Divigel 0.1% Gel

Divigel 0.1% Gel is a hormone replacement therapy (HRT) product containing estradiol, a form of the natural female hormone oestrogen, at a strength of 0.1%. It is supplied in single-use sachets and is applied topically to the skin, where the estradiol is absorbed through the skin into the bloodstream to restore oestrogen levels that fall after menopause. Divigel is used to relieve moderate to severe menopausal symptoms such as hot flushes, night sweats, and vaginal dryness, and may also be used for the prevention of osteoporosis in postmenopausal women who are at high risk of fractures and cannot use other suitable therapies.

Because Divigel is a prescription-only hormone therapy, it is only supplied through DoctorOnCall after an online medical consultation. A doctor will review the patient’s medical history, menopausal symptoms, and any risk factors (such as history of breast cancer, blood clots, or liver disease) before issuing a prescription, and will typically recommend the lowest effective dose for the shortest duration needed to control symptoms.

Divigel delivers estradiol directly through the skin into the bloodstream, bypassing the liver’s first-pass metabolism that occurs with oral oestrogen tablets. Once absorbed, estradiol binds to oestrogen receptors throughout the body, helping to restore hormonal balance that declines during and after menopause. This reduces the frequency and severity of hot flushes and night sweats, improves vaginal tissue health, and helps maintain bone density by slowing the bone loss that accelerates when natural oestrogen production falls.

Divigel should only be used according to the dose and schedule prescribed by the doctor. The gel is typically applied once daily to clean, dry, intact skin on the thigh or lower abdomen, using a different application site each day as advised. The sachet contents should be spread in a thin, even layer over the recommended area and allowed to dry fully before covering with clothing; the treated area should not be washed for at least one hour after application. Hands should be washed thoroughly with soap and water immediately after use to avoid transferring estradiol to other people, especially children and pregnant women.

The dose of Divigel 0.1% Gel is individualised by the prescribing doctor based on menopausal symptoms, treatment goals, and whether a progestogen needs to be taken alongside it (for women who still have a uterus). Treatment usually starts at the lowest sachet strength that controls symptoms, with the dose reviewed periodically and adjusted only on medical advice. Patients should never increase, decrease, or stop the dose on their own without consulting their prescribing doctor first.

Divigel 0.1% Gel should be used within the shelf life stated on the sachet and outer carton, and the expiry date should always be checked before use. Do not use any sachet beyond its printed expiry date, and dispose of unused or expired sachets responsibly rather than discarding them in household waste.

Store Divigel below 30°C in a cool, dry place away from direct sunlight and out of the reach of children. Keep each sachet in its original packaging until ready for use, and reseal or dispose of opened sachets immediately after application rather than leaving gel exposed.

• Known, past, or suspected breast cancer
• Known or suspected oestrogen-dependent cancers, such as endometrial cancer
• Undiagnosed vaginal bleeding
• Untreated overgrowth of the uterine lining (endometrial hyperplasia)
• Current or past history of venous thromboembolism (blood clots in the legs or lungs)
• Known blood clotting disorders
• Active or recent arterial thromboembolic disease, such as heart attack or stroke
• Active liver disease or a history of liver disease with abnormal liver function

• Certain anticonvulsant medicines (such as carbamazepine, phenytoin) may reduce the effectiveness of estradiol
• Some antibiotics, such as rifampicin, may lower estradiol levels in the blood
• St John’s Wort may reduce estradiol’s effectiveness
• Medicines that affect blood clotting should be discussed with the doctor before starting Divigel
• Alcohol intake should be discussed with the doctor, as it may influence how the body handles hormone therapy

• Apply the gel to a different site on the thigh or lower abdomen each day to reduce skin irritation
• Let the gel dry fully before dressing and avoid washing the area for at least an hour afterward
• Wash your hands thoroughly with soap and water immediately after every application
• Attend scheduled follow-up appointments so your doctor can review whether continued therapy is still appropriate
• Report any new breast lumps, unusual bleeding, or leg swelling to your doctor without delay
• Never share your Divigel sachets with another person, even if they have similar symptoms

Patients using Divigel should attend regular medical reviews so their doctor can reassess whether continued hormone therapy is appropriate, typically at least once a year. Women who still have a uterus will usually need to take a progestogen alongside Divigel to protect the lining of the womb, unless advised otherwise. Any new breast lumps, unusual vaginal bleeding, signs of a blood clot (such as leg swelling or sudden breathlessness), or jaundice should be reported to a doctor immediately.