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[Lamplighter]

Hi everyone, have been having a fun time trying to find an HRT that works for me, and recently switched from Elleste Duet Conti 2mg estrogen to two pumps of Oestrogel gel and Utrogestan pills. 

I'm wondering what the maximum dose of Oestrogel pumps is, as I'm finding two pumps a day is not enough to keep the horrendous post menopausal symptoms at bay and would like to up the doses in line with the amount of estrogen I was taking with the Elleste. 

Is four pretty normal?  And does two pumps roughly equal 1mg estrogen and four equal 2mg?  And if you take four, do you split them, say twice in the morning and twice at night, or all at once, and where do you apply all four?  I'm using inner thighs at the moment, where else can you apply the gel?  Questions questions!

A consultant I saw said I could up the dose if I needed to, but my doctor is being inflexible about prescribing me extra, claiming that two pumps is the normal dose.  I'm hoping to speak to the consultant again but am still waiting to hear back, so in the meantime have come here for help.

I'm looking for advice on this both for me to feel ok about upping the dose myself, and also for when I speak to my GP (earliest next Monday! and today is Wednesday, so much for quick and easy access to your GP with this phone call surgery business). 

Thanks

LL


p.s. I realize there's probably a ton of stuff on this in the forums, but it's difficult and time consuming trawling through all the posts trying to find specific info. 

[Dotty]

Hi Oestrogel dosage is up to 4 pumps per day , but this is increased for some ladies under supervision from a specialist .

The rough equivalent to Elleste Duet Conti is 2 pumps. It’s hard to say exactly how much is equivalent as they are different methods. Did the Elleste Duet Conti work for you ?

I use 4 pumps and put it all on at once in a morning. There’s no need to split the dose, but some ladies do split it.

You need as much gel as stops your symptoms. x

[sheila99]

I use 4 now but started on 2 in peri, I increased when symptoms returned. You can put it outside arms/shoulders (read the leaflet!) but I use thighs only and apply 2 pumps twice a day but this is just for ease of use. You should increase gradually.

[Lamplighter]

Thanks Dotty and sheila99 for replying.   

Sheila, I should have said what my leaflet says (only upper arms) and that thighs was the consultant's recommendation - so I'm interested to know if anyone uses any other part of their body.

Dotty, thanks for the info - I'm surprised though about two pumps Oestrogel equalling Elleste as I understood two pumps equalled roughly 1mg estrogen, whereas my Elleste is the 2mg dose.  If it's equal that means I'd be having more estrogen than before (probably not a bad thing actually!) but I can see having problems convincing my GP to accept it.  Bleh.

I'm quite happy to take more estrogen until it gets the symptoms under control, the trouble is convincing doctors.  I'm hoping for some references to bring to my GP to persuade her that it's ok to up my prescription (which she ekes out on a monthly basis as it is, talk about being made to feel insecure...) 

LL

[Dotty]

Hi 2 pumps is 1.5mg of oestrogen. It is roughly equal to a 2 mg tablet as some of it is lost in the digestive tract when taking it orally.

I have a conversion table but not sure how to post it . X

[Dotty]

https://thebms.org.uk/wp-content/uploads/2018/08/HRT-Practical-Prescribing-AUG2018.pdf


Here’s the link to the table that gives you equivalent doses.

[Lamplighter]

Thanks Dotty for the link, very much appreciated 

Yeah it looks like they're more or less equivalent, though from my own experience with for instance the evorel conti patches which in the link are equal to 2mg estrogen, I had significantly increased symptoms of post menopause compared to the oral HRT I'd been taking originally.  I'd always assumed (on that basis) that the patches were more or less equal to the 1mg range, which also gave me no relief from post menopausal symptoms.

Maybe transdermal just isn't right for me?  How utterly depressing it all can be.

LL

[Dotty]

I think you just need to find the right dosage of Oestrogel. I took Elleste Duet Conti for 3 months and it didn’t nothing for my horrendous symptoms. I started on 3 pumps of Oestrogel and after a month increased to 4. Then my symptoms started to disappear. Once I was on the right dosage, I was fine. X

[Lamplighter]

Thank you Dotty 

LL xx