Oestrogel pump

Oestrogel is a transdermal, body-identical oestrogen medication, meaning it is a type of hormone replacement therapy (HRT) delivered through the skin. It is used to treat symptoms of the menopause, such as hot flushes, night sweats, and vaginal dryness.

The active ingredient in Oestrogel is estradiol, specifically estradiol hemihydrate, and is manufactured by Besins Healthcares.

Oestrogel works by replacing the natural oestrogen that is lost during menopause. Low oestrogen affects almost all organ systems and can lead to many symptoms, including:

• hot flashes
• night sweats
• mood changes
• vaginal dryness
• joint pain

Applying Oestrogel directly onto the skin sends oestrogen straight into the bloodstream, helping to increase levels in the body and relieve symptoms.

How long does Oestrogel last?

Oestrogel usually stays in your system for a very short period of time. Studies have found that once treatment with Oestrogel has stopped it takes around 76 hours for it to leave your body. It has a half-life of 36 hours which means it takes 36 hours for the dose to reduce by half each time, meaning it would take between 2 to 5 days to get out of your system fully.

How long does Oestrogel take to work?

Oestrogel takes around 4 to 12 weeks to fully work to relieve menopause symptoms, but some women may notice improvements in certain symptoms, such as mood or sleep, within the first few weeks. It requires a constant daily application to build up and maintain hormone levels.

How effective is Oestrogel?

Oestrogel is an effective treatment for menopause symptoms. Many women see a significant improvement in their symptoms after 3 months, and some see improvements within a few weeks.

When using Oestrogel for the first time, you should:

• remove the cup from the canister
• take the stopper off the neck of the plunger
• press the plunger a few times until the gel comes out
• do not use the first dose of gel from the pump and discard it

To apply Oestrogle, you should:

1. Wash your hands
2. Remove the canister cap to reveal the plunger
3. Remove the stopper from the spout
4. Squeeze the directed amount of gel into your hands
5. Gently rub the gel into a large area of clean, dry, unbroken skin on your lower body or arms. The instructions will tell you where you can apply it. Do not use the same area of skin 2 days in a row, and do not use it on the skin near the breasts or genitals.
6. Cover the spout with the stopper and replace the cap
7. Wait up to 5 minutes for the gel to dry before getting dressed
8. Do not wash the area for at least 1 hour
9. Wash your hands after applying the gel

The gel should be applied once a day at the same time, and your doctor will instruct you on the number of pumps to use. You should follow the instructions that come with the gel.

How long do you need to take Oestrogel for?

Commonly, HRT such as oestrogel is taken for 2 to 5 years, but how long you take oestrogel will depend on your personal health benefits and risks.

What if I miss a dose of Oestrogel?

If you miss a dose of Oestrogel, and it is more than 12 hours until your next dose, you should apply the gel as soon as you remember. If it is less than 12 hours until your next dose you should skip it and take the next dose at the usual time. You should never use 2 doses of Oestrogel at the same time or take extra doses to make up for missed ones.

What if I take too much Oestrogel?

Taking too much Oestrogel is unlikely to cause harm, but you should talk to your doctor or pharmacist if you are worried.

Oestrogel is a prescription-only medication that can be bought from a trusted online doctor service like ZAVA.

Can I buy Oestrogel online?

Yes, you can buy Oestrogel online, but you will need a prescription from a licensed healthcare professional.

You can request a prescription from a trusted online doctors service like ZAVA that is monitored and regulated and guarantees that you will receive genuine, safe medication.

Requesting a prescription from ZAVA is quick and easy.

1. Complete a short online medical questionnaire - Answer questions about your health and symptoms so doctors can make sure Oestrogel is the most effective treatment option for you.
2. Order and pay online - Sign in or create your ZAVA account, select Oestrogel Pump, and securely make your payment.
3. Doctor review and approval - a UK-licensed doctor will check over your medical questionnaire and approve your request if Oestrogel is a suitable treatment option for you.
4. Fast and discreet delivery - Once approved, Oestrogel will be delivered quickly and discreetly, directly to your home or to a local post office for collection.

Can I buy Oestrogel over the counter?

No, Oestrogel is a prescription-only medication, so it cannot be bought over the counter. There are other low-dose HRT options available over the counter in some UK pharmacies.

Can I get Oestrogel on the NHS?

Yes, you can get Oestrogel on the NHS, and it is a commonly prescribed HRT. You will need to talk with your doctor, and if Oestrogel is a suitable treatment, they will provide a prescription that can generally be dispensed immediately. You will usually be given a branded estradiol gel.

You may experience some side effects when taking Oestrogel, but they often go away after a few months.

