Sandrena (Estradiol Gel) 0.1 % 1 mg / 1g

Sandrena 1 mg

Sandrena (Estradiol Gel) 0.1 % 1 mg / 1g

Daily oestrogen gel in individual sachets

Sandrena (Estradiol Gel) 0.1 % 1 mg / 1g

Hot flushes, night sweats or sleep interrupted by menopause symptoms? Sandrena is a daily oestrogen gel that may help. Each 1 mg sachet gives you a measured amount to apply to your skin as part of your prescribed HRT plan.

Sandrena contains oestrogen only. If you have a womb, you will usually need a separately prescribed progestogen to protect its lining. Your clinician will explain how the medicines fit together.

LIVVE product price

From £10

Pack size: 28 or 91 sachets

Medicine cost only. Consultation and ongoing reviews may be separate unless stated in your treatment plan.

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View product facts How to use it

1 mg estradiol per sachet

Separate womb protection if needed

Applied once daily

Regular HRT review

Oestrogen absorbed through the skin

Treatment that fits your symptoms, your health and your everyday life.

A measured sachet, a routine that fits your day

Apply your prescribed gel dose each day and follow any separate progestogen plan. We’ll help you feel clear about where to apply it and how to use it safely.

Medicine type

Oestrogen-only HRT gel
Hormones

Estradiol
Strength or daily release

1 mg estradiol in each 1 g sachet
Routine

Apply the prescribed dose once daily
Pack size

28 or 91 sachets
Progestogen included

No; a separate plan is usually needed with a womb
Bleeding pattern

Depends on your separately prescribed progestogen regimen
Prescription needed?

Yes

Pack sizes and price

Sandrena 1 mg

Your prescription confirms the dose and quantity supplied.

We’ll usually review treatment at around 3 months, then at least annually. Ask for advice sooner if you need it.

Sandrena 1 mg pack sizes and prices
Product	Pack	Strength	LIVVE price
Sandrena 1 mg gel	28 sachets	1 mg estradiol in each 1 g sachet	£10
Sandrena 1 mg gel	91 sachets	1 mg estradiol in each 1 g sachet	£30

Key application steps

Check the dose on your dispensing label. For a prescribed 1 mg dose, use one whole 1 mg sachet. Do not estimate part of a sachet.
Apply to clean, dry skin on the lower body or thighs, alternating sides each day. Do not use on your breasts, face, irritated skin or near your eyes.
Spread gently over an area about one to two hand sizes. Allow a few minutes to dry before dressing.
Wash your hands with soap and water after applying. Do not wash the application area for at least one hour.
Cover the site with clothing once dry and prevent other people, especially children, or pets touching the treated skin.
Before anticipated skin contact, shower the application site, allowing at least one hour after the dose. If accidental transfer occurs, wash the affected person’s or animal’s skin promptly with soap and water; seek medical or veterinary advice if symptoms develop.

Practical tips

A phone reminder and a simple symptom and bleeding diary can help you stay on track.
Store below 25°C. Keep out of the sight and reach of children. Do not use after the expiry date.
Ask your pharmacist how to dispose of unwanted medicine.

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Dose and routine

Making your routine easier to follow

Use this table alongside your dispensing label and patient leaflet. Do not increase the dose or alter your hormone plan yourself.

Dose and schedule

Dose and schedule
Dose and schedule	Details
Daily dose	Use the prescribed amount once daily. A 1 mg daily dose is one 1 mg sachet. Any dose adjustment needs clinical review.
Starting or switching	Confirm your start date with your clinician, particularly when changing from HRT that gives you a monthly bleed.
Separate progestogen	Follow the prescribed schedule exactly if you need womb protection.
Missed by no more than 12 hours	Apply the missed dose when remembered, then continue your usual schedule.
More than 12 hours late	Skip the dose and continue normally. Do not double the next dose. Missing doses may cause spotting.
Too much gel or accidental swallowing	Contact a doctor or pharmacist for advice. Wash off excess gel if too much was applied.

