How you take oestrogen depends on which type you're using.
Always follow the instructions from a pharmacist or GP, or the leaflet in the medicine packet.
Dosage
Oestrogen (estradiol) tablets come in strengths of 1mg or 2mg. You take them once a day.
The patches release different amounts of estradiol into your body every 24 hours, depending on the brand.
The amount of oestrogen you need depends on:
- your symptoms
- your age
- other health conditions you have
You'll usually start on a low dose, and it may be increased later. This depends on how well it works and if you get any side effects.
It may take a few weeks before you notice your symptoms improving, and you may get some side effects at first.
It's best to keep taking it for at least 3 months to see if it helps.
If your symptoms do not improve, your GP may suggest changing your dose or the type of HRT you're taking.
How to take tablets
Swallow the tablets with a drink of water. Try to take them at the same time each day.
If you still have regular periods, start taking oestrogen tablets between day 1 and day 5 of your period. Then continue to take them every day.
If your periods have stopped or do not happen often, or if you've had a hysterectomy, you can start taking the tablets at any time.
Always follow the instructions on the leaflet that comes with your medicine.
How to use patches
If you're still having regular periods, start using the patches between day 1 and day 5 of your period.
If your periods have stopped or are infrequent, or if you've had a hysterectomy, you can start using the patches at any time.
Always follow the instructions on the leaflet that comes with your medicine.
Stick the patch onto a hairless area of skin below your waist, such as on your thigh or buttock.
Do not put the patch:
- near your breasts
- on top of cuts, spots or irritated skin
- under elasticated or tight areas of clothing
- on creases or folds in your skin
- on your skin if you have recently used cream, talcum powder or moisturiser
- on skin exposed to direct sunlight
Wait at least 1 hour after putting the patch on before you do any activity or exercise that will make you sweat. This can affect how the patch sticks to your skin.
You'll need to change your patch twice a week.
Make sure you remove the old patch when you put on a new one. Put the new patch on a different area of skin.
If your patch falls off, put a new patch on a different area of skin, and then change it again at the usual time.
Your patch should stay on while bathing, swimming, exercising or showering. But if it does fall off, dry your skin and cool down before putting on a new one.
The patch should be covered from sunlight. When swimming, you can wear the patch under your bathing suit.
How to use gel
Oestrogen gel comes in sachets (for example, Divigel) or in a pump dispenser (for example, Oestrogel).
Put the gel on once a day. Try to use it at the same time each day.
Your doctor will tell you how many pumps or sachets to use. Follow the instructions that come with the gel.
- Wash your hands.
- Squeeze the right amount of gel onto your hand.
- Gently rub the gel over a large area of clean, dry skin, on your lower body or arms - check the instructions for where you can use it.
- Wait up to 5 minutes for the gel to dry before getting dressed.
- Do not wash the area for at least 1 hour.
Wash your hands after putting on the gel.
Don't
-
do not use the gel on the same area of skin 2 days in a row
-
do not use the gel on skin near your breasts or genitals
-
do not use the gel on skin where you have applied talcum powder or other creams or ointments
If another person accidentally touches the area of your skin where you applied the gel, tell them to wash with soap and water right away.
How to use spray
Oestrogen spray is called by the brand name Lenzetto.
The usual dose is 1 to 3 sprays, once a day, at the same time each day. Your GP will tell you how many sprays to use.
- Take off the cover and put the cone flat against your skin, on your inner forearm. If that is not possible, apply the spray on the inner thigh. Do not apply to the breasts or any area near the breasts.
- Press and hold the button fully down once.
- If you need to use more than 1 spray, move the cone to a different place on your inner forearms for each spray.
- Allow up to 2 minutes for the spray to dry before getting dressed.
- Do not wash the area for at least 1 hour.
If another person accidentally touches the area of your skin where you applied the spray, tell them to wash with soap and water right away.
How long to take it for
It's common to take HRT for 2 to 5 years to treat menopause symptoms. But sometimes you may need to take it for longer.
If you have early or premature menopause you'll usually be advised to take HRT at least until you're age 51 (the average age of menopause).
How long you take HRT for depends on the benefits and risks to you. Ask your GP for advice.
If you stop taking oestrogen your menopause symptoms might come back. If you're taking it for osteoporosis there is a chance that your bones will get weaker. You may be more likely to have fractures in the future.
Talk to your GP if you're thinking of stopping. They will help you decide what's best for you. They may suggest that you reduce your dose gradually, to help stop symptoms coming back.
If you forget to take it
If you forget your daily dose of oestrogen tablets, gel or spray, take it as soon as you remember unless the dose is more than 12 hours late.
If it is more than 12 hours late, skip the missed dose and continue the treatment at the same time on the next day. Missed doses may cause some vaginal bleeding or spotting (like a period).
If you forget to put on a patch, change your patch as soon as you remember and then change it again on the usual day.
Important
Never take or use 2 doses at the same time. Never take or use an extra dose to make up for a forgotten one.
If you often forget doses, it may help to set an alarm to remind you. You could also ask a pharmacist for advice on other ways to help you remember to take your medicine.
If you take or use too much
Taking or using an extra dose of oestrogen is unlikely to harm you. You may feel sick, vomit, dizzy, sleepy and have withdrawal bleeding or breast tenderness.
If you take more than you should, talk to a GP or pharmacist for advice.
Stopping oestrogen
Tell your GP if you're thinking of stopping your oestrogen. They may suggest that you reduce your dose gradually. This is to help prevent your menopause symptoms coming back.
If you're having problems with side effects, your GP might suggest changing your dose or switching to another type of HRT.
If you have surgery
If you are going to have surgery, tell the surgeon that you are using oestrogen as HRT. They will advise you to stop taking your oestrogen tablets about 4 to 6 weeks before the surgery. This is to reduce the risk of a blood clot.
Ask your GP or surgeon when you can start using HRT again.
Oestrogen and alcohol
You can drink alcohol while taking oestrogen. But it may be helpful to cut down on alcohol during the menopause to reduce symptoms of flushing and improve your sleep.
Oestrogen and diet
You can eat and drink normally while taking oestrogen. Eating a healthy, balanced diet can help with menopause symptoms and keep you well.
Cutting down on caffeine may help reduce hot flushes and improve your sleep.