Common side effects of Oestrogel include:

• feeling sick (nausea)
• abdominal pain
• headache
• breast pain or tenderness
• abnormal or irregular bleeding
• white or yellow vaginal discharge
• weight change

Uncommon side effects of Oestrogel include:

• mood swings
• migraine
• depression
• vertigo
• being sick (vomiting)
• intense itching
• vaginal yeast infection
• wind (flatulence)
• increase in the volume of the uterus
• inflamed vagina causing discharge, itching, and pain (vaginitis)
• feeling of weakness

Rare side effects include:

• change in libido
• intolerance to glucose, which may affect blood sugars
• high blood pressure
• acne
• bone pain
• an allergic reaction (anaphylaxis)
• worsening of epilepsy symptoms
• changes in the way the liver works

In some very rare cases, Oestrogel can cause contact lens intolerance.

Stop using Oestrogel immediately if you experience:

• yellowing of your skin or whites of the eyes (jaundice)
• swollen face, tongue, or throat, or you are having difficulty breathing or swallowing
• a large rise in your blood pressure
• migraine-like headaches that happen for the first time
• signs of a blood clot, including painful swelling and redness of the legs, sudden chest pain, and difficulty breathing

You should read the patient information leaflet for a full list of side effects.

How long do Oestrogel side effects last?

Oestrogel side effects usually clear up on their own in a few months.

What to do if you get Oestrogel side effects

Most side effects of Oestrogel are mild and can be treated by you at home. You can ease and treat:

• headaches by taking over-the-counter pain medication such as paracetamol or ibuprofen, staying hydrated, and resting
• nausea by eating small, bland meals, getting fresh air, and staying hydrated
• skin irritation by applying a cool compress to the affected area, taking lukewarm baths, and wearing loose-fitting clothes

If you experience symptoms that you are struggling to manage, get worse, or last for longer than a few months, you should speak to your doctor.

Does Oestrogel cause weight gain?

Some people may experience weight gain as a side effect of taking Oestrogel, but it does not cause weight gain for everyone.

Oestrogel is a safe and effective medication, but it may not be right for everyone. There are some medical conditions or medications that can interact with Oestrogel and make it less effective, or potentially unsafe.

List of contraindications

Do not use Oestrogel if you:

• are allergic to estradiol or any other ingredients in Oestrogel
• have, have had, or suspect you might have oestrogen-dependent cancer (breast, uterine, or ovarian)
• have or have ever had a blood clot in a vein, such as deep vein thrombosis or pulmonary embolism
• have a blood-clotting disorder, such as protein C or antithrombin deficiency
• active or a history of liver disease
• have had a recent illness due to blood clots in the arteries, such as angina, heart attack, or stroke
• have undiagnosed vaginal bleeding
• have untreated thickening of the womb
• are or become pregnant

Before you start using Oestrogel, tell your doctor if you have ever had any of the following conditions. You may also need more frequent check-ups while using this medication:

• epilepsy
• asthma
• fibrosis inside the womb
• growth of the womb lining outside the womb (endometriosis) or excessive growth of the womb lining (endometrial hyperplasia
• high blood pressure
• increased risk of developing blood clots
• increased risk of getting an oestrogen-sensitive cancer (such as having a close family member, mother, sister, or grandmother, who has had breast cancer)
• a liver disorder, such as a benign tumor
• gallstones
• diabetes
• a disease affecting the eardrum and hearing (otosclerosis)
• migraine or severe headaches
• a disease of the immune system that affects many organs of the body (Systemic Lupus Erythematosus, SLE)
• a very high level of fat in your blood (triglycerides)
• fluid retention due to heart or kidney problems
• hereditary and acquired angioedema

If you have any of these conditions, your doctor will decide whether Oestrogel is suitable for you and how closely you should be monitored during treatment.

List of medications that interact with Oestrogel

Some medications may interact with Oestrogel and cause it to be unsafe or ineffective. You should speak to your doctor before using Oestrogel if you are already taking:

• epilepsy medications, including carbamazepine, phenobarbital, and phenytoin
• TB treatments such as rifampicin and rifabutin
• HIV/Hepatitis C medications, including ritonavir, nelfinavir, nevirapine, and efavirenz
• herbal medications, including St. John's wort

Oestrogel can also affect how other medications work, these include:

• an epilepsy medication called lamotrigine
• combination regimens for Hepatitis C virus, such as obitasvir/paritaprevir/ritonavir and dasabuvir with or without ribavirin, or glecaprevir/paritaprevir or sofosbuvir/velpatasvir/voxilaprevir
• skin cleansers and products containing benzalkonium chloride or sodium lauryl sulphate
• skin products containing alcohol, such as astringents or sunscreens
• products to treat skin and scalp disorders such as acne or dandruff
• skin medications that change how skin is made, such as anti-cancer products

If you find Oestrogel is not working for you, or you want to try something different, there are other HRT options available with ZAVA to help manage symptoms of the menopause. These options include:

• patches
• vaginal creams
• vaginal tablets
• oral tablets

HRT Patches

This treatment comes in the form of patches that you stick on the skin, and they contain a combination of artificial hormones. HRT patches provided by ZAVA include:

Evorel Conti

Evorel Conti patches are a combined form of HRT containing estradiol and norethisterone. They are applied directly to the skin twice a week.

