Hormones and HRT
HRT risks & benefits
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Everything you need to know about Sandrena Gel
Everything you need to know about Sandrena Gel
Sandrena is a transdermal oestrogen gel used as part of Hormone Replacement Therapy (HRT) to help relieve menopause symptoms. It contains estradiol, a form of oestrogen identical to the one your body naturally produces.
By applying Sandrena directly to the skin, the oestrogen is absorbed into the bloodstream without passing through the digestive system, making it a gentler option for women who experience stomach sensitivity with oral HRT and avoids risks associated with oral HRT.
Medically reviewed by Dr. Liz Andrew
BMS Accredited Doctor
Reviewed: 10/03/2025 Published: 20/03/2025
The basics
Key information about Sandrena gel
Oestrogen levels decline during menopause, leading to symptoms such as:
- Hot flushes and night sweats
- Brain fog and difficulty concentrating
- Low mood and anxiety
- Joint pain and muscle stiffness
- Vaginal dryness and discomfort
Sandrena contains estradiol, a body identical oestrogen, meaning it has the same chemical structure as the oestrogen naturally produced in the body. Sandrena helps restore oestrogen levels and alleviate these symptoms.
It is applied directly to the skin, allowing oestrogen to be absorbed without passing through the digestive system. This can make it a better option for some women, in particular those who may be experiencing digestive issues or have tried oral HRT and found that it upsets their stomach.
Yes, Sandrena gel is considered safe when prescribed appropriately and used as directed. Like all HRT, it is backed by research and regulated to ensure safety and effectiveness. Using Sandrena through the skin (transdermally) avoids the small risk of blood clots associated with tablet forms of HRT. However, individual risks vary, so it’s important to discuss your medical history with your doctor at Menopause Care, or your GP.
Sandrena gel is body identical. It contains estradiol, which has the same chemical structure as the oestrogen naturally produced by the body. This makes it a well-tolerated option for many women.
If you still have a womb (uterus), then yes, you need to take a separate progestogen to protect the uterine lining. This can be in the form of:
- Micronised progesterone (Utrogestan) – taken orally
- The Mirena coil – which releases progestogen directly into the uterus
- Synthetic progestogen tablets
- If you have had a hysterectomy, you do not need progesterone
There is no strong evidence that Sandrena gel directly causes weight gain. Some women experience temporary fluid retention or bloating, but this often settles with time. Hormonal changes in menopause can naturally lead to a shift in fat distribution, but HRT does not cause fat gain—and for some, it can help maintain muscle mass and metabolism.
Avoid showering, swimming, or vigorous exercise for at least 1 hour after application. This is to ensure that you have given the gel enough time to absorb, and you see the most benefit you can for this treatment.
Yes, all our expert clinicians can prescribe sandrena gel. If you book into a consultation your doctor will review your symptoms and medical history, and talk through your options. Whilst many women do start oestrogen gel through our service, the final prescription decision will be with the prescribing clinician. We can not guarantee any prescriptions.
Benefits of Sandrena gel
Replacing oestrogen with Sandrena gel can have an impact on all 40 symptoms of menopause.
- Relieves menopause symptoms
- Supports bone health - reduces the risk of osteoporosis
- Bypasses digestion - making it a gentler option for those who experience stomach issues with oral HRT
- Lower risk of blood clots - compared to oral oestrogen
Some women notice improvements in symptoms within a few days to weeks, particularly for hot flushes and night sweats. However, for full benefits—especially for mood, sleep, and joint pain—it can take up to three months. If symptoms persist after this time, your dose may need adjusting.
4 tips to help you
How and where to apply Sandrena gel
- 1
Open sachet and squeeze out the prescribed amount
Squeeze the gel onto your hand. Mostly sandrena is prescribed to use whole sachets each day
- 2
Apply it to clean, dry skin
Do not apply after a shower or bath until the skin is fully dry
- 3
Spread thinly over the area of skin on the thighs or lower abdomen
Do not rub it in completely; let it absorb naturally
- 4
Allow it to dry, and do not apply any other products
Do not apply anything else to the skin for at least 2 hours after application. Wash your hands after application.
Learn more about your treatment options
Book a complementary discovery call with our patient expert Jane James. Jane can help you by:
- Explaining the clinical pathway and how oestrogen patches can be prescribed through Menopause Care
- Offering guidance as to whether you may benefit from hormone replacement therapy (HRT)
- Share personal insight and other patient experiences of oestrogen treatment (non-clinical advice)
- Offering compassionate support and a safe, confidential space to openly discuss your concerns
Side effects of Sandrena Gel
Common side effects:
- Breast tenderness
- Bloating or fluid retention
- Headaches
- Nausea
- Skin irritation at the application site
Less common side effects:
- Mood changes
- Leg cramps
- Increased vaginal discharge
- Changes in libido
Many women will experience some side effects in their first few weeks of taking HRT - as your body adjusts to having different hormone levels. Side effects often settle in the first few weeks, and should have resolved fully by your 3 month review with your clinician.
If your side effects are impacting your quality of life, or they have not settled at three months, please speak to a doctor. If your side effects are severe, or you are concerned, you should speak to a doctor.
Yes, you can try alternative transdermal forms of oestrogen (patch or spray) or you could try oral progesterone.
- Women with a history of breast cancer, blood clots, stroke, untreated high blood pressure, or severe liver disease.
- Those who have unexplained vaginal bleeding should consult a doctor before use.
Sandrena gel explained
Dr. Laura Cawley and Dr. Liz Andrew explain oestrogen gel on one of our latest webinars all about HRT and testosterone products. You can watch the fully recorded webinar on YouTube.
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