What is Oestrogel?

Oestrogel is a transdermal oestrogen supplement that is used to replace lost hormones during peri menopause and menopause. It’s also less commonly used to suppress the ovarian cycle in the treatment of Premenstrual Dysphoric disorder, which happens to be what I am using it for. After twenty years and many, many attempts at treatment, including antidepressants, birth control and birth control induced cycle suppression, my symptoms have, over time, bettered and then worsened again. After giving birth to my son in 2021 and suffering severe perinatal mental illness, I noticed an increase in the severity of my PMDD symptoms. Symptoms included intrusive thoughts, suicidal ideation, anxiety, and brain fog. Along with exacerbation of physical symptoms; frequent migraine attacks, perennial fatigue, recurrent shingles outbreaks and an increase in fibromyalgia associated musculoskeletal pain. My doctor, (after some persuasion) finally got advice from gynaecology who agreed to proceed with Oestrogel as a treatment, providing I had a mirena coil fitted which contains localised progesterone to protect my uterus from hyperplasia. Please note it’s strongly advised you discuss the use of add back progesterone with your health care provider in the treatment of PMDD.

Treatment pathway for PMDD

Below is the treatment pathway for UK patients. You can find out more detailed information by visiting IAPMD or NAPS for resources.

How to apply the gel.

There are various ways to apply Oestrogel, for most women, application to the upper arms is the easiest and preferred method. I was specifically advised by my doctor not to apply above the waist due to the other health issues I have, and therefore, I apply my Oestrogel to the inner thighs, one pump to each. Rub the gel over a large area leaving a sheen on the skin and then allow to dry before getting dressed. It’s important not to apply too close the the genitals due to the absorption differences in that area, or breasts, because of the oestrogen receptors present there. I was also advised to apply the gel at roughly the same time each day.

How’s it going?

I’ve been applying this gel everyday for a week and I’ve felt pretty rubbish if I’m honest. I’ve experienced saturating night sweats, insomnia, nightmares, nausea, migraine attacks, plus prominent feelings of anxiety and agitation. However – and this is important; looking at my cycle tracker I felt the same on these days last month. Aside from the night sweats and insomnia, last month at this exact time, I reported feeling ‘keyed up’ suffered a three day migraine attack, and felt particularly unwell requiring a day off from work. I also believe some of my current anxiety could be directly related to my personal fear of negative side effects. I did ask my GP the likelihood of a worsening in symptoms upon starting the HRT, and she said it was unlikely to have a result on mood – she knows pretty much nothing about PMDD so naturally I did my own research and pulled the below reference from the late Prof John Studd’s clinic website, referring to the use of transdermal oestrogen in the treatment of PMDD:

Ovulation can also be suppressed by moderately high dose transdermal oestrogens in the form of oestradiol patches or oestradiol gel. Appropriate doses would be a 200ugs oestradiol patch or 2 or 3 doses of oestrogel twice daily. Woman may occasionally feel a little worse in the first two weeks on this high dose, like an early pregnancy, but should be advised to continue as substantial benefit is almost certain if the diagnosis is correct.

John Studd Women’s Health Clinic

I found this reference particularly relevant because I said to my husband just yesterday that I feel almost exactly like I did in early pregnancy, and that was bad!

Moving forward

There’s a fair amount of controversy about the long term use of HRT particularly for women who are not yet experiencing symptoms of menopause. That said, it’s not a short term fix either, my doctor advised I need to give the Oestrogel a minimum of three months at the current dose before deciding if it’s of benefit. So I’ll continue, and aim to update you fortnightly going forward. I also plan to save enough money to visit a private gynaecologist, because sadly as we know the NHS is not doing so great and the wait times for appointments when you’re feeling suicidal or experiencing symptoms so debilitating it’s affecting your everyday life just aren’t acceptable. If you’re wondering how I can afford this, the answer is, I can’t afford it, but nor can I continue to live through this hell. Wish me luck.

Disclaimer: Every PMDD patient will respond to treatment differently. In the writing of this blog I aim to provide an honest account of my personal experience. Although this post contains hyperlinks to official medical resources, it does not constitute medical advice. My experience is individual and yours will be too. Please see your healthcare provider to discuss all of the treatment options available to you.