Oestrogel is a hormone replacement therapy (HRT) gel that contains the active ingredient estradiol, a form of estrogen. It is used to relieve symptoms of menopause, such as hot flashes, night sweats, and vaginal dryness, by replenishing the body’s declining estrogen levels. Oestrogel is applied directly to the skin, usually on the arms or thighs, where it is absorbed into the bloodstream to provide steady hormone levels. It offers a convenient and flexible option for women seeking relief from menopausal symptoms.
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GP, Medical coach
What is Oestrogel?
Oestrogel is a hormone replacement therapy (HRT) gel that contains estradiol, a form of estrogen. It is used to treat symptoms of menopause such as hot flashes, night sweats, vaginal dryness, and mood changes, which occur due to the natural decline in estrogen levels. Oestrogel is applied topically to the skin, where it is absorbed into the bloodstream, helping to restore the body’s estrogen levels and alleviate menopausal symptoms. It is typically prescribed to women who are experiencing menopausal symptoms and can be used as part of a combined HRT regimen with progesterone, depending on individual needs.
What is the active ingredient in Oestrogel?
The active ingredient in Oestrogel is 750 micrograms of Estradiol in each 1.25 gram pump.
What is Oestrogel used for?
Oestrogel is used as part of hormone replacement therapy (HRT) to treat symptoms associated with menopause. These symptoms include hot flashes, night sweats, vaginal dryness, mood swings, and other discomforts caused by the decline in estrogen levels during menopause. By supplementing the body’s estrogen, Oestrogel helps to relieve these symptoms, improving the quality of life for women going through menopause. Additionally, it can be used to prevent osteoporosis in postmenopausal women who are at high risk of fractures and cannot take other treatments.
How does Oestrogel work?
Oestrogel works by delivering estrogen (in the form of estradiol) directly into the bloodstream through the skin. When applied to the skin, the gel is absorbed and helps to restore estrogen levels in the body, which typically decline during menopause. This replenishment of estrogen helps to alleviate menopausal symptoms such as hot flashes, night sweats, and vaginal dryness by compensating for the natural decrease in hormone production.
By maintaining a more consistent level of estrogen, Oestrogel also helps in reducing the risk of osteoporosis by maintaining bone density, which can decrease significantly after menopause. The gel offers a flexible and controlled method of hormone replacement, allowing for adjustments in dosage based on individual needs.
How do you use Oestrogel?
Use Oestrogel exactly as your doctor has instructed. If you’re unsure, check with your doctor or pharmacist.
Instructions for Using Oestrogel:
Starting Oestrogel: If you’ve never used HRT medicines before or are switching from a period-free HRT product, you can start using Oestrogel on any convenient day. If you’re switching from an HRT product that includes a period, finish your current pack before starting Oestrogel.
Application: Only you should apply the gel. Avoid using strong skin cleansers or detergents on the area where you will apply the gel. Apply the gel once daily, either in the morning or evening, on clean, dry skin. The usual dose is 2 pumps of gel, but follow your doctor’s instructions.
Application Sites: Apply the gel to the outer arm and shoulder or mid-inner thigh, spreading it evenly over a large area. Avoid applying near the breasts or genital area. Wash your hands thoroughly after application and avoid close skin contact with others for at least one hour until the gel has dried.
Preparing the Pump Pack: Before the first use, remove the cap and stopper, then press the plunger until gel is dispensed. Discard the first dose.
Missed Dose: If you miss a dose and it’s more than 12 hours until your next dose, apply it as soon as you remember. If less than 12 hours remain, skip the missed dose and continue as normal. Do not double up on doses.
Overdose: If you use too much, you might experience breast tenderness, nausea, or vaginal bleeding. Contact your doctor if this occurs.
Additional Precautions:
Surgery: If you’re scheduled for surgery, inform your surgeon that you’re using Oestrogel. You may need to stop using it 4-6 weeks before the operation to reduce the risk of blood clots. Consult your doctor about when to resume use.
Follow these guidelines to ensure effective and safe use of Oestrogel. If you have any further questions or concerns, contact your doctor or pharmacist.
Who should not use Oestrogel?
Medical History and Regular Check-ups
When deciding whether to start or continue hormone replacement therapy (HRT), it's important to consider the associated risks. This is especially true if you experience premature menopause due to ovarian failure or surgery, as the risks may differ. Always discuss these factors with your doctor.