Evorel Sequi

Evorel Sequi are HRT patches that are intended for people going through perimenopause, the time just before the menopause, where you may have symptoms of the menopause but are still having a period. They contain 2 different patches:

• Evorel 50, which contains the hormone oestrogen
• Evorel Conti, which contains oestrogen and progesterone

Vaginal HRT creams and tablets

Vaginal creams and tablets are applied directly into the vagina and can help to reduce symptoms of vaginal irritation and dryness by replacing hormones directly at the source. At ZAVA, we offer:

Estriol cream

Estriol cream, also available under the brand name Ovestin, is a prescription-only HRT medication that contains the active ingredient estriol, a synthetic type of oestrogen. It works by targeting symptoms locally to treat vaginal dryness, irritation, and pain during sex. It can also help with recurring UTI symptoms associated with the menopause.

Estriol cream can be used alone or with other forms of HRT, such as patches and tablets.

Gina

Gina is a low-dose vaginal tablet that contains the active ingredient estradiol hemihydrate, a synthetic form of oestrogen. It is a local vaginal HRT, meaning it does not circulate in the blood and only treats the area it has been applied to.

It is inserted into the vagina where it dissolves and releases oestrogen directly into your vaginal tissue. Gina is available over the counter.

Vagifem

Vagifem is a prescription-only vaginal tablet containing estradiol. It is used to treat vaginal dryness, irritation, and pain during sex.

Oral tablets

A common form of HRT is oral tablets, which are an easy way to manage menopause symptoms. However, they are not suitable for everyone as they can increase the risk of blood clots.

Oral HRT tablets that ZAVA offers include:

Elleste Duet Conti

Elleste Duet Conti is a continuous oral HRT, meaning it is taken every day without a break. It contains synthetic versions of oestrogen and progesterone. It is taken once daily to relieve you from menopause symptoms.

Tibolone

Tibolone, also sold under the brand name Livia, is a synthetic steroid medication that mimics the effects of various sex hormones that occur naturally in the body, such as oestrogen and progesterone. You should take it once a day to relieve menopause symptoms.

Kilofem

Kliofem is a continuous and combined form of hormone replacement therapy, meaning it contains both oestrogen (estradiol) and progesterone (norethisterone) replacements. It is to be taken daily to ease menopausal symptoms and also helps prevent osteoporosis.

Kilovance

Kliovance is a combined hormone replacement therapy, it contains both oestrogen (estradiol) and progesterone (norethisterone) to help with menopause symptoms. It is to be taken at the same time daily. It works to help with menopausal symptoms as well as preventing osteoporosis. It contains the same active ingredients as Kliofem but contains half the amount.

Femoston Conti

Femoston Conti contains both oestrogen and progesterone replacements to ease symptoms like hot flushes, vaginal dryness and night sweats. Effects of treatment can be experienced within just 2-3 months. You take it just once a day.

Premique

Premique is a form of continuous combined hormone replacement therapy. You take it once daily. It contains 0.3 mg conjugated oestrogens and 1.5mg medroxyprogesterone acetate. It works to relieve vaginal dryness, hot flushes and night sweats.

Can you take Oestrogel and Utrogestan together?

Yes, you can take Oestrogel and Utrogestan together. Utrogenstan (a progesterone) is often recommended to be used in combination with oestrogen (such as in Oestrogel Pump) in hormone replacement therapy (HRT) for people who still have a womb to protect the uterine lining from cancer. Some types of HRT may already have progestogen included. Your doctor should recommend the best solution for you.

Lenzetto vs Oestrogel

Lenzetto and Oestrogel are both forms of topical HRT containing estriodal that deliver hormones directly into the bloodstream.

Lenzetto is a quick-drying spray that is usually applied to the forearms, and Oestrogel is a gel applied to the inner arms or thighs. Lenzetto can offer a more discreet application and cause less skin irritation.

Sandrena gel vs Oestrogel

Sandrena gel is an HRT gel that is applied to the skin. It’s more concentrated than Oestrogel and comes in a sachet. Sandrena gel has a concentration of 0.1% estradiol, and Oestrogel has a concentration of 0.06%; this means that less gel is applied for the same dose.

Sandrena gel comes in single-dose 0.5mg or 1mg sachets.

Evorel vs Oestrogel

Evorel patches are used to treat symptoms of the menopause and can also help prevent osteoporosis in postmenopausal women. They are applied to the skin twice a week instead of daily and can be a more convenient way to manage symptoms. However, some people may find that the adhesive can cause more skin irritation than Oestrogel gel.