EstroGel Gel: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

EstroGel Gel is a prescription hormone replacement therapy containing estradiol, used in postmenopausal women. It is applied to the skin to reduce moderate to severe hot flashes, relieve vaginal dryness and irritation, and help prevent osteoporosis in women at high risk of fractures. It belongs to the estrogens drug class and comes as a transdermal gel in a pump pack.

What is EstroGel Gel

EstroGel is a clear, colorless gel medicine that contains an estrogen hormone called estradiol. Estrogens are female sex hormones that regulate many processes in the body. It is a prescription hormone replacement therapy used in postmenopausal women.

EstroGel Gel uses

• Reduce moderate to severe hot flashes caused by menopause
• Relieve vaginal symptoms such as dryness, burning, and irritation
• Prevent osteoporosis (fragile bones) after menopause in women at high risk of fractures who cannot use other osteoporosis medicines

Benefits of EstroGel Gel

• Helps relieve moderate to severe hot flashes associated with menopause.
• Helps reduce night sweats and other vasomotor symptoms.
• Replaces some of the estrogen lost after menopause.
• Can help improve sleep and daily comfort when symptoms are related to low estrogen.
• Provides transdermal estradiol therapy, allowing estrogen to be absorbed through the skin.

How EstroGel Gel works

EstroGel works by replacing the estrogen your body stops making after menopause, bringing your estrogen level closer to what it was before menopause. This is chemically identical to the natural hormone estradiol made by the ovaries.

EstroGel Gel dosage

Apply only to clean, dry, unbroken skin; do not apply to skin that is red or irritated. Never apply to the breasts, face, or vaginal area. Apply at the same time each day, either in the morning or evening.

If you bathe, shower, or use a sauna, apply your dose afterward; if you plan to swim, leave as much time as possible between applying the gel and swimming. Make sure skin is completely dry before applying.

Spread the gel thinly over a large area of skin such as the arms and shoulders or inner thighs, keeping the area as consistent as possible from day to day. Do not rub or massage the gel in; let it dry for up to 5 minutes before dressing.

Avoid smoking or being near an open flame until the gel has completely dried, as it is flammable. Wash your hands with soap and water after applying.

Avoid close skin contact with others, especially a partner, for about an hour after applying, and cover the treated area with clothing. Do not wash the skin or apply other skin products until at least one hour after application. Do not use strong skin cleansers or detergents on the area where you apply the gel.

Children should avoid contact with skin where the gel has been applied. Wait at least 25 minutes after applying before putting on sunscreen on the same area.

If you miss a dose and it has been more than 12 hours, skip the missed dose; do not double up. This medicine should only be applied by the person it is prescribed for, not by anyone else.

Available forms and strengths

• Transdermal gel (pump pack), 1.25 g gel containing 0.75 mg estradiol per pump

Side effects of EstroGel Gel

Common

• Breast pain or tenderness
• Headache
• Vaginal itching or discharge, changes in menstrual periods, light vaginal bleeding or spotting
• Thinning scalp hair or hair loss
• Nausea, vomiting, bloating, stomach cramps or pain
• Flatulence
• Weight change (increase or decrease), water retention with swelling
• Mood swings, depression
• Vertigo
• Change in libido
• Skin discoloration, acne

Serious

• Signs of an allergic reaction: hives, difficulty breathing, swelling of face, lips, tongue, or throat
• Heart attack symptoms: chest pain or pressure, pain spreading to jaw or shoulder, nausea, sweating
• Signs of a blood clot: sudden numbness or weakness, sudden vision loss, slurred speech, stabbing chest pain, coughing up blood, pain or warmth in one or both legs, shortness of breath
• Severe stomach pain spreading to the back, with nausea and vomiting (gallbladder problems)
• Jaundice (yellowing of the skin or eyes), dark urine, light-colored stools, loss of appetite, unusual tiredness (liver problems)
• Memory problems, confusion, unusual behavior
• Unusual vaginal bleeding or spotting, pelvic pain
• A new lump in the breast, or breast changes such as dimpling or nipple changes
• High calcium levels: confusion, tiredness, nausea, vomiting, loss of appetite, constipation, increased thirst or urination, weight loss
• Signs of stroke: sudden numbness or weakness of face, arm or leg, trouble speaking, confusion, trouble walking, loss of balance, dizziness, severe headache, vision changes
• Large rise in blood pressure: headache, tiredness, dizziness
• Migraine-like headaches happening for the first time
• Rash with target-shaped reddening or sores
• Swollen nipples or enlarged breasts in a child who has had contact with the medicine

