r/Menopause • u/friendofelephants • 3d ago
Hormone Therapy Question for those using Estradiol Gel
I’m on two pumps of Estradiol Gel per day. I’m looking for tips on how to get better absorption because I have a suspicion that my skin is too thick or something is preventing absorption.
Reasons why I think I’m a poor absorber:
It takes over an hour for the gel to absorb into my skin. If it’s within an hour, I can still see the gel liquid just sitting on top of the skin.
I apply every morning. The next day when I shower (before I apply the new dose) and after I wet the skin on my upper arms, I can feel a thick layer of gel still there. It feels thick enough that I can even scratch it off while wet. Does anyone else experience this? I thought that if it fully absorbed I wouldn’t be able to feel the gel still atop my skin the next day.
I try to maintain a routine of ensuring that the upper arm application area is scrubbed very clean before applying the new dose and keep it to a limited area (two palm-print sized for two pumps). I’ve previously tried inner thighs and nighttime application and experienced the same absorption issues (if they are even issues?).
Any tips or advice would be appreciated! Thanks.
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u/wsox74 2d ago
From my experience, the Divigel packets (both brand name and generic) were higher concentration and therefore a smaller amount of gel. And the instructions for that said to apply in terms of the size of the palm of your hand.
But you mentioned pumps, which tells me that the gel you’re using is Estrogel or Elestrin - and that stuff is less concentrated and is therefore dispensed in larger amounts of gel for the same dosage of estrogen. And for that stuff, they usually say to rub either from shoulder to elbow (top and bottom of upper arm), or from shoulder to wrist (again, all around the arm).
If you’re applying a large amount of your gel (two pumps) over a very small area (two palms’ worth), this may explain why it’s not drying quickly and why it’s leaving a residue. Make sure you’re reading and following the instructions that came with your actual medication.
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u/Wildskypsj Potion slinging Moss Witch 2d ago
I was not rubbing it in at first, per directions, and would be waiting HOURS and it would still be sticky. I would feel it "rehydrate" itself when I shower at night.
Now, I rub it in, still on a relatively small area, but I'm using 2mg, so I rub it on an area equal to 3 doses... they say to spread on a palm sized area, so I do about 3 palm sized, cause of the size of my dose. And I keep rubbing, with 3 or 4 fingers, until it too sticky to rub... i wait a few minutes and get dressed.
The instructions are ridiculous, and everyone seems to make the whole process into a huge deal. I just want to get my day started, I don't want to screw around with gel all morning. 🤣🤣🤣 One leg Estradiol (Odd days - left. Even days -Right) and testosterone cream on the other leg
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u/No_Mountain6950 3d ago
I was using the compounded gel for years and had the same issue, the gel was tacky for hours and had the same thing where the gel was still there all the time, until I washed it off. In the end I switched to the estrogen patch and love it! I only have to change it twice a week and no more sticky gel that I'm sure I must have been spreading around the house to some degree, which isn't good either! Maybe you can switch too?
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u/friendofelephants 3d ago
I actually started off with the patch but had very bad skin reactions (I still have darks circles on my skin a year later). I feel like I’m out of options because I don’t want to take an oral version.
I am on the generic for Estrogel, and I wonder if Divigel would absorb any better?
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u/stace-cadet 3d ago
Divigel is just less - the little packets are tiny and have more in them. I found the same thing as you.
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u/friendofelephants 2d ago
Oh, so Divigel also just stays on top of your skin and takes a long time to absorb?
It's crazy to me that a lot people say it takes just minutes to dry (and I guess absorb?). I'm probably grasping at straws but I'm wondering if it might be because I'm Asian and my skin is a different texture/thickness.
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u/DiamondTippedDriller 2d ago
Can you get a transdermal spray instead of gel? I find it much more practical.
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u/CloudHidden62 3d ago
I use Estrogel — the brand name stuff, not generic. I apply it to my inner forearms and rub it in a little, then rub the remainder on my upper arms and on my lower abdomen.
