Hormonal changes adversely affect the health of any woman. This not only reflects on her reproductive function, but also on her health, mood, as well as relationships with others.
In such cases, doctors can prescribe the drug "Divigel", instructions for use of which will be presented in this article. What is this remedy? Can I take it during pregnancy? What contraindications and side effects does the drug have? You can learn about all this by carefully studying the instructions for using Divigel and the reviews of those women who used the medication for treatment.
Drug Release Form
What is the drug? Simply put, this is a gel. The instruction to “Divigel” explains that the product is used for external use.
Each package of the drug consists of 28 small single-dose sachets made of three-layer aluminum foil.
The price of the drug depends on the amount of active substance.
Briefly about the composition
What is the main component of Divigel ointment? Instructions for use of the product explain that it is a synthetic hormone estradiol. In each dosed sachet of the drug, five hundred milligrams or one gram of the active substance is present.
Auxiliary components providing the desired gel consistency are purified water, 96% ethanol, triethanolamine, carbomer and propylene glycol.
What happens when these substances enter the body?
Pharmacological effects
According to the instructions and reviews, “Divigel” is not a simple synthetic hormone. From a chemical and biological point of view, it is completely identical to natural estradiol, which is produced in the female body by the ovaries, starting with the very first menstruation and ending with menopause. What happens when this synthetic substance enters a woman’s body?
According to the instructions for use with Divigel gel, the active substance has the ability to penetrate into the necessary cell, figuratively called the “target”, where it forms a connection with receptors of organs such as the uterus, mammary glands, liver, urethra, vagina, pituitary gland and so on . Due to this complex (or compound), an interaction occurs with genome elements and intracellular proteins, which, in turn, induces (or stimulates) the synthesis of RNA and proteins, as well as releases cytokines and growth factors.
Such an effect on the female body does not go unnoticed. The development of the uterus and fallopian tubes, vagina and mammary glands is stimulated, processes of the secondary sexual characteristics of the female type are formed, growth, closing of the bone epiphyses (end sections of the tubular skeletal bones) are accelerated. This effect of synthetic estradiol is accurately described in the instructions for “Divigel”. Reviews of women using the drug for treatment, for the most part, confirm such a positive effect of the substance on the body.
Moreover, synthetic estradiol regulates menstrual bleeding, contributing to endometrial rejection in due time, reduces lactation, minimizes the destruction process that occurs in bone tissues, improves the connection of some transport proteins (such as thyroxin-binding globulin, protein, transcortin).
Moreover, due to an increase in the required level of estradiol, the concentration in the blood of such beneficial substances as thyroxine, copper, iron increases, and negative substances such as cholesterol, on the contrary, decrease. The active component of Divigel improves liver function, as a result of which it produces the necessary enzymes responsible for blood coagulation. Synthetic hormone is also able to normalize the smooth muscle tone and regulate the sensitivity of special receptors to progesterone. Due to its effect, intravascular fluid passes into the tissues, and the body also compensates for the delay in water and potassium. Moreover, the active substance prevents the degradation (deterioration, loss of necessary properties) of such important substances as catecholamines, which are responsible for the body's response to stress and regulate other important processes.
It is noteworthy that the drug is used for menopause. The instruction to “Divigel” explains that the active substance of the drug is able to increase estradiol in the body of a woman after menopause. Due to this, the vascular system is regulated. Due to the fact that there is no hormone deficiency, the woman is less concerned about the so-called hot flashes, sleep is normalized and other symptoms of early menopause are minimized. However, there are pitfalls.
Synthetic estradiol, after oral administration, is concentrated in the microflora and intestinal walls, as well as in the liver. With prolonged use of the drug, this concentration increases and worsens. Until the end, it is not known what threatens this situation for a woman in the future, however, many studies show that estrogens can increase the number of protein compounds, thereby provoking an increase in blood pressure.
Pharmacokinetic properties of the drug
How does the hormone get into the patient? According to the instructions for use, the medication is a gel-like mass for external use. The alcohol contained in the product evaporates quite quickly, due to which estradiol itself is absorbed into the skin and gradually enters the circulatory system. There, the hormone binds to the desired carrier protein, due to which it is transported through the vessels to the necessary organs and liver, where it breaks down into two components - estriol and estrone. Then the active substance with bile enters the small intestine, where it is again absorbed. Re-entering the liver, the hormone oxidizes and finally loses its properties. The drug is excreted by the kidneys.
