If you’re starting Oestrogel, you may have questions about how to use it and what to expect. This guide explains your treatment, how to use it safely, and when to speak to your clinical team.
What you need to know
Oestrogel is an oestrogen-only hormone replacement therapy (HRT), treatment that replaces hormones that fall during menopause. It contains estradiol, a form of oestrogen, in a gel that’s absorbed through your skin; each pump press delivers a measured amount.
This guide covers Oestrogel Pump-Pack 750 micrograms/actuation gel. Apply your prescribed dose once a day and wash your hands afterwards. Avoid skin contact with other people for at least one hour, and keep away from flames until the gel is dry. If you still have your womb, you must also use a separate progestogen — a hormone that protects your womb lining — as prescribed.
Always follow your prescription and read the patient information leaflet supplied with your treatment.
What’s in your treatment?
Oestrogel is an oestrogen-only HRT in the form of a clear, alcohol-based gel. It contains the body-identical hormone estradiol and is applied to the skin (transdermal route). Each press (actuation) of the pump delivers a measured dose of gel.
What is it used for?
Oestrogel is used for the relief of oestrogen deficiency symptoms in women after menopause, such as hot flushes, sleep problems, and vaginal dryness. It is also used for the prevention of osteoporosis (weakened bones that are more likely to break) in women after menopause at high risk of fractures.
Progestogen Requirement: If you have a womb, you must also take a separate progestogen to protect your womb lining. Speak to your clinical team for further advice if you are unsure.
How long does it take to work?
You may notice an improvement in symptoms within a few weeks, but it can take up to three months to adjust and feel the full benefit. Speak to your clinical team if symptoms aren’t improving.
How to use your treatment
Before using a new pump for the first time, you must prime it by pressing the pump once and discarding the first dose:
Apply the gel once daily to a large area of clean, dry, intact skin on your outer arms, shoulders, or inner thighs.
Do not apply it on or near your breasts or genital area.
You should spread the gel thinly, and allow it to dry for at least five minutes before dressing.
Do not wash the area or apply other skin products for at least one hour after application.
It is important to wash your hands with soap and water after applying the gel to avoid transfer from the hands of any remaining gel to other areas (see Other Important Safety Information for Oestrogel).
If you miss a dose
If you forget to apply a dose and it is more than 12 hours until the next dose, the missed dose should be applied and normal dosing resumed the next day. If your next dose is less than 12 hours away, it is best just to wait and apply the next dose normally, and you should not apply two doses at the same time. Forgetting a dose may increase the likelihood of unexpected bleeding and spotting.
Your dose and treatment plan
The usual starting dose is two pumps of Oestrogel gel (1.5 mg estradiol) daily. This can be adjusted by your clinician, up to a maximum of four pumps daily, depending on your symptoms. Your clinician will aim to use the lowest effective dose for the shortest time needed to manage your symptoms, with regular reviews.
There are no special dosage requirements for older patients, although experience in treating women over 65 is limited. This medicine is not for use in children.
Contraception, pregnancy, and breastfeeding
This treatment isn’t contraception. You may still need contraception, including if it’s been less than 12 months since your last period or you’re under 50. Ask your clinical team for advice tailored to you.
If you become pregnant, stop treatment immediately and contact your clinician. This treatment isn’t indicated during breastfeeding.
Other important safety information
It is crucial to understand that if you have not had a hysterectomy (surgery to remove the womb) (i.e., you still have your womb), you must take a separate progestogen hormone (which protects the womb lining) alongside Oestrogel. This is typically prescribed for 12 to 14 days each month. This is a vital safety measure to protect the lining of your womb from the effects of oestrogen, which, when taken alone, can lead to a build-up of the lining (endometrial hyperplasia) and increase the risk of endometrial cancer (cancer of the womb lining).
Risk of Transference: The gel can transfer to others via skin contact.
You should avoid skin contact with other people, especially men and children, for at least one hour after application.
Wait for at least five minutes for the gel to dry before covering the application site with clothing.
If accidental contact occurs, the other person's skin should be washed with soap and water as soon as possible.
Oestrogel should not be applied on or near the breasts or on the vulval region, and we recommend frequently changing the area of application.
Do not apply to any areas of broken skin, and don't swallow.
Please see the Patient Information Leaflet supplied with your treatment for illustrations of how to directly apply Oestrogel.
Flammability: The gel is alcohol-based and flammable until dry. Avoid fire, flames, or smoking during and immediately after application.
Side effects and treatment risks
Common side effects of using Oestrogel include skin reactions at the application site, headache, breast tenderness, and nausea. These often settle in the first few weeks. As a transdermal form of HRT, Oestrogel bypasses the liver and carries a lower risk of blood clots (venous thromboembolism) compared to other systemic forms of HRT, such as oral tablets or capsules. The other risks associated with systemic HRT, such as a small increased risk of breast cancer and stroke, still apply, although the overall risk remains low for most patients being treated. For a full list of side effects, please see the Patient Information Leaflet provided with your medication .
Reviews and ongoing clinical support
Your clinician will review your treatment after three months, then at least once a year. They’ll check your symptoms, side effects, any vaginal bleeding, your weight, and your blood pressure, and decide whether further tests are needed.
Examine your breasts regularly and attend routine screening appointments, including mammograms and cervical screening where appropriate. If you had menopause earlier than expected, discuss how this may affect the benefits and risks of HRT with your clinician.
When to stop treatment and seek medical help
Stop using Oestrogel and seek urgent medical advice if you develop:
Signs of a blood clot, such as painful swelling in a leg.
Swelling of your face, tongue, or throat, difficulty swallowing, or hives with difficulty breathing — possible signs of a severe allergic reaction.
Yellowing of your skin or eyes (jaundice).
A significant increase in your blood pressure.
A new migraine-type headache.
Pregnancy.
If you have difficulty breathing or another life-threatening symptom, call 999. Don’t wait for an email response.
For planned changes or stopping treatment, speak to your clinician. They may recommend reducing your dose gradually to help prevent menopausal symptoms from returning suddenly.
Conditions that need closer monitoring
Tell your clinical team if you have any of the following conditions, have had them before, or they worsened during pregnancy or previous hormone treatment. You may need closer monitoring because they can return or worsen during treatment.
Fibroids (non-cancerous growths in the womb) or endometriosis (tissue similar to the womb lining growing outside the womb)
Risk factors for blood clots
Risk factors for tumours affected by oestrogen, such as breast cancer in a close relative
High blood pressure
Liver conditions, including non-cancerous liver tumours
Diabetes, with or without blood vessel complications
Gallstones
Migraine or (severe) headache
Lupus (an immune-system condition)
A history of thickening of the womb lining
Epilepsy
Asthma
Otosclerosis (a condition affecting the bones in the ear)
How to store your treatment
There are no special storage conditions. Keep out of reach of children.
When to speak to your clinical team
Contact your clinical team if you have questions about your prescribed schedule, side effects, symptoms that aren’t improving, or bleeding that concerns you. For non-urgent questions or to discuss your clinical plan, email [email protected].
Read the patient information leaflet supplied with your treatment for the full list of reasons not to use it, side effects, and precautions. This guide doesn’t replace that leaflet or your clinician’s instructions.
Frequently asked questions
Can I apply it to my breasts or genital area?
No. Apply it only to the areas described in your treatment instructions. Don’t apply it on or near your breasts, to your genital area, or to broken skin.
Can I change my dose myself?
No. Follow your prescription and speak to your clinical team before changing your dose or treatment schedule.
Is this treatment contraception?
No. Ask your clinical team whether you still need contraception and which options are suitable for you.