A Practical Guide to Hormone Preparations in the UK, Part 1 - Oestrogen

By: Dr Rhy Brignell

Rhy is the Director of Service Delivery at Eden New Life and is responsible for ensuring all of our subscribers get fast, high-quality care in accordance with our treatment protocols. They hold a PhD from the University of East Anglia and have specialised in gender services for more than 4 years, managing and advising on service delivery for thousands of patients. This is one of a series of articles where they share answers to common questions we receive from our members.

At a Glance

Oestrogen therapy is available in different preparations, including tablets, patches and gels, which deliver the hormone through different routes but offer comparable outcomes. Choice depends on individual health, risk factors and lifestyle. Safe, effective treatment requires appropriate dosing, clinical oversight and ongoing monitoring. 

Understanding Preparations of Oestrogen

In their regular review sessions with clients, our specialists are often asked about the differences between types of oestrogen hormone preparations. There’s a lot of anecdotal information on the internet about whether some oestrogen preparations are more effective than others, and whether you’ll get faster or bigger results if you use patches over tablets, tablets over gels. 

This guide offers a practical overview of the different oestrogen hormone preparations available in the UK to support your conversations with our specialists at Eden New Life and to help you consider the right option.

What Do We Mean by Preparations?

In this context, preparation is a medical term to describe the form in which a medication is administered. In gender medicine, it might refer to tablets, gels, patches or injections. These preparations are just different forms of the same medicine. Each form gets the medicine into your body in a different way, which can lead to different effects on your health.

There is no evidence of differences in outcomes between preparations, and no preparation works better or quicker than any other. It’s also important to note that taking higher doses than prescribed does not cause desired changes to happen more quickly and can put your health at risk. This is why all hormone therapy decisions need to be made along with supportive clinical conversations that consider your complete health picture.

If you are receiving hormone treatment from Eden New Life, our specialists always prioritise a safe, evidence-based approach and advise you about the different hormone preparations and dosages in your prescription and review sessions. If you're looking for treatment options, explore our affordable plans.

What Are the Different Preparations of Oestrogen?

In the UK, oestrogen can be given as tablets taken by mouth, patches applied to the skin or a gel rubbed into the skin. In some countries, oestrogen hormone injections can be prescribed, but they are not currently licensed for use in the UK and so are not an available option for Eden New Life clients.

How Do Different Oestrogen Preparations Work?

Here are the various types of oestrogen preparations, along with their benefits and limitations, that we often recommend to our clients at Eden New Life.

Tablets

Oestrogen tablets are taken by mouth, usually daily. The tablet is then absorbed in your gut, and the blood carrying the medicine goes straight to the liver for processing before it spreads around the rest of the body. 

Because tablets pass through your liver first, you sometimes need bigger dose adjustments for the oestrogen to take full effect, which will be managed by your Eden specialist. Your liver also makes extra proteins when it processes the oestrogen, including the type of proteins that increase the chance of blood clots. 

Potential Benefits of Oestrogen Tablet Preparations

Some people prefer tablets because they are very easy to take and don’t have the mess associated with oestrogen gel preparations or the potential skin irritation of patches. 

Potential Limitations of Oestrogen Tablet Preparations

Due to the way tablets work, they can put more strain on your liver and increase your chance of blood clots. Tablets are therefore not a recommended preparation for people who have certain risk factors, like smoking, obesity, clotting disorders or other cardiovascular risks. Our specialists will advise if tablets are not an option for you.

Patches

Oestrogen patches work transdermally, are applied to your skin and typically changed every 3-4 days. The medicine inside the patch is absorbed through your skin (this is what ‘transdermal’ means). The medicine is then absorbed directly into your bloodstream, rather than first being absorbed into your gut and processed by your liver, like with tablets.

Potential Benefits of Oestrogen Patches

Patches have a lower risk of blood clots and are less demanding on the liver. They are therefore a good preparation for people who are over 45, smoke, are overweight or who have cardiovascular risk factors. Since you change them every few days, you don’t have to remember to take a tablet or apply gel every day.

Potential Limitations of Oestrogen Patches

The glue around the patch’s edges, which helps it stick, can be irritating if you have sensitive skin. Patches can also come off more easily if you sweat a lot, but this can be counterbalanced by using micropore tape to help them stay stuck down.

Gel

Oestrogen gel is rubbed into your skin, usually daily. Similar to patches, the medicine is then absorbed through your skin and enters your bloodstream.

Potential Benefits of Oestrogen Gel Preparations

As with patches, gel has a lower risk of blood clots and is less demanding on the liver, making it a good oestrogen preparation option for people over 45, who smoke, are overweight or who have cardiovascular risk factors. Gel dosage can also be adjusted up and down in small steps by your specialist, allowing for gradual fine-tuning to find the right dose for you.

Potential Limitations of Oestrogen Gel Preparations

Gel absorption can vary depending on many factors, including your skin, where you apply it and your daily habits (like showering, bathing, or sweating). There is some risk of transmission to others through skin-to-skin contact, which may be a consideration for you if you have young children or work with them or animals.

Which Preparation Is Right for Me?

The hormone preparation that works best for you is highly dependent on a number of factors, including your individual health, risk factors, lifestyle and where possible, your preferences. This article is intended to provide you with some general information about how different preparations work on the body and the factors to consider, and is not a substitute for medical advice from a trained professional.

It’s important to remember that finding the right hormonal preparation may involve some trial and error. How your body responds to oestrogen can vary, and our specialists can adjust the type, dose or delivery method that suits your body the best. 

At Eden New Life, ongoing monitoring and follow-up are core elements of our care model, which fully takes all your needs into account throughout treatment. 

Hormone Preparations with Eden New Life

We know that going through hormone therapy can be overwhelming at times. You may have questions like, “How much oestrogen should I take?” or “Which oestrogen preparation is ideal for me?” That’s why we aim to provide more than prescriptions, but clear guidance and support that helps you understand where and how your treatment works and what to expect at each stage of your journey.

We offer monthly and annual subscription plans:

• Hormone Advisory Plan

• Hormone Advisory Plus plan

  
  

These cover diagnosis, GAHT prescription sessions, e-prescription from our specialists, 12-week review sessions and annual review sessions.

If you are starting hormone therapy with our service, or are all set for a regular review, our expert specialists will talk you through the different preparations available to you, and tailor their recommendations to your individual circumstances and health needs.

With the right information and clinical support, you can make confident and informed decisions about your care. At Eden New Life, we combine practical guidance on gender affirmation hormones with personalised treatment to help you make the right choice that feels right for your body and for your goals.

Sign up to book your first session today.