Before beginning (or restarting) HRT, your doctor will ask about your medical history and that of your family. A physical examination, including a breast or internal exam, may be necessary.
Once you begin using Oestrogel, you should have regular check-ups with your doctor, at least once a year, to evaluate the benefits and risks of continuing the treatment. Additionally, follow your doctor’s recommendations for regular breast screenings.
When Not to Use Oestrogel
Do not use Oestrogel if any of the following conditions apply to you. If you are unsure about any of these points, consult your doctor before starting Oestrogel:
History or suspicion of breast cancer.
History or suspicion of estrogen-sensitive cancers, such as cancer of the womb lining (endometrium).
Unexplained vaginal bleeding.
Untreated excessive thickening of the womb lining (endometrial hyperplasia).
History of blood clots in veins (e.g., deep vein thrombosis or pulmonary embolism).
Blood clotting disorders (e.g., protein C, protein S, or antithrombin deficiency).
Recent or past disease caused by blood clots in arteries (e.g., heart attack, stroke, or angina).
History of liver disease with unresolved liver function tests.
Rare inherited blood disorder called porphyria.
Allergic reactions to estradiol or any ingredients in Oestrogel.
If any of these conditions appear while using Oestrogel, stop immediately and consult your doctor.
Warnings and Precautions
Before starting treatment, inform your doctor if you have a history of the following conditions, as they may reoccur or worsen during Oestrogel use. Your doctor may recommend more frequent check-ups if you have:
Uterine fibroids.
Endometriosis or a history of excessive growth of the womb lining (endometrial hyperplasia).
Increased risk of blood clots.
Increased risk of estrogen-sensitive cancer (family history of breast cancer).
High blood pressure.
Liver disorders, such as benign liver tumors.
Diabetes.
Gallstones.
Migraines or severe headaches.
Systemic Lupus Erythematosus (SLE).
Epilepsy.
Asthma.
Otosclerosis (hearing disorder).
High triglyceride levels.
Fluid retention due to heart or kidney issues.
Hereditary or acquired angioedema.
Stop Using Oestrogel and Seek Medical Attention Immediately If You Experience:
Any of the conditions listed under "Do not use Oestrogel."
Yellowing of the skin or eyes (jaundice), which may indicate liver disease.
Swelling of the face, tongue, and/or throat, difficulty swallowing or breathing, or hives, which may suggest angioedema.
Significant increase in blood pressure (symptoms include headache, tiredness, dizziness).
First-time migraine-like headaches.
Pregnancy.
Signs of a blood clot, such as painful swelling and redness in the legs, sudden chest pain, or difficulty breathing.
For further details, refer to the section on "Blood Clots in a Vein (Thrombosis)."
Note: Oestrogel is not a contraceptive. If it has been less than 12 months since your last menstrual period or you are under 50 years old, additional contraception may be necessary to prevent pregnancy. Consult your doctor for advice.
HRT and Cancer: FAQs
What is the risk of endometrial cancer with HRT?
Using estrogen-only HRT increases the risk of excessive thickening of the womb lining (endometrial hyperplasia) and endometrial cancer. To mitigate this risk, a progestogen is usually prescribed alongside estrogen for at least 12 days of each 28-day cycle, particularly if you still have your womb. If you have had a hysterectomy, consult your doctor to determine if you can safely use estrogen-only HRT.
For women aged 50 to 65 who do not use HRT, about 5 in 1000 are diagnosed with endometrial cancer. In contrast, those who use estrogen-only HRT face a higher risk, with 10 to 60 in 1000 women being diagnosed, depending on the dosage and duration of use.
What should I do if I experience unexpected bleeding while on HRT?
If you experience unexpected bleeding or spotting outside of your monthly withdrawal bleed while using Oestrogel, especially if it:
Persists beyond the first 6 months,
Starts after more than 6 months of use,
Continues after you’ve stopped using Oestrogel,
You should consult your doctor as soon as possible.
Does HRT increase the risk of breast cancer?
Yes, evidence shows that using combined estrogen-progestogen or estrogen-only HRT increases the risk of breast cancer. This extra risk becomes noticeable within 3 years of use and may persist for 10 years or more after stopping HRT, especially if used for more than 5 years.
