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[Liz]

When I was applying to inner thighs, I noticed a bit of "pudginess" developing, bit of cellulite.  Very unusual for me, as I'm slim and not had cellulite before.  Anyone else noticed this? 

Anyway, applied gel to lower leg last night and it seemed OK, slept reasonably well.  Outer arms may be a better option than lower inner arms, thinking about it. Less chance of transferring to boobs, I would have thought, so may try that if the lower legs don't work.

Thanks for everyone's input - very interesting.

[Dawncam]

Puddginess is probably water retention. Both E and P can cause that. You've not been using it that long so it takes time to settle and find the correct dose/site for you.

Good luck

Dxx

[Hurdity]

Studd advocates arms too.

It's do with fat cells so if you apply to thighs it can sit in the fat cells and not fully absorb. Feet are another option and palms of hand, as really good absorption there but not always practical!

The thing is it is not just about absorption though - there are two aspects - how different application sites on body affect absorption (so the aim is to maximise the serum estradiol levels levels from a particular dose), and secondly the safety aspects. The second should obviously take priority over the first.

When most of these products are/were first developed there are trials which include different application sites so - the one I can remember is the Intrinsa testosterone patch as this is the one I read most recently (could look up about the others sometime!) - which showed 25% more absorption of T from the front lower abdomen (tum) vs the buttocks. However I think it was andius which found some info showing the reverse for an oestrogen patch.

The problem is that all of these trials are conducted with very small groups of women who will show wide variation in absorption (this is well known) according to skin, fat etc. As I said before - as long as you are consistent with the location that you use for any transdermal HRT then you will maximise the chance of getting a consistent/stable dose!

I still remain puzzled though as to the discrepancy between the advice for application of oestrogel and the rest of the transdermal oestrogens including Sandrena, in the absence of any explanation as to why, and lack of information on transport through (along) the skin.

If I were to use gel I would always choose Sandrena because it is more concentrated so you need less of it for a given dose of oestrogen.

Hurdity x

[Liz]

If you used gel, Hurdity - where do you reckon you'd apply it on the body then?  Just interested in what you think you'd do.

[Liz]

Puddginess is probably water retention. Both E and P can cause that. You've not been using it that long so it takes time to settle and find the correct dose/site for you.

Good luck

Dxx

Been using if for 2 years, Dawn, so a good while now. x

[Dawncam]

Menomale - more info on gels I didn't know about. Thank you. The hairless thing definitely fits with me. Hope you're oestrogen-free trial is still going well.

Liz - apologies, I'd no idea you'd been using the gel for so long. Even longer than me and I'd have thought after this length of time you'd have established some sort of 'pattern'. I just presumed you were a newbie. In terms of 'pudginess' - with the best will in the world and even when employing  the most stringent exercise and eating regime (Madonna aside) we really can't expect to stay pert bosomed and slim limbed forever. A little reality must seep in to what hrt can/can't do.

Dxx

[Liz]

Menomale - more info on gels I didn't know about. Thank you. The hairless thing definitely fits with me. Hope you're oestrogen-free trial is still going well.

Liz - apologies, I'd no idea you'd been using the gel for so long. Even longer than me and I'd have thought after this length of time you'd have established some sort of 'pattern'. I just presumed you were a newbie. In terms of 'pudginess' - with the best will in the world and even when employing  the most stringent exercise and eating regime (Madonna aside) we really can't expect to stay pert bosomed and slim limbed forever. A little reality must seep in to what hrt can/can't do.

Dxx

Hi Dawn, sorry, what I actually meant was a change in the texture of my inner thighs where I'd actually been applying the Oestrogel..... I'm not overweight, just noticed a bit of cellulite just where I'd been applying the gel for the past 2 years.

I am in a routine with the HRT but recently my sleep has gotten worse, hence trying the gel at night.  Anyway, last night applied it to lower leg and didn't sleep too well....... the two nights I applied to lower arm (inside, from wrist to elbow) I slept much better.  I just was concerned that my inner arm may rub against my boobs during the night, but it seems that as long as a couple of hours have passed, this may be OK??  May have to go back to inner thighs otherwise but think I absorb best on arms personally. 

[Hurdity]

If you used gel, Hurdity - where do you reckon you'd apply it on the body then?  Just interested in what you think you'd do.

Hi Liz

If i used gel I would apply it to my legs as I do for the testosterone gel (or bum) and in the morning! The latter would probably be too difficult so most probably inner thighs. In the summer when wearing short shorts not sure what I would do but depends if it dries with a white residue like testosterone gel does.

Hurdity x

[Hurdity]

Hello ladies,

I'm not using gel but I have been reading a lot about application sites because I was on a BHRT cream.