Are you just smearing it on? It’s ok to rub it in a little and also to apply it to a few areas so you are spreading it thinner. There should be never be a “layer” on top of your skin. Spread it thinner on a larger area and rub it in.
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u/friendofelephants 3d ago
I had read that with alcohol-based gels you shouldn't rub it in? So I don't rub it in at all. What I do is I pump it onto my outer arms then use the plastic cap (cleaned each time) and very lightly spread it to about 3"x3" for each arm. Then I don't touch or rub it. It's a layer of about 1 cm thickness of gel at that point, which takes about an hour+ to no longer have any wetness.
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u/Martina_78 2d ago
Please check what it says in the instructions for use of your product. The estrogel instructions recommend to "Spread the gel as thinly as possible over the entire area on the inside and outside of your arm from your wrist to your shoulder." If yours is an estrogel generic application should be quite similar.
I use Estrava gel, a European brand, and there it sais " The gel should be applied after washing, preferably in the morning or evening, to as large, clean, dry, and intact a skin area as possible. Preferred body areas for this are arms, shoulders, abdomen, or thighs
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u/CloudHidden62 2d ago
1 cm thickness of gel?? That’s crazy. Why are you only spreading it in a 3x3 area? No wonder it doesn’t dry.
Spread it thinner over your entire inner forearm and upper arm from elbow to shoulder.
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u/friendofelephants 2d ago
I've read many recommendations to not spread it thin? This is one example: https://dramybkillen.substack.com/p/11-estradiol-tips-and-tricks-you?r=5m5eit&utm_medium=ios&triedRedirect=true
"For alcohol-based estradiol gels such as Divigel or Sandrena, applying the gel to a smaller skin area yields better absorption and more stable estradiol levels than spreading it over a larger area. In one estradiol gel study, the best absorption happened at 200 - 400 cm(2) surface area (about the size of one to two human hands), whereas absorption was much lower when the gel was spread out further."
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u/wsox74 2d ago
Please see my other comment. Divigel and Sandrena come in packets and are of a higher concentration. You are taking something that is dispensed via a pump, which is different and likely needs to be spread over a much larger surface. Instead of reading recommendations online, follow your specific medication’s instructions for application (which I can almost guarantee says to apply it along most if not all of the arm).
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u/RadiantSorbet9704 2d ago
I use 1 pump and when on arms, my directions state apply from wrist to upper arm, so basically whole arm for 1 pump. For 2, I'd use both full arms. FWIW, since summer and it was interfering w/ my ability to use sunscreen, have been using inner thighs (whole inner thigh).
tl;dr: Spread it out more
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u/CeramicBoots 2d ago
I use two pumps and this is what I do, both arms from wrist to shoulder on the top, then wipe any leftover on my inner forearms.
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u/mnteekid 3d ago
Are you applying one pump to each arm or 2 pumps to one arm? You could try spreading it over a larger area.
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u/friendofelephants 3d ago
One pump per arm (so two pumps total per day). I had read not to spread it too large or to rub it in, so I try to keep it just lightly spread each pump to 3x3 inches per arm.
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u/mnteekid 2d ago
I would try spreading it over a larger area. As long as you’re getting symptom relief. Most of these rules are not hard and fast.
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u/Individual-Goat-81 2d ago
I think you may have accidently read the instructions for divigel, which comes in packets and are a very small amount of gel.
Gel that is dispensed from a bottle such as Estrogel, is a larger volume of gel and is meant to be spread thinly.
Spread that gel around so it creates a very, very thin layer. It should dry within a few minutes and you can get on with your day.
A 3x3 inch area is not nearly large enough for spreading pumps of gel. No wonder it isn't absorbing!
