Oestrogel

Oestrogel is a type of hormone replacement therapy (HRT) used to relieve menopause symptoms caused by low oestrogen levels. It’s a transdermal gel, which means it’s applied directly to the skin, where the hormone is absorbed into your bloodstream. The active ingredient is estradiol, an artificial oestrogen that is identical to the body’s natural oestrogen.

Oestrogel is used to:

• relieve menopause symptoms such as hot flushes, night sweats, and mood changes
• treat vaginal dryness and discomfort
• help prevent osteoporosis in postmenopausal women at high risk of fractures when other treatments are not suitable

Each measured dose of gel delivers a specific amount of estradiol through the skin, with the usual dose being 2 pumps a day.

Oestrogel works by replacing the oestrogen that your ovaries naturally produce before menopause. During menopause, oestrogen levels fall, which leads to symptoms such as hot flushes, night sweats, low mood, and vaginal dryness. By restoring these hormone levels, Oestrogel helps reduce these symptoms.

Because it’s applied to the skin, Oestrogel delivers estradiol directly into the bloodstream, avoiding the digestive system. This can help maintain more stable hormone levels.

How long does Oestrogel last?

Oestrogel is applied once daily, and each dose provides a steady release of oestrogen over 24 hours. A single bottle of Oestrogel will usually last between a few weeks to over a month, depending of how much is being used.

How long does Oestrogel take to work?

In studies, relief of menopause symptoms was reported within the first few weeks of treatment. It can take a few months of daily treatment to get the full benefits of Oestrogel.

How effective is Oestrogel?

Oestrogel has been used and studied for over 40 years, with many clinical trials proving its highly effective in reducing menopause symptoms, including mood changes and vasomotor symptoms like night sweats and hot flushes.

It’s also been proven to reduce the risk of hip, spine, and other fractures in healthy women, as well as prevent fractures in women diagnosed with osteoporosis or low bone density.

Oestrogel comes in a pump pack. It should be applied once a day, at the same time each day if possible. It does not matter what time you apply it, so choose a time that suits you. The usual starting dose is 2 pumps per day, but your doctor may adjust your dose depending on your symptoms.

Oestrogel should be applied evenly on clean, dry, and unbroken skin on either:

• each outer arm
• each shoulder
• the mid-inner thigh of both legs

Preparing your Oestrogel pump

When you first get your Oestrogel pump, you will need to prepare it. To do this:

1. Remove the cap and stopper from the plunger.
2. Press the plunger down a few times until the gel starts to come out.
3. Discard any gel that comes out of the plunger this way.
4. Your Oestrogel pump is now ready for use.

Using your Oestrogel pump

When you’re ready to apply Oestrogel, follow these steps:

1. Press the pump to dispense the gel into your hand.
2. Spread the gel over a large area of skin – if you have been prescribed 2 pumps, apply 1 pump to each arm, shoulder, or thigh. If you are taking 4 pumps, apply 2 pumps to each.
3. Allow it to dry for 5 minutes before dressing.
4. Wash your hands with soap after applying.

Make sure that nobody else comes into contact with your Oestrogel pump or the area of skin you’ve applied it to until it’s completely dry. If you think this has happened, get the person to wash the area straight away with soap and water.

You may be running out of Oestrogel when the pump does not return to its original position after using it. When this happens, you need a new Oestrogel pump as it will no longer be providing the correct dose.

Where should I not apply Oestrogel?

Do not apply Oestrogel:

• on or near the breasts
• on the genital area
• to broken or irritated skin

How long do you need to take Oestrogel for?

You can take Oestrogel for as long as needed to manage menopause symptoms, as long as it remains suitable for you. Your doctor will review your treatment regularly. HRT is usually used for 2 to 5 years to manage menopause symptoms.

What if I take too much Oestrogel?

If you take too much Oestrogel, let your doctor know. You might get symptoms like nausea (feeling sick), breast tenderness, or vaginal bleeding. These should go away within a few days.

What if I miss a dose of Oestrogel?

If you miss a dose and it’s less than 12 hours since it was due, apply your missed dose straight away, then continue taking it at your usual time.