Fewer hot flushes

May help make those sudden waves of heat less frequent or intense.
Less night sweating

May help ease menopause-related sweating at night.
More settled sleep

You may sleep better as night sweats and other menopause symptoms ease.
Support for everyday wellbeing

When symptoms feel more manageable, daily life may feel easier too. Tell us about low mood or anxiety that persists so we can help you explore the right support.
Help vaginal symptoms

It may help dryness or irritation, although local vaginal treatment may still be needed.
A role in bone health

Sandrena may also be prescribed after menopause to help prevent osteoporosis in people at high risk of fractures who cannot use other approved prevention medicines because of side effects or medical reasons. Your clinician must choose the dose for this purpose; one 1 mg sachet is not necessarily sufficient.

What is Sandrena

A measured sachet, a routine that fits your day

Sandrena contains estradiol, an oestrogen with the same chemical structure as the hormone your body produces. It is absorbed through the skin. Each 1 g sachet contains 1 mg estradiol; it does not contain a progestogen.

Do I need separate progesterone

Sandrena contains oestrogen only. If you have a womb, you will usually need a separately prescribed progestogen to protect its lining. Your clinician will explain how the medicines fit together.

Why it matters

Oestrogen can thicken the womb lining. An adequate progestogen plan helps prevent excessive growth and the associated risk of womb-lining cancer. If you have had a hysterectomy, oestrogen alone is often suitable, although a history of endometriosis can change the advice.

Your separate plan

Your clinician will prescribe the dose and schedule, such as progestogen for at least 12–14 days in each monthly cycle, or another suitable womb-protection regimen. A suitable 52 mg levonorgestrel intrauterine system may also provide womb protection when within its HRT replacement interval. Do not stop or shorten this part of your treatment yourself.

Oestrogen-only HRT

Oestrogen without an included progestogen
May suit people who have had their womb removed or those using a separate progesterone or progestogen plan.
- Tablets, patches, gels or sprays
- Flexible separate progesterone plan
- Womb protection needed if the womb is present
LIVVE examples

Elleste Solo Evorel Estraderm MX FemSeven Mono Oestrogel Sandrena Lenzetto
Sequential combined HRT

Oestrogen is taken every day, with a progestogen added for part of each monthly cycle.
Often considered when periods are continuing or have only recently stopped.
- Structured monthly cycle
- Planned withdrawal bleed usually expected
- Both hormones may be supplied in one pack or as separate medicines, depending on the prescribed regimen.
Things to consider: the treatment sequence must be followed correctly and a monthly bleed is normally part of treatment.
LIVVE examples

Elleste Duet Evorel Sequi Elleste Solo + separately prescribed progestogen (separate regimen)
Continuous combined HRT

Oestrogen and progestogen used continuously
May suit postmenopausal patients who need both hormones without a planned monthly withdrawal bleed.
- Both hormones used every day
- No planned monthly bleed once settled
- Available as combined products or separate medicines
Things to consider: spotting can occur during the early months and continuous progestogen can cause side effects for some people.
LIVVE examples

Evorel Conti Bijuve Elleste Duet Conti Oestrogen + separate progesterone

Tablets are swallowed each day; patches stay on the skin between changes; gels are applied and allowed to dry; sprays have their own application routine. Doses are not directly interchangeable. We’ll help you weigh up skin sensitivity, daily habits, health history and the need for womb protection.

Getting started

Give yourself time to get used to the routine. Breast tenderness, headache, nausea or spotting can occur. Let us know if these bother you.
The first few weeks

Some symptoms may begin to ease within a few weeks. Sleep may improve as night sweats settle, but everyone’s response is different.
Your bleeding pattern

Your bleeding pattern depends on the progestogen regimen prescribed alongside the gel. A monthly course usually leads to a withdrawal bleed. Tell us about unexpected bleeding.
Around 3 months

Your review is a chance to talk about symptom relief, side effects and bleeding. Ask for advice sooner if anything concerns you.