For example, in women aged 50 to 54 not using HRT, 13 to 17 in 1000 may be diagnosed with breast cancer over a 5-year period. For those on estrogen-only HRT, the risk increases to 16-17 in 1000, and for those on combined HRT, the risk rises to 21 in 1000.
How can I monitor for breast cancer while on HRT?
Regularly check your breasts for any changes such as dimpling of the skin, changes in the nipple, or any lumps you can see or feel. It’s also important to participate in mammography screening programs as advised by your doctor. When having a mammogram, inform the healthcare provider that you are using HRT, as it can increase breast density and affect the mammogram results.
Does HRT increase the risk of ovarian cancer?
There is a slightly increased risk of ovarian cancer with the use of both estrogen-only and combined estrogen-progestogen HRT. For women aged 50 to 54 who are not using HRT, about 2 in 2000 will be diagnosed with ovarian cancer over 5 years. This increases to about 3 in 2000 for women using HRT.
HRT and Circulation: FAQs
How does HRT affect the risk of blood clots?
The risk of blood clots in the veins (thrombosis) is 1.3 to 3 times higher in HRT users compared to non-users, particularly during the first year of use. Blood clots can be serious, especially if they travel to the lungs, potentially causing chest pain, breathlessness, fainting, or even death.
In women in their 50s not using HRT, about 4 to 7 in 1000 might develop a blood clot over 5 years. This increases to 9 to 12 in 1000 for women using combined HRT, and to 5 to 8 in 1000 for those using estrogen-only HRT after a hysterectomy.
Does HRT affect heart disease risk?
HRT does not prevent heart attacks. Women over 60 using combined estrogen-progestogen HRT are slightly more likely to develop heart disease compared to non-users. However, for women who have had a hysterectomy and are using estrogen-only therapy, there is no increased risk of heart disease.
Does HRT increase the risk of stroke?
Yes, the risk of stroke is about 1.5 times higher in HRT users compared to non-users. For women in their 50s not using HRT, 8 in 1000 are expected to have a stroke over 5 years. This number increases to 11 in 1000 for those using HRT.
Other FAQs
Can Oestrogel be transferred to others?
Yes, Oestrogel can be accidentally transferred from your skin to others, especially children. To prevent this, avoid letting others touch the treated area until it is dry and cover it with clothing if necessary. If a child comes into contact with the treated area, wash their skin with soap and water immediately. If you notice signs of early puberty (e.g., breast development) in a child who may have been exposed to Oestrogel, contact your healthcare provider.
Does HRT affect memory?
HRT does not prevent memory loss, and there is some evidence that starting HRT after age 65 may increase the risk of memory loss. Consult your doctor for advice.
What should I know about Oestrogel and pregnancy?
Oestrogel is intended for use in postmenopausal women only. If you become pregnant, stop using Oestrogel and contact your doctor.
What are the side effects with Oestrogel?
Like all medicines, this medication can cause side effects, although not everyone experiences them.
Women using HRT have a higher reported frequency of the following conditions compared to those not using HRT:
Breast cancer
Abnormal growth or cancer of the womb lining (endometrial hyperplasia or cancer)
Ovarian cancer
Blood clots in the veins of the legs or lungs (venous thromboembolism)
Heart disease
Stroke
Probable memory loss if HRT is started after the age of 65
For more details on these side effects, refer to Section 2.
