel in so i go there now.

Hi Tinkerbell - it is precisely this sort of reaction that is intended to be investigated under the yellow card scheme.  An allergic reaction is totally different from a perceived difference in efficacy of a medication and must be reported both to the MHRA and to Besins as it would indicate potential fraud, given the provenance of the gel. It was ongoing speculation about different ingredients between the two named products that led me to contact Besins in some depth a couple of years ago, and which established that in fact (from Besins)  there were no differences in ingredients or proportions, and that any differences, if there were any, would occur after the products left the manufacturers.

Hurdity x

[Hurdity]

I watched the you tube video and gosh what an eye opener, I also did what she suggested by pealing the label the pharmacy put on the gel  and it revealed that the oestrogel was actually ostrodose  😳

Shocking that pharmacies are allowed to do that.

I have made notes and will be mentioning it next time I put on prescription (if I don't forget ofcourse  )

Hi DS68

I think it would be shocking if a generic product manufactured by a different company were passed off as the branded product but in this case I don't feel it is shocking as such really. Having watched the video also I think unfortunately Liz E is being somewhat melodramatic and scaremongering to the many women who are perfectly happy using Besins estradiol  gel whatever it's called, and it is marketed in good faith (as much as any pharma product can be  !)

The main point about the over-labelling as I do keep saying, is that it is a different name Oestrodose given to the same product (Besins estradiol 0.06% gel), lavelled as such for different markets. If it were different then Oestrodose would be an alternative product licensed in UK but it does not exist on the EMC database of medicines. The storage conditions or some other shady business going on, from what I gather remain a potential means of differences but that has not yet been demonstrated.

Hi GypsyRoselee!

Hope you're doing OK? If you do see a difference in texture then again this should be reported because analysis would confirm any differences.

Hurdity x

[Donna-paul]

Well I know I'm not going crazy and was one of the first people who brought up about oestrodose. I react to oestrodose and cannot use it and have filled in the yellow card. My pharmacist knows he had to get me the original estrogel but once again I've been given this month a bottle with a oestogel label stuck on the oestrodose bottle . I didn't notice straight away so started to use it and once again I had the same side effects  hence I had good look at bottle and found label stuck on top!! So be careful the women like me who can't use it as they are now sticking labels on top🤷‍♀️