Estrogen gel is a type of hormone therapy (HT) that contains estradiol. It’s used to help relieve symptoms of menopause such as hot flashes and night sweats. Estrogen gel is one form of transdermal estrogen, which means it is absorbed through the skin.
Find what you need quickly
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What is estrogen?
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Who needs to take estrogen as part of hormone therapy?
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What is estrogen gel?
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Why should you consider estrogen gel?
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How do you use estrogen gel?
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Benefits of estrogen gel
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Disadvantages of estrogen gel
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What are the risks of estrogen gel?
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What are the side effects of estrogen gel?
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Final word
What is estrogen?
Estrogen is a hormone produced by the ovaries. It plays an important role in regulating many of your body’s functions, including how your reproductive system works.
Estrogen levels fall during menopause, which can cause unpleasant symptoms like hot flashes, night sweats, vaginal dryness, and mood changes.
Hormone therapy (HT) relieves the symptoms caused by low estrogen levels during menopause. HT contains estrogen and sometimes progesterone too.
Who needs to take estrogen as part of hormone therapy?
Estrogen is the key medication in HT. It helps reduce menopause symptoms such as hot flashes, night sweats, mood changes, and vaginal symptoms, like dryness, tightness, and itch. Your healthcare provider will be able to tell you about your personal treatment options.
What is estrogen gel?
Estrogen gel is a type of systemic HT. Systemic HT is hormone therapy that is absorbed into your blood and distributed throughout your body. It treats most menopause symptoms including hot flashes, mood changes, joint pain, sleep problems, and low libido.
Systemic HT comes in two categories: oral HT and transdermal HT. Oral HT means tablets or capsules that you swallow. Transdermal HT is absorbed through your skin. Transdermal HT comes as a patch, cream, gel, or spray.
Why should you consider estrogen gel?
Estrogen gel is popular because:
- Like HT patches, gels appear to have lower risks of blood clots and strokes compared to tablets
- It can be convenient if you can’t use or don’t like patches – for example, if your skin reacts to the patch
- Your estrogen dose can be easily increased or decreased as needed simply by applying more or less of the product
For these reasons, estrogen gels are often favored by both doctors and patients.
How do you use estrogen gel?
Estrogen gel is rubbed onto your skin to be absorbed and released into your bloodstream. The leaflet that comes with your medication will contain instructions, but in general you should:
- Apply the gel to clean, dry skin. Your upper arms and thighs are both good options. Do not apply the gel to your breasts or genital area
- Do not wash or wet the skin, or apply skin products (like moisturizers and lotions) for at least an hour after applying your estrogen gel
- Avoid close skin contact with others for at least one hour after applying the gel
- Leave the gel to dry for 5 minutes before getting dressed
- Wash your hands after applying the gel
If you still have your uterus, you will also need to take some form of progesterone. This is because taking estrogen alone can lead to abnormal thickening of the uterus lining, which can lead to cancer of the uterine lining in some cases. Thankfully, using progesterone removes this risk. Progesterone is available in a number of different forms including oral medicines and hormonal intrauterine devices (IUDs). Your healthcare provider will be able to advise which options are appropriate for you.
Benefits of estrogen gel
Estrogen gel is an effective form of HT, and many users find it a good way to control their menopause symptoms. Estrogen gel comes with all of the advantages of other forms of HT, including boosting bone density which helps prevent osteoporosis.
Estrogen gel is as effective as other forms of systemic HT including patches and tablets.
Like other forms of transdermal HT (patches and sprays), estrogen gel may not increase your risk of blood clots, which can be the case with oral HT such as tablets.
Read more about the benefits and risks of HT.
Disadvantages of estrogen gel
1) Convenience
Estrogen gel is applied daily. This can mean that it is harder to remember than patches, which are only changed twice per week.
2) Absorption
Applying the gel properly and allowing time for it to dry can also be more time-consuming than simply applying a patch or taking a pill. Similarly, if you have any problematic skin conditions, you may struggle to find an unaffected area of skin on which to apply the gel.
3) Cost
Estrogen gel can be more expensive than patches or tablets – it depends on your insurance coverage. It will usually be more expensive than oral forms of HT and many patches if you are paying out of pocket.
What are the risks of estrogen gel?
Like all medications, HT comes with certain risks as well as benefits. Your risk profile will depend not only on the estrogen gel itself, but also on your personal medical history and any other medications you use alongside the gel, for example, progesterone if you need to take combined HT.
Unlike oral HT, estrogen gel does not appear to increase your risk of serious blood clots like pulmonary embolism, or deep vein thrombosis – collectively known as venous thromboembolism or VTE. Despite this, if you have risk factors that put you at higher risk of these conditions, such as a strong family history or a BMI over 30, you may need to see a specialist for HT to be prescribed.
What are the side effects of estrogen gel?
Estrogen gel comes with the same side effects as other systemic HT. These often include:
- Sore breasts
- Bloating
- Nausea
- Cramps
- Indigestion
- Irregular vaginal bleeding
These usually settle within 1-3 months. See your healthcare provider if they are severe or persistent.
See your healthcare provider urgently if you have any:
- Vaginal bleeding if it has been over one year since your last period
- Bleeding after sex
- Breast lumps or other changes in your breasts (find out how to check your breasts)
- Any severe pain
- Leg swelling, tenderness, or redness
- Chest pain or breathlessness
- Other persistent, severe, or worrying symptoms
Final word
Estrogen gel is a popular and convenient way to take HT. Speak to your healthcare provider if you would like to find out whether it would be a good fit for you.
Find out more about menopause on our blog or in our symptoms library.
Samsioe, G. (2004) Transdermal hormone therapy: gels and patches, Climacteric, 7:4, 347-356
Stella, Vaginal estrogen
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