Oestrogen gels are topical hormone treatments used for oestrogen replacement therapy or gender-affirming care. They deliver oestrogen through the skin, providing steady blood levels without injections.
Common brands include Estrogel, Divigel, Dosiergel, Oestrogel, and Sandrena.
All contain the same active ingredient (oestrogen) but differ in strength, formulation, packaging, and regional availability. Always check with your dispenser or pharmacy beforehand to make sure they can provide your chosen gel.
| Product Name | Active Ingredient & Strength | Typical Dose Form | How It’s Applied | Key Notes |
|---|---|---|---|---|
| Estrogel 0.75 mg dose (0.06% gel) | Estradiol 0.75 mg per measured dose (0.06%) | Metered dose from tube or applicator | Applied to clean, dry skin on arms or legs | Usually 1 measured dose daily; strengths differ from pump-pack Estrogel |
| Oestrogel Pump-Pack (750 micrograms per actuation) | Estradiol 0.75 mg (750 micrograms) per pump | Pump dispenser | Spread thinly over arms or legs | One pump provides 0.75 mg; number of pumps per day varies by prescription |
| Divigel 0.1% (1 mg per 1 g sachet) | Estradiol 1 mg per sachet (0.1%) | Individual sachets | Entire sachet spread on lower abdomen or thigh | Single-use sachets for easy dosing; usually 1 sachet daily |
| Dosiergel (0.6 mg/g estradiol) | Estradiol 0.6 mg per gram of gel | Tube with metered doses | Applied to arms or legs | Dose measured using dosing card or instructions; daily amount varies |
| Sandrena 1 mg gel | Estradiol 1 mg per sachet (1 mg/1 g) | Sachets (1 mg or 0.5 mg options) | Applied to lower abdomen or thigh | Often 1 sachet daily; small application area compared with some other gels |
How to Use These Gels
Application Steps
Apply to clean, dry, unbroken skin. Common areas: upper arms, shoulders, inner thighs. Avoid breasts and genital areas.
Use your prescribed dose (pump, measured amount, or sachet), then spread gently over the area.
Allow the gel to dry before dressing.
Do not wash the application site for a while after – usually 1–2 hours, depending on the gel. With Oestrogel, washing too early can significantly reduce absorption.
Wash your hands after applying to avoid accidentally transferring oestrogen to others (or pets).
What Dose Might You Take?
Oestrogel / Oestrogel Pump: Often started at 0.75 mg (1 pump) daily, then titrated. You might increase or decrease depending on your blood estradiol levels.
Sandrena: Initial doses often 0.5 mg daily, adjusted up based on your response.
Benefits and Considerations
Pros of Gel:
Steady hormone levels: Gels tend to offer a more stable estradiol level than some other methods.
Flexible dosing: You can adjust daily dose more easily than some long-acting injections.
Non-invasive: No needles, so good for needle aversion.
Lower liver impact: Transdermal delivery avoids first-pass liver metabolism.
Things to Be Careful About:
Transfer risk: Because it's on the skin, there’s a risk of transferring the hormone to others if not fully dry or if you touch someone too soon.
Skin reactions: Some people may get irritation where they apply.
Absorption varies: How well the gel is absorbed depends on where you apply, skin type, and how well you spread it.
Monitoring is important: To make sure your levels are right (not too low, not too high), blood tests matter.
Dose adjustments: If your estradiol isn’t in your target range, we might adjust your dose.
What Side Effects Might You Experience?
Common side effects include (but are not limited to):
Breast tenderness or growth
Fluid retention, bloating
Mild nausea or indigestion
Headaches
Mood changes (e.g., anxiety)
You can read more about oestrogen gel side effects here.
When Might Gel Not Be the Best Option?
If you have very sensitive skin or get irritation regularly.
If you struggle to apply daily.
If you have since developed a health condition that makes monitoring difficult.
If you want very rapid hormone-level changes (though gel can still work well, depending on your goals).
Safety & Monitoring
Ongoing blood tests: After starting or changing dosage, make sure to keep up with your blood tests.
Dose titration: We may adjust your gel dose every few months, based on test results and how you feel.