In what cases is it advisable to administer estradiol?
Indications for use
From the above it can be concluded that “Divigel” has extensive capabilities to improve the hormonal background and overall well-being of women. At what ailments can doctors recommend taking the gel?
The list of situations when a remedy is prescribed is quite significant. First of all, the drug can be prescribed as hormone replacement therapy when a woman is found to have a lack of estrogen.
As mentioned above, the natural period of menopause (due to aging) is also an indication for the use of the drug, which can also serve as a prophylaxis of osteoporosis. Moreover, the climacteric process may develop during surgery (for example, if the ovaries have been removed) or in the case of radiation castration. Then taking the hormone may also be warranted.
In what cases is a medication prescribed? This is done, according to the instructions for use "Divigel", when planning pregnancy. Annotation to the drug explains that estradiol is an important hormone responsible for the conception and development of a new life. For example, a woman who wants to become pregnant may have a thinner uterine mucosa (called endometrial hypoplasia). In this case, the drug will help to increase the level of the necessary hormone, so that the uterus will function in full force.
What else can you learn from the instructions for use? “Divigel” when planning pregnancy using artificial insemination is also an indispensable tool, since with IVF the estrogen level is much lower than with conception naturally. In this case, the drug should be used fourteen days before the probable transfer of the embryo to the uterus and two to three weeks after the procedure. According to the instructions for use, “Divigel” in IVF should be used only as directed by the doctor, strictly adhering to the scheme prescribed by him.
Also, the drug can be used to stimulate such an important process as ovulation.
About contraindications
Above, we sorted out in what situations they appoint “Divigel”. And now let's try to figure out when its use in treatment is contraindicated. The list of situations when you can not take a hormonal drug is also very extensive, so be careful.
The first and most natural contraindication is the individual intolerance of estradiol or any other component of the gel. Also, the medication can not be used for benign, and especially malignant neoplasms on the mammary glands or genitals (uterus, ovaries, endometrium), especially if the patient has a history of cancer or cancer is questionable.
Also, “Divigel”, according to the instructions, is not prescribed if a woman is concerned about bloody vaginal discharge of unknown origin, if there is a pathological proliferation of tissues in the uterine mucosa, or if there are infectious or inflammatory processes in the genitals.
Other contraindications of the hormonal drug include diseases such as vein diseases (thrombosis, embolism), thrombophlebitis, tumor processes occurring in the liver or pituitary gland, diabetes mellitus, otosclerosis, cholestatic jaundice, retinopathy, circulatory disorders in the brain (types of stroke), as well as high estrogen levels.
This is what relates to the absolute contraindications for the use of Divigel. However, there are situations when the drug can be taken, but with extreme caution. Such circumstances include other diseases of the woman, such as bronchial asthma, epilepsy, hypertension, ischemia, heart failure, endometriosis, edema, mastopathy of the fibrocystic form, as well as age over 65 years.
General recommendations for use
How to use the drug so that it benefits? Before talking about the dosage, let's get acquainted with the general instructions of the manufacturer regarding the application of “Divigel” on the skin of patients.
How often should I use the drug? This is one of the most common questions. Unless otherwise prescribed by the attending physician, the agent should be used once a day, preferably at the same time.
Where should I apply the gel? This may be the lower abdomen, lower back, shoulders or forearms, left or right buttocks. If the specialist did not recommend otherwise, then every day the drug should be applied to a new place, that is, to alternate the area of application of the gel every day. Before the procedure, the skin should be washed and well dried with a towel.
How wide should the area be used to spread the gel on? According to women, the area for applying the drug should be one or two palms, no more. You can’t dress right away. It is better to stand for three to five minutes and wait until the gel-like mass is absorbed into the skin. Instructions for use recommend not to wash off the application area for another sixty minutes.
What to do if a woman missed the procedure? If 36 hours have not passed since the last application, then the drug should be used as soon as possible. If the time interval approaches forty hours or more, then you should wait and apply the gel already according to the schedule. In the matter of the regimen, one should be extremely careful, since irregularities in the use of the medication can lead to uterine bleeding, not to mention the fact that such treatment will not bring the necessary result.
What else do women say about using Divigel? They recommend applying the product with clean hands, using gentle massage movements. In no case should the gel be rubbed into the skin. It should also be avoided in the eyes and mucous tissues of the nasopharynx. After the procedure, the hands should be washed with soap to get rid of the remnants of the product on the skin of the palms.