If you miss a dose and it’s more than 12 hours since it was due, skip the dose. Never take 2 doses to make up for a missed dose. Missing a dose can cause breakthrough bleeding or spotting.

Important: Any change in bleeding pattern from taking too much Oestrogel or missing doses should resolve quickly once you return to your prescribed dose. If unexpected bleeding continues, speak to your GP for a review.

Oestrogel can cause side effects, although not everyone will get them.

Common side effects (may affect up to 1 in 10 people) include:

• headache
• breast pain or tenderness
• irregular vaginal bleeding or spotting
• painful periods
• heavy or longer-lasting periods
• stomach pain
• nausea
• white or yellow vaginal discharge
• weight change

Uncommon side effects (may affect up to 1 in 100 people) include:

• mood changes, including low mood and mood swings
• feeling weak
• migraine
• vertigo
• wind
• vomiting
• increase in the volume of the uterus
• intense itching called pruritus
• vaginal yeast infection (thrush)
• inflamed vagina causing discharge, itching, and pain (vaginitis)

Rare side effects (may affect up to 1 in 1,000 people) include:

• change in sex drive (libido)
• acne
• high blood pressure
• intolerance to glucose, which may affect your blood sugar levels
• bone pain
• epilepsy symptoms may get worse
• changes in liver function, which may show on a blood test
• a severe allergic reaction (anaphylaxis), especially if you have a history of allergies

Very rare side effects (may affect up to 1 in 10,000 people) include:

• an intolerance to the use of contact lenses

For more information on side effects, check the patient information leaflet included with your medication.

Serious side effects

Stop using Oestrogel and see a doctor straight away, or call 999 in an emergency, if you notice any of the following:

• yellowing of the skin or the whites of your eyes (jaundice), which may be a sign of liver disease
• swelling of the face, tongue, or throat, difficulty swallowing, hives, or breathing problems, which are signs of a serious allergic reaction – call 999 straight away, this is an emergency
• a large increase in blood pressure, with symptoms such as headache, tiredness, or dizziness
• migraine-like headaches that happen for the first time while using Oestrogel
• pregnancy symptoms, or you test positive on a pregnancy test
• signs of a blood clot, such as painful swelling and redness in the legs, sudden chest pain, and difficulty breathing

HRT can slightly increase the chances of certain serious conditions, such as:

• cancer of the breast, ovary, or lining of the womb
• abnormal growth of the lining of the womb (endometrial hyperplasia)
• blood clots in the legs or lungs
• heart disease
• stroke
• memory loss if you start HRT over the age of 65

These risks decrease once you stop HRT, but it can take several years or longer for the risk to go back to how it was before starting HRT for conditions like cancer. Your doctor will monitor you during treatment, and it’s important to go to any cervical cancer screenings or mammograms that you are invited to.

You should also regularly check your breasts and report any side effects that you get on HRT to your doctor. Because of the increased risk of these side effects, a doctor will make sure your medical or family history does not put you at an increased risk before starting HRT, or may recommend a different treatment that does not contain hormones.

How long do Oestrogel side effects last?

Side effects are more common when you first start treatment and usually improve within a few weeks to a few months as your body adjusts. Serious side effects can develop at any time, so report any changes to your doctor straight away.

What to do if you get Oestrogel side effects

If you get Oestrogel side effects, let your doctor know, especially if they continue or get worse over time. You can also do some things to manage side effects at home, such as:

• applying the gel to a different area of skin each day to help reduce skin irritation
• taking over-the-counter painkillers to help manage headaches or general pain
• staying hydrated
• eating a balanced diet and doing gentle exercise to help with weight and mood changes, and digestive symptoms

Do not use Oestrogel if you:

• are allergic to estradiol or any of the other ingredients in the gel
• have or ever had breast cancer, or if it’s suspected
• have or are suspected to have oestrogen-sensitive cancer, such as cancer of the womb lining (endometrium)
• have unexplained vaginal bleeding
• have untreated thickening of the womb lining (endometrial hyperplasia)
• have or have ever had a blood clot in a vein, such as deep vein thrombosis (DVT) or a pulmonary embolism
• have a blood-clotting disorder, such as protein C, protein S, or antithrombin deficiency
• have or recently have had a disease caused by blood clots in the arteries, such as a heart attack, stroke, or angina
• have or have ever had liver disease and your liver function has not returned to normal
• have porphyria, a rare inherited blood disorder