I bumped into a very interesting article (there are a lot on this subject, I'll post it as soon as I find where I have saved it) which tested the safety (for partners/pets) and absortion of oestrogen gel. In short, they found that the important thing is to spread the gel in areas with the least amount of hair and with thin skin (ie, inner upper arms and inner thighs) and never apply to breasts or mucosal areas. Also of the utmost importance is to let it dry for AT LEAST one hour (ideal 2 hours) to minimize partner/pet absortion. I had to laugh when they described the method: husband kept rubbing wife's thighs for 30 minutes or so  They found traces of oestrogen in both husbands'/partners' and pet's blood samples, up to 8 hours, but lower than expected to cause any harm (although in some the amount was 25% above the average, so definetely NOT a good idea to let pets in bed and better have sex before applying the thing!)

Some leaflets say: Oestrogen gels are better absorbed when just spread over a great area and oestrogen creams/emulsions have to be rubbed until they disappear.  Very confusing indeed!!

I imagine I have read the same article - in fact have posted the link some time ago as this subject does come up regularly!

http://www.menopausematters.co.uk/forum/index.php/topic,29985.msg477935.html#msg477935

If it helps I will reproduce what I posted on that thread for those concerned/interested (all in italics is from the earlier post)!

"Thanks for posting this matildamouse - that's a good reason for applying the gel to your inner thighs rather than your arms.

In fact the information in the product leaflet say that skin to skin contact should be avoided for one hour after absorption. This is from the Summary of Product Characteristics. Look in Section 4.2:

"The gel should be applied by the patient herself, not by anyone else, and skin contact, particularly with a male partner, should be avoided for one hour after application. Washing the skin or contact with other skin products should be avoided until at least one hour after application of Oestrogel."

https://www.medicines.org.uk/emc/medicine/19898

This from the drugs website - two different places:

"Children should avoid coming into contact with skin areas where you have applied Estrogel. Topical estradiol is absorbed through the skin and can cause side effects in a child who comes into contact with this medicine or with skin where Estrogel was applied."

"Children should avoid coming into contact with skin areas where you have applied Estrogel. Topical estradiol is absorbed through the skin and can cause premature puberty in a child who comes into contact with this medicine or with skin where the medicine was applied. Cover treated areas with clothing to protect others from coming into contact with the skin where you apply this medicine".

http://www.drugs.com/estrogel.html

There is also this paper (only the abstract is available) - I've just extracted the relevant bits:

" Absorption, bioavailability, and partner transfer of estradiol from a topical emulsion.
Objective : To investigate the systemic absorption of estradiol in partners of postmenopausal women after making skin-to-skin contact with the application sites of estradiol topical emulsion.

Intervention: Women applied 1.74 g/day of estradiol topical emulsion (containing 2.5 mg estradiol/g) to each leg on 2 consecutive days. Their male partners were exposed to the application sites by mean of vigorous skin-to-skin contact at 2 and 8 hours after application.

Conclusions: Estradiol was transferred to male partners by means of vigorous skin-to-skin contact at application sites. Although the increase in postexposure levels of estradiol was statistically significant, all levels were still below the upper limit of the normal range for men (45 pg/ml)."

http://www.ncbi.nlm.nih.gov/pubmed/18503399

The mind boggles at what "vigorous skin-to skin contact" involved 

The same will apply to contact with animals I would imagine.

Hope this helps "

There is also a paper (and I can't find it - have soooo many bookmarks!) where there has been research looking at the application area of gel and absorption - again I have posted about this but some while ago but i did mention it recently somewhere. This showed that absorption was reduced if the gel was spread over the  largest possible area ( and I presume this is because it dries too quickly - before it is absorbed). There were two other skin areas looked at - half the size and smaller again but there was no difference between these two.

It is well known that there are enormous differences in how much oestrogen get from gel - due to skin differences, site of application and area of skin covered.  It is clearly important to get the right technique! One paper I looked at gave a ten-fold difference. The important thing is to be consistent so that you are doing approx the same thing every day - same site, same area covered etc  - and then your dose will be the same.

Liz - I would not apply to my arm at night just before bed and then sleep with bare skin exposed - where either my arm (or leg) could rub against breast or partner - just to be on the safe side. If you cover with night clothes then OK! We're probably only talking about a bit of transfer so I would probably be being over-cautious!!

Hurdity x

[Liz]

Thanks so much for that, Hurdity.  I have applied my gel this morning (to inner thighs). Will not be applying at night or to my arms in future (luckily only did it for a couple of nights).  I have a dog so always wash my hands thoroughly after using the gel anyway, but it seems night time application could be more of a problem re. transferring anyway.

Thank you for taking the time to put all that info. up.