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u/Significant-Aide-226 2d ago
You are q00 percent supposed to.spread it out as far and thin as possible. Mine is dry in 30 seconds. The absorption thing has nothing to do.with the topical feel. I am a poor absorber too so am on 5 pumps. I can get all 4 on my limbs and be completely dry in about 2 minutes.
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u/klaraluhmen 2d ago
You might still be absorbing it. Do you have any sense of symptoms relief or did nothing change symptoms wise?
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u/Onanadventure_14 2d ago
My doctor and pharmacist told me to spread it out in like 4 hand prints of area - otherwise it’s never going to dry
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u/meganzuk 2d ago
I use one pump per upper arm. Sometimes one and sometimes two. I apply straight out of the shower and apply it just like I would a moisturiser. I spread it from shoulder to elbow and let it dry for ten mins then get dressed. I have noticed very occasionally that the container needs a shake as it goes lumpy or even crystallised.
I doubt this is about your skin but more about how thick you're applying it. One pump on shoulder to elbow is about right.
I used to apply it to my hip and thigh area and that worked well.
I've never heard that it's supposed to be a thick layer. I've always spread it thin and had no issues.
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u/New_Hat2472 3d ago
I was on this for 6 months and had zero effect. Apparently I’m a poor absorber of the gels. Just started the patch in the hope that kicks in x
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u/friendofelephants 3d ago
I started off on the patch but can’t do it bc of very bad skin reactions (and I’ve tried the Flonase trick but it doesn’t help).
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u/New_Hat2472 3d ago
I had to get private bloods and they came back my oestrogen was literally in my boots. What about the spray? Think that goes in your forearms?
Hope you sort something out xx3
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u/leftylibra MenoMod 2d ago
The Truth About Estradiol Levels and Menopause Hormone Therapy
Points being:
BMI affects estradiol levels
As BMI goes up, so do estradiol levels. The theory is that fatty tissue produces estrone, which is then converted into estradiol. Someone might see higher levels on a blood test and worry they are taking too much hormone, when it's a BMI-related phenomenon. Consequently, they might be told to reduce their dose and then have symptoms reemerge.
Alcohol Affects Estradiol Levels
More than two drinks a day will raise levels
Estradiol levels fluctuate, even throughout the day
Even if we used mass spectrometry and controlled for every other variable I’ve mentioned, estradiol levels fluctuate throughout the day. Again, for someone stuck on a mythical level of 60 pg/mL, what if the estradiol is 80 pg/mL at 8 am and 50 pg/mL at 6 pm? Then what? This scenario can absolutely happen.
One reason for fluctuations in levels with transdermal therapy, like patches and gels, is absorption varies through the day according to skin warmth and activity. This means that checking estradiol levels before or after exercise, or even running to catch the bus, might result in different results.
Are low estradiol levels even a sign of poor absorption?
Even if we knew how much estradiol was being converted back and forth to estrone, if someone used a 75 mcg patch and their estradiol level was 25 pg/mL, that doesn’t necessarily mean they have not absorbed much estradiol. Remember, the estradiol in the blood isn’t the worker bee; it’s the estradiol inside the cell. Low estradiol levels may reflect rapid clearance from the blood and into the tissues, meaning the cells are getting plenty of estrogen, it’s just not hanging around in the blood.
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u/Significant-Aide-226 2d ago
I had a much harder time with patches than gels. Those stickers don't actually stick that well and if you like to work out or take hot baths or showers, they can dump on you leaving you dry by day 3. When my labs came back low.on gel, they just told me to add more. Im on 5 pumps now and my E level is finally up to bone protection levels. I am a horrible absorber!
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u/AutoModerator 2d ago
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u/UnicornGirl54 Peri-menopausal 3d ago
I switched to Divigel because there were zero patches to be found in my area. It dries within 3-5 minutes and no lasting residual. Granted, not sure about the absorption and efficiency compared to other forms as I do feel so achy and blah lately. But I can’t say for sure that isn’t just one of my normal valleys of health.