Hi Crossfitmum
Yes your doc is right that you absorb differently from the different methods so you my not be absorbing the gel but theoretically as Dotty and Tinkerbell says, 4 pumps is classed as a high dose so equivalent would be 100 mcg patch. 0.25 mcg is a low dose. If you are not absorbing the gel then I wouldn't start with 100 mcg but get 75 mcg and then cut down initially to around 50 or a bit more for a few weeks and see how you feel.
In any case if your symptoms are joint pain only - this may not be due to insufficient oestrogen and I presume you have had other causes investigated? The primary indicators of whether the dose is sufficient are hot flushes and sweats, as well as mood (oestrogen = feel good hormone!), and a myriad of other symptoms too, palpitations, joint pain etc but some of these are more subtle and less easy to determine in terms of oestrogen I would say?
Also to say that estradiol is the type of oestrogen and this is the same in the gel and the patch.
All the best
Hurdity x
