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Oestrogel

Oestrogel is a form of hormone replacement therapy (HRT) used to replace the female sex hormone oestrogen. The treatment helps to relieve the unpleasant symptoms of the menopause in women, such as hot flushes, sweating, problems sleeping, vaginal dryness and a reduction in sex drive. Oestrogel is a gel that is topically applied to the skin and can be used during and after the menopause.

What is Oestrogel?

Oestrogel is also known as estradiol (spelled oestradiol in the UK). It is a synthetic form of oestrogen, which occurs naturally in the female body. Oestrogel is used to manage the symptoms of menopause which can include:

  • Sweating;
  • Hot flushes;
  • Mood swings;
  • Anxiety;
  • Depression;
  • Vaginal dryness;
  • Pain when having sex;
  • Low sex drive (drop in libido);
  • Problems with sleeping;
  • Memory or concentration problems.

This is a gel that is applied externally to the skin (on the lower part of the body – it should not be applied to the breasts or face). It is used every day, although in some cases a woman may be advised by her doctor to take a one-week break each month. In addition to the symptoms mentioned above, periods stop when women have gone through the menopause.

There are three stages to the menopause: peri-menopause (when the first signs begin), menopause (when full menopause is taking place) and post-menopause (when the menopause is complete and a woman has not had a period for a year). The menopause usually begins from a woman’s late-40s up until the mid-50s and occurs when the body no longer produces as much oestrogen as it has done throughout the reproductive years. The menopause process can take several years and be unpleasant and uncomfortable for some women. It is also referred to as ‘the change’. Oestrogel can help to relieve these symptoms and improve a menopausal woman’s well-being.

If you suspect you are beginning the menopause but are not sure, you can ask your doctor for a blood test to check the levels of oestrogen in your blood. Common results of this test for oestrogen levels in the blood are 30–400 pg/ml (picogrammes per millilitre) pre-menopause and 0-30 pg/ml post-menopause.

Oestrogen is a female sex hormone which is naturally produced by the ovaries. It contributes to the development of a young woman when she reaches puberty and also helps the body to regulate a woman’s menstruation cycle. During a woman’s reproductive years, the levels of oestrogen rise in the body once a month which causes an egg to be released from the ovaries. In addition, oestrogen facilitates the implantation and fertilisation of the egg. If the egg is fertilised by a sperm cell, a woman becomes pregnant. The other main female sex hormone is progestogen, which helps the egg to implant in the lining of the womb, but there is no progestogen in Oestrogel.

There are three main types of oestrogen:

  • Oestradiol –the strongest that is produced by the ovaries. It is linked with female reproduction and the reproductive organs;
  • Oestrone – also produced by the ovaries but not as strong as oestradiol. It is the main hormone produced in women who have gone through the menopause;
  • Oestriol – a low-level form of oestrogen that is only a minor female sex hormone. The levels of this hormone increase in the body during pregnancy.

Oestrogen also assists with the development of the brain, skin and bones. Osteoporosis (thinning of the bones resulting in fractures being more likely) is more common in post-menopausal and older women due to low oestrogen levels, and your doctor may prescribe Oestrogel for this condition.

When is Oestrogel used?

Oestrogel is used when a woman wants to use HRT to help with the symptoms of the menopause. Oestrogel is easy to use as it comes in gel form and is applied to the body once a day, whereas other forms of HRT come as tablets, skin patches, vaginal creams, rings or pessaries. Many women find Oestrogel a convenient way of taking supplemental oestrogen as it merely has to be rubbed into the skin each day. This is a short-term solution to the symptoms of the menopause such as hot flushes, sweating, mood swings and vaginal dryness. It can be taken for up to a year and after this should be reviewed annually by a doctor.

How do you use Oestrogel?

Oestrogel supplemental oestrogen is applied each day externally to the body below the waist. It is usually put on the buttocks, inner thighs or stomach. You must not put Oestrogel on or near the breasts or face, or to damaged or irritated skin. It should be applied at approximately the same every day, preferably after bathing or showering. Ensure your hands are clean and wash them after the application. Spread the Oestrogel gently over a small area of your skin and wait a few moments before getting dressed to allow the gel to absorb. Do not apply skin creams or powders on the area where you have applied the Oestrogel.

