What does it do?

As you go through menopause, you produce less of the hormone oestrogen. MHT gel contains oestrogen, which treats symptoms of menopause and helps prevent weak bones (osteoporosis). If you still have your uterus (womb), you need to take progestogen as well to protect the lining of your uterus.

Before you start

• Tell your doctor if you have heart, liver, or gallbladder problems, migraines, diabetes, or if you smoke.
• Women taking MHT may have a small increased risk of breast cancer, blood clots, stroke and heart attacks. Tell your doctor if you, or someone in your family, has ever had any of these problems.

How should you use it?

Apply the gel regularly as directed to clean, dry, intact skin.

For Estrogel®: You need to prime the pump the first time you use it. Press the plunger down a few times until the gel comes out and then discard this gel.

If your dose is:
1 pump: Apply 1 pump of gel onto a large area of skin on one arm.
2 pumps: Apply 1 pump of gel onto a large area of skin on each arm.
3 pumps: Apply 2 pumps of gel onto a large area of skin on one arm, and 1 pump onto your other arm. You can also use your inner thigh.
4 pumps: Apply 2 pumps of gel onto a large area of skin on each arm. You can also use your inner thigh.

Wash your hands and allow the treated area to dry for 5 minutes before getting dressed.
Avoid washing the area, applying other products, and skin contact with others, for at least 1 hour afterwards.

What if you forget a dose?

If it is nearly time for your next dose, skip the missed dose and apply your next dose at the usual time. Otherwise, apply the missed dose as soon as you remember. Do not apply two doses at the same time.

Can you take other medicines?

Tell your pharmacist or doctor about all medicines or treatments that you may be taking, including vitamins, herbal products (e.g. St John's wort) or recreational drugs.

What side effects might you notice?

Side Effects	Recommended action
Symptoms of a blood clot including: sudden shortness of breath, swelling or pain in one leg Symptoms of a stroke including: sudden weakness of the face, arm or leg, especially on one side, face drooping, sudden changes in vision or speech, sudden loss of balance Severe headache Chest pain	Tell your doctor immediately
Unexpected vaginal bleeding	Tell your doctor
Headache, mood changes Sore or enlarged breasts Weight gain, swollen feet or legs Dry eyes, brown patches on the face Stomach upset, stomach cramps, bloating Vaginal itch/discharge	Tell your doctor if troublesome

If you notice any other effects, discuss them with your doctor or pharmacist.

Other information:

• If you are having surgery, it is important to tell your doctor that you are taking MHT.
• MHT does not protect against pregnancy. You can still get pregnant up to 1 year after your last period if you are older than 50, or up to 2 years if you are under 50. Talk to your doctor about contraception options.
• MHT is also known as hormone replacement therapy (HRT).