You should speak to your doctor before using Oestrogel if you have:

• epilepsy
• asthma
• diabetes
• migraine or severe headaches
• high blood pressure
• gallstones
• fibroids inside your womb
• endometriosis, or a history of excessive thickening of the womb lining (endometrial hyperplasia)
• a liver disorder, such as a benign liver tumour
• very high levels of fat (triglycerides) in your blood
• fluid retention caused by heart or kidney problems
• a disease of the immune system affecting multiple organs called systemic lupus erythematosus (SLE)
• otosclerosis, a condition affecting the eardrum and hearing
• hereditary or acquired angioedema
• an increased risk of blood clots
• an increased risk of oestrogen-sensitive cancers, such as a close family history of breast cancer, like your mother, sister, or grandmother

You can get Oestrogel prescribed from a doctor, either through online regulated healthcare services like Asda Online Doctor, or from your GP. Oestrogel is a prescription-only medication, so it cannot be bought over the counter.

Can I buy Oestrogel online?

Yes, Oestrogel can be prescribed online from Asda Online Doctor and other regulated services.

To get Oestrogel through our HRT service, follow these steps:

1. Complete a medical questionnaire – provide details about your symptoms and medical history through our secure online consultation form.
2. Submit your request – log in or create your account and provide payment information.
3. Doctor review – a registered doctor will review your information and decide if Oestrogel is suitable for you or if another treatment is more appropriate.
4. Prescription and dispensing – if approved, your treatment is prescribed and dispensed by our registered pharmacy.
5. Delivery or collection – your medication can be delivered to your home or collected from an Asda Pharmacy near you.

If you’re not sure whether you are in menopause, completing the Asda Online Doctor medical questionnaire will allow a doctor to check your symptoms. They can let you know if HRT is suitable, or if you need to see your GP.

Can I buy Oestrogel over the counter?

No, Oestrogel is not available over the counter. It is a prescription-only medication because it contains oestrogen and requires medical supervision during treatment.

Can I get Oestrogel on the NHS?

Yes, Oestrogel is available on the NHS. You can be prescribed it by your GP or a menopause specialist after a consultation. Your doctor will assess your symptoms, medical history, and whether Oestrogel is the most suitable HRT option for you before starting treatment.

There is a range of treatment options available for menopause symptoms, including hormone replacement therapy (HRT) and non-hormonal medications. The most suitable option will depend on your symptoms, medical history, whether you still have a womb, and personal preference.

Alternative menopause treatments available through Asda Online Doctor include:

Combination HRT patches

These patches are applied directly to your skin twice a week: 1 for 3 days and the other for 4 days. They contain oestrogen and progesterone. Some are used if you no longer have periods, others are more suitable if you still have periods. You only need to take progesterone if you still have a womb.

Combination HRT patches include:

• Evorel Conti – contains estradiol and norethisterone
• Estradot Conti – contains estradiol and norethisterone in two dose strengths (30mcg/95mcg or 40mcg/130mcg)
• Evorel Sequi – contains estradiol and norethisterone and is taken sequentially, so can be used if you still have periods

These are used for all menopause symptoms, particularly in postmenopausal women (when you no longer have periods).

HRT patch and tablet combinations

These treatments combine oestrogen patches with progesterone oral tablets. They can be used either continuously or in a sequential cycle where you only add progesterone during the last half of a 28-day cycle, depending on whether you still have periods.

HRT patch and tablet combinations include:

• Estradot 50 patches (estradiol) with Utrogestan tablets (progesterone) – continuous or sequential
• Evorel patches (estradiol) with Utrogestan tablets – sequential*
• Estraderm MX patches (estradiol) with Utrogestan tablets – sequential*

*as a sequential regime when prescribed from ZAVA, but these can be taken continuously as well

These are used for all menopause symptoms, for pre- and postmenopause.

