How to use gel – menopausal hormone therapy

On this page, you can find out how to use menopausal hormone therapy gel, including step-by-step instructions and tips for safe and effective use.
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  • Last updated:
    May 7 2026
  • Last reviewed:
    May 7 2026
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What is MHT gel?

Menopausal hormone therapy (MHT) is used to treat menopausal symptoms. There are different types of MHT, including MHT gel.

MHT gel is also called transdermal gel. Transdermal means the medicine is absorbed through the skin.

MHT gel contains measured doses of oestrogen and is used on the skin to deliver hormone into the bloodstream.

It’s available in Australia as:

  • pump packs – each pump gives a measured dose (prescribed under the brand name Estrogel Pump Pack®)
  • single-use sachets (prescribed under the brand name Sandrena gel®)

Gel is usually applied once a day. Your doctor will prescribe a specific number of pumps (for pump packs) or a particular sachet strength.

If you’ve had surgery to remove your uterus (a hysterectomy), this might be the only form of MHT you need. If you still have a uterus, you will also need another hormone called progestogen. This reduces the risk of endometrial cancer (cancer of the uterus).

About progestogen

When used with gel, progestogen is usually taken as a tablet or delivered via intrauterine device (IUD). Progestogen tablets are either taken every day without a break (continuously) or 10 to 14 days each month (cyclically) – this depends on whether you still have periods.

How to use MHT gel

Before you start

To use the pump pack for the first time:

  1. Remove the cap from the canister.
  2. Press the pump down a few times until the gel comes out.
  3. Collect in a tissue and throw in the rubbish.

Do not use this first dose of gel, as it may not be a full dose.

1. Prepare your skin

Choose a large area of unbroken skin on the arms, shoulders or thighs. Clean and dry this area.

Do not apply moisturiser, oils or sunscreen to the area, as this can affect absorption of the gel.

2. Measure the gel

For pump pack – Remove the cap and press the pump the number of times prescribed. Push the pump down firmly to ensure you get a full dose.

For sachets – Open one sachet and use the full contents unless your doctor has advised otherwise.

 

3. Apply the gel

For pump pack  – Spread the gel in a thin layer over a large area. For example:

  • the outer arm and shoulder of one or both arms
  • the mid-inner thigh of one or both legs.

For sachets – Spread the gel over a small area on your lower belly (abdomen) or thighs. The area should be about one or 2 times the size of your hand.

4. Allow to dry

Let the gel dry completely for about 5 minutes before getting dressed.

 

 

5. Wash your hands

Wash hands thoroughly with soap and water after applying the gel.

This information is based on commonly used medicines in Australia. Always follow medicine instructions and advice of your doctor, pharmacist or health professional.

Funded by the Australian Government through the Quality Use of Diagnostics, Therapeutics and Pathology Program.

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