Oestrogel general information
What is Oestrogel used for?
Oestrogel is a transdermal gel containing oestrogen that is applied to the skin and used for hormone replacement therapy (HRT), to substitute for a lack of oestrogen production by the ovaries that happens during menopause or following surgical removal of the ovaries. Using Oestrogel helps relieve symptoms of menopause caused by oestrogen deficiency, such as hot flushes, night sweats, sleeplessness, vaginal dryness, headaches, mood swings, lack of concentration and loss of energy. Oestrogel is also used to help prevent postmenopausal bone loss (osteoporosis) and reduce risk of fracture. Oestrogel stimulates the development of female sexual characteristics, and can be used as part of a transgender hormone therapy for male to female transsexuals.
How does Oestrogel work?
The active ingredient in Oestrogel is oestradiol, the major and the most active form of the female hormone oestrogen. When you rub the gel into your skin the oestradiol is absorbed through the skin into your blood. Oestrogen is a steroid hormone produced by the ovaries that binds to specific receptors inside oestrogen-responsive cells and stimulates them to make proteins involved in producing secondary sexual characteristics, such as breast development and in regulating the menstrual cycle. Oestrogen also has several other actions in various metabolic processes including maintaining bone mass and lipid (fat) metabolism. Because the oestadiol in Oestrogel enters your blood directly and continuously, it is not metabolised (broken down) by the liver, as happens when you take oral oestrogen tablets, which means that Oestrogel is effective at a lower dose and provides more even blood levels similar to the natural release of oestrogen by the ovaries.
What does Oestrogel contain?
Oestrogel is a clear, colorless gel that contains oestradiol (0.06%) as the active ingredient, which is the most active form of the female hormone oestrogen and is responsible for the development of female sexual characteristics and regulation of the menstrual cycle. Oestrogel also contains a hydroalcoholic gel base, formulated to provide a controlled release of the active ingredient, made up of purified water, ethanol, trolamine, and carbomer. One dose measured on the spatula provided delivers 2.5g gel containing 1.5mg of oestradiol.
Treating symptoms of menopause with Oestrogel
Oestrogel substitutes for the loss of oestrogen production by the ovaries that occurs during menopause causing symptoms such as hot flushes, night sweats, sleeplessness, dry vagina, headaches, mood swings, lack of concentration loss of energy and bone loss (osteoporosis). Oestrogel is a transdermal gel that is applied to the skin that and contains oestradiol, an active form of the female hormone oestrogen that alleviates moderate to severe menopausal symptoms.
Oestrogel for hormone replacement therapy
Oestrogel is a transdermal gel containing oestrogen that is applied to the skin and used for hormone replacement therapy (HRT) to substitute for a lack of oestrogen production by the ovaries during menopause or following surgical removal of the ovaries. Oestrogel is used to relieve symptoms of menopause caused by oestrogen deficiency, such as hot flushes, night sweats, sleeplessness, vaginal dryness, headaches, mood swings, lack of concentration and loss of energy. Oestrogel is also used to help prevent postmenopausal bone loss (osteoporosis), which is also caused by lack of oestrogen, and reduce risk of fracture.
Oestrogel for transgender treatment
Oestrogel can be used as part of a gender reassignment program for male to female transsexuals, by providing a source of oestradiol, an active form of the female hormone oestrogen. Oestrogel is a transdermal gel containing oestrogen that is applied to the skin and stimulates the development of female secondary sexual characteristics, such as breast development and also induces metabolic changes such as fat distribution to redefine the general body shape.
What are the side effects of Oestrogel?
The most frequently reported side effects when using Oestrogel are: itching where the gel is applied, breast tenderness, breast pain, abdominal pain, nausea, oedema, and headache, skin rash and itching, insomnia and depression. More severe side effects include changes in liver function at higher doses.
When should Oestrogel not be used?
You should not use Oestrogel if you:
- have a past or family history of carcinoma of the breast, endometrial carcinoma or liver disease
- have deep venous thrombosis, thromboembolic disorders, cerebral vascular accident associated with oestrogen use
- abnormal genital bleeding of unknown cause
- are pregnant or planning to become pregnant
- are allergic to oestradiol or any of the ingredients in Oestrogel gel
- are taking other medications that may interact with Oestrogel, such as anticonvulsants like phenytoin and carbamazepin, anti-infectives like rifampicin, rifabutin, nevirapine, efavirenz or preparations containing St John's Wort.
What medications interact with Oestrogel?
Several medications interact with Oestrogel and should either not be taken while you are taking Oestrogel or only after discussion and instruction from your doctor. Drugs that decrease effectiveness of Oestrogel:
- anticonvulsants, such as phenobarbital, phenytoin, carbamezapin
- anti-infectives, such as rifampicin, rifabutin, nevirapine, efavirenz
- ritonavir and nelfinavir for HIV
- preparations containing St John's Wort, such as Hypericum Perforatum
What are the health risks of Oestrogel?
Long-term HRT with Oestrogel does have associated health risks, including an increased risk of breast cancer, endometrial cancer, stroke and deep vein thrombosis. For women with an intact uterus adding a progestogen to an oestrogen replacement regimen like Oestrogel is recommended to reduce the risk of endometrial cancer. There is also an increased risk of developing dementia in postmenopausal women 65 years of age or older.
How should Oestrogel be used?
You should apply a dose of Oestrogel gel to your skin once a day for 24-28 days a month, for as long as recommended by your doctor. The usual starting dose is one measure (2.5g) of Oestrogel (1.5mg oestradiol) daily at the same time each day. Avoid using any skin products that may alter the barrier structure or function of your skin while using Oestrogel, such as strong skin cleansers and detergents, skin care products of high alcoholic content (astringents, sunscreens) and keratolytics (e.g. salicylic acid, lactic acid), products containing benzalkonium or benzothonium chloride and sodium lauryl sulphate, as these could make the Oestrogel less effective.
- Squeeze the gel out of the tube onto the spatula provide, measuring out one dose of 2.5g gel (containing 1.5mg oestradiol) against the marked rule.
- Apply to clean, dry, unbroken skin on the outside of your upper arm, buttocks, upper thigh, lower abdomen or lumbar region. You do not need to rub the gel in, but allow it to dry on your skin for at least 5 minutes. Do not wash the skin or apply other skin care products until at least one hour after application. Do not apply to skin that is red or irritated or to the breasts.
- Wash your hands after applying Oestrogel gel, to reduce the chance that the gel will spread from your hands to other people.
How long should you take Oestrogel?
You can use Oestrogel daily for 24-28 days a month, continuously for as long as recommended by your doctor.
Missed dose of Oestrogel
If you miss a dose of Oestrogel take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should Oestrogel be stored?
Store your Oestrogel tube with the cap on securely, in a cool dry place below 30°C.