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Estradiol (as hemiyhdrate)

Sandrena is a gel which is used in Hormone Replacement Therapy (HRT) and is made by Orion Pharma. It alleviates the symptoms associated with the menopause.

It’s simple to buy Sandrena online with our secure service. All HRT orders are reviewed by a GMC-registered doctor before being dispensed at our UK pharmacy.

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Sandrena is a gel which is used in Hormone Replacement Therapy (HRT) and is made by Orion Pharma. It alleviates the symptoms associated with the menopause.

It’s simple to buy Sandrena online with our secure service. All HRT orders are reviewed by a GMC-registered doctor before being dispensed at our UK pharmacy.

This content was reviewed by a clinician on

19 May 2022
dr daniel

Dr Daniel Atkinson

(GP Clinical Lead - GMC No. 4624794) 19 May 2022
Product information


Sandrena is a gel containing estradiol which is used as a hormone replacement therapy (HRT) to treat symptoms of the menopause. It is manufactured in the United Kingdom by Orion Pharma Limited and is available in dose sizes of 0.5mg and 1.0 mg. The gel is applied once a day to the lower body or thighs.

All women experience the menopause as they approach middle age. When this happens, a woman will not be able to have children as her reproductive system is no longer able to create eggs. Her periodic cycle becomes disturbed as the levels of the hormone oestrogen start to fall, before periods eventually stop completely. The menopause generally occurs between the ages of 45 and 55 but in some cases it can happen earlier or later.

The menopause can manifest itself in a number of symptoms, both physical and psychological. Some of the most common include difficulty sleeping, abrupt changes in mood, hot flushes, anxiousness and aching joints. They can also include difficulty concentrating, lapses in memory and a low sex drive.

Many women find these symptoms difficult, but tolerable. However in some cases they can be more serious and affect quality of life. In this instance it may be necessary to seek medical advice and begin HRT to ease them. Sandrena, which you can buy online from our UK pharmacy, is one such treatment.

When a case of HRT is undertaken it can last up to five years and needs to be reviewed at least once a year. The dosage is reduced as the symptoms diminish. You should also check your breasts regularly and seek medical advice if you notice any changes such as lumps or dimpling in the breasts or nipples.

Sandrena contains the active ingredient estradiol, and works by augmenting the falling levels of oestrogen in the body. It can be used continuously or cyclically. The gel is applied once a day to an area once or twice the size of your hand, somewhere on your thighs or lower body. Sandrena comes in two dose sizes of 0.5 mg and 1.0 mg. You may be required to use a combination of these depending on the level of treatment prescribed.

If you have not had a hysterectomy then you will also need to be prescribed a medicine with the progestogen hormone. This will prevent excess thickening in the lining of the womb which has been known to cause endometrial cancer. This medicine would be taken alongside Sandrena for 12 to 14 days of each monthly cycle.

You can get your repeat prescription and buy Sandrena gel online from our UK based pharmacy. You won’t have to wait for an appointment; just complete our online consultation form and one of our doctors will review your case and issue a prescription remotely, so that you can get the treatment delivered to your door by courier within one working day.

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Page last reviewed:  19/05/2022


It is very important that you follow the instructions given to you by your prescriber closely. You should also carefully read the information leaflet that comes with your medicine. This will make sure that you get the best out of your treatment and minimise any possible side effects.

  1. You can use Sandrena straight away if you have never used HRT before or are changing from a HRT that is period free: if not, you should wait until the end of your period before use.
  2. The recommended daily dose is between 0.5 mg and 1.5 mg depending on your prescription.
  3. Use the correct number of 0.5mg and 1.0mg sachets as directed.
  4. Apply on dry and clean skin, once a day to the thighs or lower body. You should administer it to an area between one and two times the size of your hand.
  5. Use a different side of your body on alternating days.
  6. Let the gel dry for a few minutes and do not wash the site of use for an hour after applying.
  7. Never use the gel on irritated skin, the breasts or the face.
  8. Wash your hands after using Sandrena and do not allow it to come into contact with your eyes as it will irritate them.
  9. If you miss a dose then apply when you remember, provided it is no more than 12 hours late. After this time, you should skip the missed dose and apply the next one as scheduled.
  10. If you are also using progestogen tablets, continue to do as directed. Some withdrawal bleed after each course is normal.

Talk to your doctor or pharmacist if you are unsure about anything when using this treatment.

Page last reviewed:  19/05/2022
Side effects & Warnings

Side Effects

Although you may not experience side effects while using this medicine, it is imperative that you know what they are, as some can require immediate medical attention.