In what doses is the drug prescribed? How long should I take “Divigel” during pregnancy? Instructions for the use of the medication answer these questions in detail.
A few words about the dosage
How much estradiol should be used at a time? The usual starting dose of the hormone is 1 g of Divigel. Instructions for use recommend applying one sachet of the drug to the skin once a day. Is this dose sufficient for an organism that needs estrogen? It all depends on the disease and its ailment. Therefore, you should not prescribe hormone therapy yourself. Follow the recommendations of your doctor.
In some cases, a specialist may increase or decrease the dosage. On average, the daily rate of the drug can vary between 0.5-1.5 milligrams. How then is it necessary to use the drug? For ease of use, manufacturers produce hormone in a dosage of estradiol of 0.5 or 1 mg. Instructions for use "Divigel" recommends starting treatment with minimal doses.
How to calculate calculate the dosage of the drug? In this case, the calculations are very simple. If we are talking about a dosage of 0.5 milligrams of estradiol, then each bag, weighing half a gram, contains exactly half a milligram of the hormone. But what if we are talking about the dosage of Divigel in 1 mg? Instructions for use explain this. Each sachet, the mass of which is equal to one gram, has in its composition one milligram of the hormone. In this case, it is important to follow this formula: 1 mg of the hormone equals 1 g of “Divigel”.
Instructions for use of the drug explain that the duration of treatment may be different. For some, the drug is prescribed cyclically, that is, in certain courses. For other patients, the medication may be recommended for prolonged use. It all depends on the recommendations of a specialist, the severity of the disease and the effectiveness of the treatment.
Pregnancy and lactation
With nursing mothers, everything is simple - the drug can not be used during breastfeeding. But what if the medication was used when planning a pregnancy or with IVF? The instruction to Divigel explains that if the long-awaited conception has occurred, the use of the drug should be reduced to nothing. This should be done gradually, preferably according to the scheme prescribed by the attending physician.
In no case do not stop taking the hormone in one day. This can cause negative reactions from the body, up to a miscarriage. Withdrawal of estradiol should be carried out slowly and gradually.
As you can see, “Divigel” is a serious drug that has a number of serious contraindications. Can its reception cause negative reactions from the body? Of course, this will be discussed below.
Negative symptoms
The human body is an unpredictable and mysterious mechanism, so it can react negatively to even the most harmless drugs, not to mention those that affect the hormonal background.
So, the nervous system can respond to the reception of "Divigel" headache, dizziness and even depressive states. From the side of the heart and blood vessels, a woman may begin to be disturbed by the symptoms of thrombophlebitis or hypertension. The digestive system can respond to the hormone by pain in the stomach, diarrhea or constipation, nausea, and vomiting.
How does the use of the product affect the reproductive system? The patient may begin to be disturbed by excessive bleeding or spotting from the vagina, a change in libido and other unpleasant symptoms.
Also, taking the drug may be accompanied by an increase in body weight (which is especially worrying for the weaker sex), breast engorgement, visual impairment, vaginal candidiasis, as well as the occurrence of such serious ailments as ovarian sclerosis, cholestatic jaundice, endometrial carcinoma and so on.
Some women complain that rash, redness, itching, and other signs of contact dermatitis can occur in the area where the Divigel is applied.
What other unpleasant symptoms can accompany the use of the medication? Many women complain of frequent urination, pain in muscles or joints, insomnia, nervousness, shortness of breath, hair loss, fatigue, trembling limbs, shortness of breath and the like.
It should be mentioned that such unpleasant symptoms are quite rare and can quickly pass. If side effects worry the woman for several days, then this should be reported to the attending physician. Perhaps the specialist will reduce the dosage of the drug or consider it necessary to replace “Divigel” with an analog. Instructions for use explain that women during the treatment with hormones should carefully monitor their health so as not to miss the deterioration.
Use this hormonal drug should be very careful, since the drug can cause the development of dangerous diseases such as thromboembolism, ischemia, stroke, cancer in the uterus, ovaries or endometrium, pathology of the gallbladder or liver.