Combination HRT tablets

These are taken by mouth and contain both artificial versions of the hormones oestrogen and progesterone in a single tablet. Treatment options include:

• Elleste Duet Conti – estradiol and norethisterone
• Kliovance – estradiol and norethisterone
• Kliofem – estradiol and norethisterone
• Femoston-conti – estradiol and dydrogesterone
• Tibolone – contains a synthetic hormone called tibolone that is broken down in the body into oestrogen and progesterone

These are used for all menopause symptoms for postmenopause.

Vaginal oestrogen treatments

These treatments are applied directly into the vagina and contain oestrogen only. Treatment options include:

• Ovestin cream (estriol)
• Estriol cream (estriol)
• Vagifem tablets (estradiol)
• Vagirux tablets (estradiol)

These are used for vaginal symptoms only, such as dryness, irritation, and discomfort during sex.

Non-HRT treatment options

These do not contain hormones and work in a different way to reduce menopause symptoms. Currently, the only non-hormonal menopause treatment offered at Asda Online Doctor is Veoza. This contains fezolinetant, a medication that acts on the brain’s temperature control centre.

This is used for hot flushes and night sweats.

Oestrogel vs Sandrena

Oestrogel and Sandrena are both HRT gels containing estradiol that are applied to the same areas of the skin. The main differences are that:

• Sandrena comes in sachets, while Oestrogel comes in a pump dispenser
• Sandrena contains 0.1% estradiol and is more concentrated than Oestrogel, which contains 0.06% estradiol

Sandrena may be preferred if you need to take higher doses of oestrogen, as there will be less gel to rub in, but apart from this, there is not much difference in which you use. As they contain the same active ingredient, the side effects are the same, and so is the effectiveness.

Oestrogel vs Estradot patches

Oestrogel and Estradot both contain estradiol. The main differences are that they come in different forms:

• Oestrogel is a gel applied to the skin daily
• Estradot patches remain in place for 3 to 4 days at a time, and are changed twice a week

Both are effective options as they contain the same active ingredient and have the same side effects. Which works best for you will depend on personal preference and possible skin reactions.

Can I use Oestrogel if I still have my periods?

Yes, you can use Oestrogel if you still have periods, but it must be taken alongside a progesterone to prevent the lining of your womb building up too much. If you’re still having periods, you’ll usually take sequential HRT treatment, which means using Oestrogel all the time, and progesterone for the final 2 weeks of a 28-day cycle. This will cause a breakthrough bleed like a period once a month, just like a natural menstrual cycle. This can help prevent irregular bleeding and spotting.

How long do I need to wait before getting dressed after applying Oestrogel?

It’s recommended to wait for 5 minutes before getting dressed after applying Oestrogel. While you’re getting used to Oestrogel, you can always check if the gel is dry after this time by touching the area of the skin you applied it to. Wash your hands if any gel is transferred to your fingers.

Can I drink alcohol while using Oestrogel?

Yes, Oestrogel does not interact with alcohol or make it unsafe. However, if you get side effects like headaches or any that affect your stomach, it might be best to avoid alcohol until these improve.

Alcohol can also worsen menopause symptoms, including causing weight gain, mood changes, and hot flushes, so it’s recommended to limit your alcohol intake if you have menopause symptoms.

Will Oestrogel make me gain weight?

Weight changes are listed as a common side effect of Oestrogel and other forms of HRT. Despite this, there is no clinical evidence that Oestrogel itself causes weight gain, and more evidence that it may be linked to menopause and declining oestrogen levels. The change in hormones during menopause leads to slower metabolism and a higher chance of fat storage around the stomach.

Is it normal to have spotting or bleeding when starting?

Yes, some spotting or bleeding after you start Oestrogel is common. This should get better within a few weeks to a few months of starting Oestrogel, as long as you keep taking it every day. Spotting or bleeding is more likely if you miss doses. Always report these side effects to your doctor and monitor them to see if they improve.

If you get any ongoing bleeding or spotting for longer than a few months, that seems heavier than usual, is causing pain, gets worse, or you also have other symptoms, speak to your doctor straight away.

How long does it take for Oestrogel to stop hot flushes?

Oestrogel is proven in clinical trials to reduce menopause symptoms in just a few weeks. You should notice a reduction in the number and severity of hot flushes within a few weeks, though taking Oestrogel for several months will provide the most benefit.