You should stop taking Sandrena and see a doctor straight away if you experience any of the following: jaundice (yellowing of the skin or eyes); migraines when you have not had them before; a substantial rise in blood pressure (symptoms of which are dizziness, headaches and fatigue); gallstones; asthma; or signs of a blood clot (breathing difficulties, chest pains, swelling in the legs).

You should also immediately talk to your doctor and stop your treatment if you become pregnant or are diagnosed with epilepsy or diabetes.

In the early stages of treatment, you may experience breast tenderness and breakthrough bleeding and spotting. These normally disappear within a few months.

This list of side effects is not exhaustive. You can find a full list on the patient information leaflet which will come with your medicine and you should tell your doctor if you experience any of them.

Common (1 in 10 people or less):

Itchy skin, rashes, weight gain, weight loss, painful breasts, hot flushes, depression, stomach aches, nausea, dizziness, headaches, swollen feet or legs, or disturbed periods.

Uncommon (1 in 100 people or less):

Migraine, anxiety, disturbed sleep, mood swings, tiredness, weakness, changes in libido, difficulty concentrating, hypertension, shortness of breath, dry eyes, increased appetite, benign tumours in the breast or womb, high cholesterol, constipation, diarrhoea, allergic reactions, urinary disorder, cramps, acne, alopecia, skin rashes, or excessive hair growth.

Rare (1 in 1,000 people or less):

Blood clots, intolerance to contact lenses, period pains, symptoms of premenstrual syndrome, alterations to function of the liver and flow of bile.


Taking it with other medicines

It is vital that you tell your prescriber about any other medicines you are taking in case they can have an adverse effect on your treatment. It doesn’t matter if you have a prescription for them or not.

Sandrena should not be taken with medicines for epilepsy (phenytoin, carbamazepine and phenobarbital), HIV (ritonavir, nevirapine, efavirenz, nelfinavir) or tuberculosis (rifabutin, rifampicin). It can also be impeded by herbal remedies that contain St. John’s Wort.

Conditions to look out for

You must tell us as must as possible about your medical history when completing the assessment form as this can effect which is the right medication for you. You should not use Sandrena if you have had any of the following: breast cancer or any cancer that responds to oestrogen; blood clots or any associated disorders; a liver disorder where your liver function results have not yet returned to normal; womb lining that is excessively thick and has not been treated; stroke; angina; heart attack; unexplained vaginal bleeding; porphyria; or allergy to estradiol.

You should also take special care when using this medicine if you have had any of the following as these can return or become worse with the treatment: a history of excessive growth of the womb lining; fibroids in the womb; a family history of breast or of oestrogen sensitive cancer; an increased risk of blood clots; diabetes; high blood pressure; epilepsy; lupus; migraines; gallstones; asthma; otosclerosis; high triglycerides; hereditary angioedema; fluid retention due to heart or kidney problems; or a liver disorder.

Regular check-ups

You will need to undergo regular check-ups with your GP when using Sandrena, to make sure it is working as it should.

HRT and cancer

Further information on HRT and cancer risk can be found in the supplied leaflet.

Pregnancy and breastfeeding

Sandrena must not be used during pregnancy or breastfeeding. If you become pregnant, do not use this product and see your doctor immediately.

Driving and using machinery

No effects of this gel on driving or ability to operate machines have been observed.

Page last reviewed:  19/05/2022

Can I still drink alcohol?

It is not likely that the effects of Sandrena will be impaired by the consumption of alcohol.

Will I still be able to drive?

Sandrena should not affect your ability to drive. However, if you find that any associated side effects are causing difficulties, you should stop and seek medical advice.

Can I take the medicine while pregnant?

This medication cannot be taken while pregnant. If you become pregnant while using it, stop immediately and see your doctor.

How should I store it?

The medicine should be stored at room temperature below 25°C. Do not use after the expiry date.

Am I allergic to anything in the medicine?

Sandrena gel contains estradiol, carbopol 974P, trolamine, alcohol, propylene glycol and purified water. Do not use this medication if you are allergic to any of the ingredients.

Is it available over-the-counter?

No. You will need a prescription to buy Sandrena.

We offer prescription renewals for Sandrena through our online service.

Is it right for me?

The HRT medication you use will ultimately be decided on by your GP. They will initiate a prescription for the most appropriate treatment following discussion with you, during face-to-face consultation.

How can I get Sandrena online?

It takes just a matter of minutes to renew your Sandrena prescription with our online consultation service. Once you request has been approved by our UK based pharmacy you will receive your Sandrena gel via 24-hour tracked delivery the following working day.

Page last reviewed:  19/05/2022
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