Apply one dose of Oestrogel daily which is dispensed by the applicator in 1.25 mg doses. You may need to use this medication continuously or your doctor may advise you to take a break each month (usually for seven days). Always follow the instructions of your doctor. If you have not had a hysterectomy (i.e. your uterus is intact), your doctor should prescribe you progestogen to take for a minimum of 12 days a month to prevent the risk of endometrial cancer, which is more likely in a woman who takes only Oestrogel supplemental oestrogen and still has her uterus. If you have had a hysterectomy, you do not need to take progestogen as well. You should not discontinue Oestrogel without talking to your doctor.

What dosages are there?

One 1.25 g dose contains 0.75 mg of oestrogen and the common treatment is one dose per day. However, you should always follow the dosage prescribed by your doctor as this will depend on your individual circumstances. If you forget to apply your Oestrogel supplemental oestrogen, you should not take a double dose. If you are due a dose within 12 hours, wait to apply the next dose. If your next dose is due in more than 12 hours then apply the missed dose straight away and the next usual dose at the normal time.

What are the side effects of Oestrogel?

The side effects of Oestrogel can include tender breasts, nausea, vomiting, stomach problems and breakthrough bleeding (light spotting). If you experience any side effects while taking Oestrogel, you should inform your doctor.

When should you not use Oestrogel?

You should not use Oestrogel supplemental oestrogen if you:

  • Are allergic to oestradiol or any of the other ingredients in this medication (see package leaflet);
  • Have or have had breast cancer;
  • Have or have a history of thrombosis or blood clots;
  • Have or have had endometrial cancer (cancer of the lining of the womb);
  • Have or have had liver disease;
  • Have or have had heart problems;
  • Experience abnormal vaginal bleeding;
  • Have or have had a kidney or blood disease;
  • Are pregnant or breastfeeding;
  • Oestrogel is only suitable for women of menopause age.

If you suspect you are pregnant, you should stop taking Oestrogel and consult your doctor as soon as possible. It is important to tell your doctor about any medication you are taking (including herbal medicines) or illnesses you have had before taking Oestrogel. It is advisable not to use Oestrogel supplemental oestrogen for the treatment of menopause symptoms over the long term. Your doctor should review your individual situation after you have been taking Oestrogel for 12 months.

This medicine is not a contraceptive. It is important to know that most women below 50 years of age who have gone through the menopause could still be fertile for up to two years. If you are over 50 years of age and have gone through the menopause, you are still considered to be fertile for up to one year after your last period. You could therefore get pregnant during this time and while taking Oestrogel, so you should also use a non-hormonal form of contraception.

Does Oestrogel interact with other medication?

As with all medicines, Oestrogel supplemental oestrogen can interact with other medication, including the following:

  • Epilepsy medicines (increasing the risk of seizures with certain medicines);
  • Medicines for infections;
  • Blood pressure medicines;
  • Diuretic medicines;
  • Medicines to treat tuberculosis (TB);
  • Herbal/plant-based medicines, for example, St. John’s Wort.

If you are diabetic, your doctor may wish to adjust your dose of insulin while you are taking Oestrogel. It is important to closely monitor your blood sugar levels if you have diabetes and are taking this medicine. If any changes occur, report them to your doctor. It is essential to tell your doctor about any medicines you are taking as they could affect the performance of Oestrogel.

Where can you buy Oestrogel?

You need a prescription from a doctor to buy Oestrogel supplemental oestrogen at a pharmacy.

Can I get Oestrogel without a prescription?

No. Oestrogel is a prescription-only medication.

References:

Cadman, B. (26 September 2018). What is an estradiol test and why is it used? Retrieved 30 April 2019 from https://www.medicalnewstoday.com/articles/323178.php

Oestrogel (estradiol). June 11, 2015. Retrieved 30 April 2019 from https://www.netdoctor.co.uk/medicines/a7261/oestrogel- estradiol/

Oestrone. March 2018. Retrieved 30 April 2019 from https://www.netdoctor.co.uk/medicines/a7261/oestrogel-estradiol/

Package leaflet. OESTROGEL 0.06% Gel. Oestradiol. June 2007. Retrieved 30 April 2019 from https://downloads.dokteronline.com/leaflets/en/patient_information_leaflet-3749-oestrogel-uk.pdf-1510756509.pdf?_ga=2.255149448.1442913771.1601361456-2071352208.1599043266

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