Warnings and precautions

• Do not use this medicine if you are pregnant or think you might be pregnant. If you become pregnant while using it, stop right away and contact your doctor.
• Do not use this medicine if you are breastfeeding. The hormone can pass into breast milk and may harm a nursing baby, and it may also reduce milk production.
• Tell your doctor if you have kidney disease before using this medicine, as it may need extra caution or monitoring.
• Do not use this medicine if you have liver disease or if your liver function tests have not returned to normal.
• This medicine has little or no effect on your ability to drive or use machines.
• Do not use if you have a history of heart attack, stroke, blood clots, a bleeding or clotting disorder, liver disease, abnormal vaginal bleeding, an allergy to estradiol, or a hormone-related cancer such as breast or uterine cancer.
• This medicine may increase your risk of a condition that can lead to uterine cancer. Tell your doctor right away about any unusual vaginal bleeding.
• Children should not touch skin where you have applied this gel, because the hormone can be absorbed through their skin and cause early puberty or breast changes.
• This medicine will not prevent heart disease, stroke, or memory loss, and may actually raise your risk of these problems. Long-term use may also raise your risk of breast cancer or blood clots.
• Using estrogen with or without a progestogen increases the risk of breast cancer and endometrial (womb lining) cancer, and the risk increases the longer you use it.
• Using this medicine raises your chance of getting a blood clot in a vein, especially during the first year of use.
• Using this medicine raises your risk of stroke.
• Do not get the gel in your eyes; if this happens, rinse with plenty of water.
• Grapefruit and grapefruit juice may interact with this medicine and cause potentially dangerous effects; talk to your doctor about this.
• If you need surgery or will be on bed rest, you may need to stop this medicine for a short time, and your surgeon should know you are using it.
• This medicine can be transferred to other people or pets through skin contact, which can cause serious side effects for them; cover the application site and wash off any accidental contact right away with soap and water.

Storage

• Store at 20–25°C (68–77°F) at controlled room temperature.
• Keep the pump container properly closed and in its original packaging.
• Protect from excessive heat, moisture, and direct sunlight.
• Keep away from open flames, sparks, and smoking, as the gel is flammable until dry.
• Keep out of reach and sight of children and pets.

When to see a doctor

• Get emergency help right away if you have signs of an allergic reaction such as hives, trouble breathing, or swelling of your face, lips, tongue, or throat.
• Stop using this medicine and call your doctor right away if you have heart attack symptoms like chest pain or pressure, pain spreading to your jaw or shoulder, nausea, or sweating.
• Get medical help immediately if you notice signs of a blood clot, such as sudden numbness or weakness, sudden vision loss, slurred speech, sharp chest pain, coughing up blood, or pain or warmth in a leg.
• Seek medical attention for severe stomach pain that spreads to your back, along with nausea and vomiting, which could be a gallbladder problem.
• Contact your doctor if your skin or eyes turn yellow, which could mean a liver problem.
• Tell your doctor about memory problems, confusion, or unusual behavior.
• Report any unusual vaginal bleeding or pelvic pain to your doctor right away.
• Tell your doctor immediately if you find a lump in your breast.
• Get medical help if you have signs of high calcium levels, such as confusion, tiredness, nausea, vomiting, loss of appetite, constipation, increased thirst or urination, or weight loss.
• If a child who has close contact with you develops swollen nipples or enlarged breasts, call your doctor.
• Seek emergency medical help or contact your local poison control center right away if you think you or someone else has taken too much of this medicine.

Alternatives

• Estrace (Estradiol)
• Estradot (Estradiol Patch)
• Vivelle-Dot (Estradiol Patch)
• Climara (Estradiol Patch)
• Divigel (Estradiol Gel)