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You should also know that barbiturates, tranquilizers, narcotic analgesics, anesthetics and some antiepileptic drugs can accelerate the metabolism of the hormone. Antibacterial drugs (including ampicillin, rifabutin, efavirenz, rifampicin, nevirapine) and phenylbutazone lower the plasma estradiol concentration. Folic acid and the hormones used to treat the thyroid gland, on the other hand, increase estradiol levels in the blood.
Briefly about the cost of funds
This is one of the important issues that interest many patients. According to reviews, the price of the product is not unbearable, but for many women it seems overpriced. How much is “Divigel”?
A package of 28 bags with a dosage of the active substance of 0.5 milligrams can be purchased for five hundred to six hundred rubles. Packaging with the same number of bags, but with a dosage of one milligram, will cost more - from seven hundred to eight hundred rubles.
How to store the product
Instructions for use recommends saving the drug in a place inaccessible to sunlight, at a temperature of no more than 25 degrees. The shelf life of the drug is three years from the date of manufacture.
Real patient reviews
Basically, women speak positively about Divigel. Many acknowledge that thanks to the tool, the artificial insemination procedure was successful. Some also note that the medication helped improve the condition of the endometrium, which made it possible to naturally conceive and safely bear the fetus.
Most often, the drug is prescribed when planning pregnancy in combination with other medications. As the girls say, who have already become mothers, if not for these drugs, they would never have known the joy of motherhood.
Also recorded many cases where “Divigel” provided real assistance to women after removal of the uterus or ovaries. The drug was able to reduce the unpleasant symptoms associated with artificially induced menopause. Women began to feel more comfortable and more confident in themselves.
However, not everything is so optimistic. Not all girls speak favorably about the drug. Many complain about the price, about the many side effects that are manifested in swelling, headaches, constant nausea, and even decreased vision. Moreover, there are reviews when the hormonal drug was completely unsuccessful. For example, in their reviews, women complain that the endometrium has not increased, and health has only worsened. In such cases, the girls were transferred to other hormonal drugs, which turned out to be more effective.
How to replace the tool
It so happens that you must cancel the use of “Divigel”. To continue hormone therapy, other, similar drugs are prescribed. They may be the following medicines:
- "Proginova." This tool is available in the form of a dragee. The active ingredient is estradiol valerate, with a dosage of two milligrams in one tablet. The medication is prescribed as hormone replacement therapy for menopausal complications, with a lack of natural estrogens due to the manifestation of menopause or sterilization. Often, the drug is prescribed one dragee per day for three weeks. Then follows a break of seven days and a dosage adjustment. Since “Proginova” has a number of contraindications and side effects, only a doctor has the right to prescribe funds.
- “Ovipol Clio” is the next analogue of “Divigel”, the instruction of which should be paid attention to. The drug is a vaginal suppository with a dosage of the active substance (estriol) of 0.5 milligrams. The medication is prescribed for atrophy of the mucous membranes of the urogenital tract (more precisely, its lower sections), as well as for bloody smears from the vagina of unknown origin. The hormone can also be used in the period before or after surgery in women in the postmenopausal period, carried out by vaginal access. How to take the drug? Usually, “Ovipol Clio” is prescribed one suppository per day every day or every other day for two weeks.
- “Estrogel.” This medication is available in the form of a gel. The active substance, estradiol, is used to treat conditions when there is not enough estrogen in the body of a woman. Also used in menopause (both natural and artificially induced), as well as the prevention of osteoporosis in the postmenopausal period. The dosage and schedule for taking the hormone is prescribed by the attending physician. However, the manufacturer advises using one gel packet both in the form of treatment and as a prophylaxis. If the therapy does not have the desired effect, a month after its start, the specialist can increase the dosage of the drug to two sachets per day, which will correspond to three milligrams of estradiol.
- “Ovestin” is a hormonal drug produced in the form of vaginal suppositories. The active substance is micronized estriol, used to treat atrophy of the mucous organs of the genitourinary system, as well as for spotting from the vagina of unknown etiology or as an adjunct to therapy carried out before and after operations performed by the vaginal method. The scheme for taking the drug is signed individually, most often - one suppository per day.
- “Klimen” is another analogue of “Divigel”. The drug is available in the form of a dragee for the treatment of amenorrhea, ovarian dysfunction, natural or artificially induced menopause, irregular menstrual cycles and so on. Also, the hormone can be prescribed as a prophylactic with a risk of developing osteoporosis due to menopause.
We have read the instructions for use "Divigel". Reviews and analogues were also presented.