One 80g (64 measured doses) Oestrogel Pump-Pack is £4.80.1 This will last 4 weeks at the standard dose of 2 measures. (1.5mg 17β – oestradiol) per day.2
Oestrogel contains approximately 100ml gel. The following recommendation is provided on the UK government website (www.Gov.uk).3
You’re allowed to carry essential medicines of more than 100ml in your hand luggage, including liquid dietary foodstuffs and inhalers.
You’ll need supporting documentation from a relevant medical professional (for example a letter from your doctor or a copy of your prescription). The same applies for gel packs.
Airport staff might need to open the containers to screen the liquids at the security point. However, airports may differ and we would recommend that the patient checks with them in advance of the flight.
Each metered dose or pump actuation from the dispenser is 1.25g of Oestrogel, which contains 0.75mg 17β – oestradiol. The usual starting dose is two metered doses or pump actuations per day (total daily dose of 1.5mg 17β – oestradiol). If after 1 month’s treatment, effective symptom relief is not obtained, the dosage may be increased accordingly, to a maximum of four metered doses or pump actuations (3mg 17β – oestradiol daily).4
Oestrogel is only applied to certain areas to obtain an optimal rate of absorption. The correct dose of gel should be dispensed and applied to clean, dry, intact areas of skin (e.g. on the arms and shoulders, or inner thighs). The area of application should be as large as possible and at least 750cm2. One metered dose or pump actuation from the dispenser, or half the prescribed standard dose, should be applied to each outer arm and shoulder of both arms or the mid-inner thigh of both legs. Oestrogel should NOT be applied on or near the breasts or on the vulval region due to its alcohol content.4
Oestrogel is a “body-identical” HRT, containing hormones that are identical in molecular structure to the hormones women make in their bodies.5
Body-identical should not be confused for compounded bio-identical hormones. NICE Guidelines on Menopause (NG23) describes compounded bio-identical hormones as unregulated plant-derived hormonal combinations similar or identical to human hormones that are compounded by pharmacies to the specification of the prescriber. NICE (NG23) recommends to healthcare professionals that they should explain to women that the efficacy and safety of unregulated compounded bio-identical hormones are unknown.6
Due to the risk of cancer of the womb when an oestrogen is given on its own, women who still have their uterus will generally be prescribed a progestogen in addition to Oestrogel. Women who have had a hysterectomy may be able to use Oestrogel on its own, but they should discuss this with their doctor first.4
1. NHS Business Services Authority DM+D Browser, available online at https://apps.nhsbsa.nhs.uk/DMDBrowser/DMDBrowser.do#. [accessed March 2019]
2. Oestrogel patient information leaflet. Available from www.medicines.org.uk/emc/product/353/pil.
3. Gov.uk. Hand luggage restrictions at UK airports. Available from: www.gov.uk/hand-luggage-restrictions/essential-medicines-and-medical-equipment [accessed March 2019]
4. Besins Healthcare (UK) Ltd; EMC. Oestrogel Pump-Pack. Summary of Product Characteristics (last updated July 2019) Available from: www.medicines.org.uk/emc/product/353/smpc [accessed July 2019].
5. Panay, N. Post Reproductive Health Vol 20, Issue 2, 2014.
6. NICE. Menopause: diagnosis and management. Guideline NG23. 2015. Available from: www.nice.org.uk/guidance/ng23 [accessed March 2019]