Aaaarrgghhh! What are they thinking of?! Do not cry!
Look - Emma has just given you the info - Sandrena is the same as estrogel in effect - just a bit more concentrated.
It is important to be absolutely clear about the terms we are using - re natural synthetic bio-identical etc.
Every single product we use whether alternative or NHS approved, compounded etc is
synthetic ( with the exception of actual dried herbs!) - in the sense that it has been
synthesised in a lab from raw materials.
Generally we use the term in HRT to distinguish between products that are bio-identical or body-identical - which means exactly as Emma wrote below!
Compounded bio-identical hormone therapy is a different issue altogether - and uses the same products as the products on NHS - in fact the raw materials (pure estradiol and progesterone) may well have been manufactured (synthesised) in the same place (haven't been able to find info on this).
Natural means extracted from natural sources usually - I presume that no other chemical steps have been taken to arrive at the finished product (maybe - usually? added excipients - ie what the active ingredient is mixed with when given as a drug or medicinal product).
So Premarin is natural = contains a mix of oestrogens extracted and purified from pregnant mare's urine (not sure of the process exactly) - but is not bio-identical. Only one of the oestrogens is estradiol and I think there are many natural constituents.
Sandrena and Estrogel are formulations of estradiol - which is bio/body identical, but are synthetic in the sense that they have been made in a lab. There are no formulations of "natural" estradiol (ie extracted from original source, rather than manufactured) that I know of.
OK?! Hope that's clear?
If you want to use gel - then either will do. Get back to them - with your prescription and get going!
Good luck
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Hurdity x