The active ingredient in Sandrena is estradiol, available in two sachet strengths: 0.5 mg and 1 mg per application. Estradiol is a body-identical oestrogen, structurally identical to the oestrogen your ovaries naturally produce. The gel base contains carbomer, ethanol, purified water, sodium hydroxide, and propylene glycol, the latter of which can occasionally cause skin sensitivity in some individuals. If you have known sensitivities to any of these excipients, mention this to your clinician before starting. Sandrena does not contain any progestogen, if you have a womb, a separate progestogen will be prescribed alongside it.

Yes, Sandrena is a well-established and effective HRT option. It provides consistent hormone delivery through the skin, which many women find convenient and well-tolerated. The pre-measured sachets mean you don't need to worry about measuring the correct dose, and it bypasses the digestive system, which may reduce certain side effects associated with oral HRT.

Sandrena is popular because:

• Pre-measured sachets ensure accurate dosing
• Quick-drying formula that absorbs within minutes
• Convenient once-daily application
• Provides steady hormone levels throughout the day
• Available in two strengths for flexible dosing up to 1.5mg daily
• Bypasses the liver, which may reduce certain risks
• Discreet and easy to incorporate into daily routine

Sandrena vs Oestrogel: Both are transdermal estradiol gels applied daily, but they differ in format. Sandrena comes in pre-measured sachets (0.5 mg and 1 mg), which some women find convenient for accurate dosing on the go. Oestrogel uses a pump dispenser, with each press delivering a fixed amount of gel, some women prefer the pump for reducing waste and ease of daily use at home. The choice typically comes down to personal preference and lifestyle.

Sandrena vs Lenzetto (transdermal spray): Both are daily transdermal oestrogen preparations. Lenzetto is applied as a metered-dose spray to the forearm, which some women find faster to apply and less messy. Sandrena requires slightly more spreading but offers more flexibility in dose increments. Again, the choice comes down to personal preference.

Sandrena vs Evorel (transdermal patch): Evorel patches are changed twice weekly rather than daily, which some women find more convenient. However, patches may cause skin irritation from the adhesive, and some women prefer the feel of a gel. Sandrena's daily application also allows for slightly more dose flexibility.

• Women with unexplained vaginal bleeding
• Those with a history of breast cancer (discuss with your specialist)
• Women with blood clots, stroke, liver disease, or untreated high blood pressure

Evidence shows that HRT itself doesn't cause weight gain. Changes in body weight and composition during menopause are primarily driven by declining oestrogen levels, shifts in metabolism, and changes in fat distribution (particularly around the abdomen), rather than by HRT itself. Some women notice mild fluid retention in the early weeks of treatment, which may feel like weight gain but typically resolves as the body adjusts. For some women, stabilising hormone levels with HRT can support a more stable body composition over time. If weight changes are a concern, your clinician can discuss this alongside your broader menopause management.

Sandrena on its own does not cause withdrawal bleeds. If you are prescribed Sandrena alongside a progestogen as part of sequential HRT, some regular, predictable bleeding is expected at the end of each progestogen phase. If you are using continuous combined HRT, some irregular spotting in the first few months is common during the adjustment period. However, any unexpected or heavy bleeding, particularly if you are postmenopausal and on oestrogen-only therapy, should always be reported to your clinician promptly so that other causes can be ruled out.

Sandrena should be applied to clean, dry skin on the thighs. Spread the gel thinly over a large area (about 1-2 times the size of your hand). Rotate application sites by using the right and left thigh on alternate days to prevent skin irritation. Do not apply to the breasts, face, vaginal area, or broken skin. Once the gel has dried, cover the area with clothing.

No, you should not change your dose without speaking to your clinician first. While Sandrena does offer dose flexibility through sachet combinations, any adjustment should be guided by your prescriber following a clinical review of your symptoms and response to treatment. Applying more gel than prescribed without guidance could result in unnecessarily high oestrogen levels.

If you feel your current dose is not adequately managing your symptoms, you can learn how to tell if your HRT isn’t working. If you are experiencing side effects, contact your Voy clinician rather than adjusting your dose independently.

If you forget a dose, apply it as soon as you remember unless it's almost time for your next dose. Do not apply a double dose to make up for a missed dose. If you frequently forget doses, try setting a daily reminder on your phone or incorporating application into your daily routine (e.g., after brushing your teeth in the morning).