Side Effects Reported Since Oestrogel Came to Market:
Frequency not known (cannot be estimated from available data):
Nausea (feeling sick)
Dizziness
Headache
Hair loss (alopecia)
Intense itching (pruritus)
Side Effects Observed During Clinical Trials:
Frequency not known (cannot be estimated from available data):
Breast pain
Infection
Pain
Vaginitis (inflammation of the vagina causing discharge, itching, and pain)
Side Effects Commonly Observed with HRT Products Used During Menopause:
Common (may affect up to 1 in 10 people):
Painful periods
Heavier or longer-than-usual menstrual periods
Abnormal or irregular bleeding
White or yellow vaginal discharge
Uncommon (may affect up to 1 in 100 people):
Mood swings
Migraine
Vertigo
Wind (flatulence)
Increase in the size of the uterus
Vaginal yeast infection (candidiasis)
Feeling of weakness
Rare (may affect up to 1 in 1,000 people):
Glucose intolerance, which may affect blood sugar levels
Worsening of epilepsy symptoms
High blood pressure
Liver function changes (as shown in blood tests)
Acne
Unusual breast milk production
Anaphylaxis, a type of allergic reaction (more likely if you’ve had allergic reactions before)
Side Effects Reported with Other HRTs:
Gallbladder disease
Various skin disorders:
Discoloration of the skin, especially on the face or neck (chloasma, or "pregnancy patches")
Painful, reddish skin nodules (erythema nodosum)
Rash with target-shaped reddening or sores (erythema multiforme)
Rash
Patchy brown or dark brown skin discoloration (melasma)
Vomiting
Abdominal pain
Breast tenderness or enlargement
Fluid retention (oedema)
Weight changes
Changes in sexual desire (increase or decrease)
Depression
Reporting of Side Effects:
If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can report side effects directly via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for "MHRA Yellow Card" in the Google Play or Apple App Store. Reporting side effects can help provide more information on the safety of this medicine.
Does Oestrogel interact with other medicines?
Yes, Oestrogel can interact with other medications, leading to irregular bleeding or other effects. Medicines for epilepsy, tuberculosis, HIV infection, and certain herbal products like St John’s wort may interfere with Oestrogel. It’s important to inform your doctor about all the medications you are taking.
Oestrogel FAQs
What is Oestrogel?
Oestrogel is a topical hormone replacement therapy (HRT) gel that contains 750 micrograms of estradiol, a form of oestrogen. It is designed to relieve menopausal symptoms by delivering oestrogen through the skin, offering a convenient and effective way to manage symptoms. The gel is manufactured by Besins Healthcare and comes in an easy-to-use pump pack.
What is Oestrogel used for?
Oestrogel is prescribed to alleviate menopausal symptoms that interfere with daily life, such as:
Hot flushes
Night sweats
Difficulty sleeping
Vaginal dryness and irritation
Reduced sex drive
Headaches
Low mood
It is also used to reduce the risk of developing osteoporosis (brittle bones) in women.
How does Oestrogel work?
Oestrogel works by replenishing oestrogen levels in women experiencing menopause. Menopause causes a natural decline in oestrogen, leading to various symptoms. Oestrogel contains estradiol, a bioidentical form of oestrogen, which is absorbed through the skin and into the bloodstream, helping to relieve these symptoms.
How quickly does Oestrogel work?
It typically takes several weeks for Oestrogel to start showing noticeable improvements in menopausal symptoms. Most women will experience the full effects of the treatment within three months. If symptoms persist or side effects occur after three months, consult your doctor to discuss your dosage.
What are the alternatives to Oestrogel?
Oestrogel is one of many HRT options. Other forms include tablets, patches, vaginal tablets, and creams. If you’re considering switching to a different HRT form, speak with your doctor for personalized advice.
How should I use Oestrogel?
Oestrogel should be used exactly as prescribed by your doctor. Apply the gel once daily, either in the morning or evening, to clean, dry skin. Recommended application areas are the outer arms, shoulders, or mid-inner thighs. Avoid applying Oestrogel to the breasts, face, or broken skin.
What are the ingredients in Oestrogel?
The active ingredient in Oestrogel is 750 micrograms of estradiol per 1.25 grams of gel. The other ingredients include carbomer, triethanolamine, ethanol, and purified water.
What are the side effects of Oestrogel?
Common side effects of Oestrogel include:
Painful or heavy periods
Irregular bleeding
Vaginal discharge or yeast infections
Mood swings
Migraines
Vertigo
Wind (flatulence)
Acne
If severe side effects or allergic reactions occur, seek medical attention immediately.
What warnings should I be aware of with Oestrogel?
Using HRT, including Oestrogel, increases the risk of developing certain health conditions, such as breast cancer, ovarian cancer, and blood clots. It's essential to maintain regular check-ups with your GP, including breast screenings and blood tests, while using Oestrogel. Women with an intact womb should also use a progesterone HRT alongside Oestrogel to reduce the risk of endometrial cancer.
Can I use Oestrogel if I am pregnant?
Oestrogel is intended for postmenopausal women and should not be used as a contraceptive or during pregnancy. If you suspect you are pregnant while using Oestrogel, consult your doctor immediately.
