The mean posology is 2.5 g of gel (1.5 mg of estradiol) applied to the skin every day, 3 weeks out of 4. This dose may be adapted according to the hypo- or hyperestrogenic symptoms noted after 1 or 2 cycles of treatment.
Application: The tube should be opened by unscrewing the cap, turning it upside down and pressing the pointed end firmly into the tube with a twisting movement in order to break the metal seal. The latter must be fully opened in order to allow the gel to be pressed out of the tube correctly.
The central groove of the plastic ruler indicates the length and width of an average dose of gel (2.5 g). Press the tube so that the cylinder of gel fills the length of the groove. All the gel must be removed from the ruler with the fingers.
Oestrogel should be applied by the patient herself, morning or evening (preferably after washing); spread out over the largest possible area of skin and applied to the abdomen, arms, shoulders, thighs and even the neck and face, but avoiding the area of the breasts and vulvar mucosa; left to dry 2 min before covering with clothing. If after 2 min the skin remains tacky, this means that the area of application was insufficient.
Association with a progestogen is necessary. Natural oral micronized progesterone (Utrogestan) appears to provoke the minimum of side effects.
Treatment Scheme: Apply 2.5 g daily (preferably on the abdomen) for 3 successive weeks, followed by 1 week combined therapy with an oral progesterone from 8th-21st day of cycle. A depletion in bleeding is generally seen during the week of interruption.