Complete your assessment

Tell us about symptoms, periods, bleeding, health history, medicines and preferences.
Clinician review

We assess the HRT type, route and womb protection that may suit you.
Personalised prescription

If suitable, Sandrena 1 mg is prescribed with clear instructions for your routine.
Ongoing support

Ask LIVVE about side effects or bleeding, and attend treatment and repeat-prescription reviews.

I'm new to LIVVE I need my next prescription

Symptoms have not improved after around 3 months or become worse.
Side effects are persistent, severe or difficult to manage.
Bleeding is heavy, prolonged or painful; do not wait for a routine review.
You miss doses repeatedly or are unsure about your gel or progestogen schedule.
Your health, medicines or treatment preferences change.
Unexpected bleeding

Unexpected spotting may occur in the first few months. Arrange assessment promptly if it lasts beyond the first 6 months, starts after more than 6 months of treatment, or continues after stopping. These time points do not mean you should wait if bleeding is heavy or concerning.

You have, have had, or may have breast cancer.
You have or may have an oestrogen-sensitive cancer, such as cancer of the womb lining.
You have unexplained vaginal bleeding or untreated excessive thickening of the womb lining.
You have or have previously had a blood clot in a vein, including a leg clot or a clot in the lungs.
You have a known blood-clotting disorder such as protein C, protein S or antithrombin deficiency.
You have or have recently had a condition caused by a clot in an artery, such as a heart attack, stroke or angina.
You have active liver disease, or previous liver disease with liver tests that have not returned to normal.
You have porphyria, or are allergic to estradiol or another ingredient.
Stop treatment and get urgent medical help

Call 999 for sudden chest pain, sudden severe breathlessness, coughing up blood, signs of stroke such as facial drooping, arm weakness or speech difficulty, or swelling of the tongue or throat with difficulty breathing or swallowing. Do not wait for a LIVVE response.
Stop Sandrena and seek urgent same-day medical advice for painful swelling or redness in one leg, yellow skin or eyes, a new migraine-type headache, or a significant rise in blood pressure. If a reason not to use HRT develops, stop and contact a clinician immediately. Use NHS 111 if you cannot reach a clinician promptly; call 999 for severe or life-threatening symptoms.
Important

Do not use during pregnancy or breastfeeding. Sandrena is not contraception. Ask about contraception if pregnancy is possible. If you become pregnant, stop treatment and contact your clinician. This medicine is not for children.
Conditions that need extra assessment or monitoring

Tell us if you have, or have had, fibroids, endometriosis, a thickened womb lining, high blood pressure, migraines or severe headaches, diabetes, gallstones or liver problems. We also need to know about breast cancer or blood clots in close relatives.
Mention epilepsy, asthma, lupus, otosclerosis (a hearing condition), heart or kidney problems, very high triglycerides, thyroid treatment or angioedema. These may mean you need extra checks. HRT can worsen fluid retention or angioedema; very high triglycerides can rarely lead to inflammation of the pancreas.
Medicines and herbal products to mention

Bring a list of everything you take, including supplements and herbal remedies. Some epilepsy, tuberculosis, HIV and hepatitis C medicines need extra checks, as does St John’s wort. HRT may affect lamotrigine and seizure control. Tell us about blood thinners and thyroid medicines too. Your clinician or pharmacist will check your list; don’t stop another medicine yourself. Let anyone arranging blood tests know you take HRT.
Ingredients

The gel contains alcohol and propylene glycol; alcohol can sting damaged skin. Read the leaflet for all ingredients and tell us about any allergy.
Important risks to discuss before starting

Breast-cancer risk depends on the HRT regimen and duration. Oestrogen-only HRT has a lower breast-cancer risk than combined HRT; a separate progestogen changes the overall regimen. HRT is also linked to a small increase in ovarian-cancer risk. Oestrogen without adequate womb protection increases womb-lining cancer risk if you have a womb.
Your clinician will assess clot, stroke and heart risks alongside the benefits of treatment. Risks differ by route, age and health history; using HRT through the skin does not remove the need for assessment. HRT is not prescribed to prevent heart attacks or dementia. The leaflet explains risks and comparisons in more detail.
Monitoring and surgery

We’ll review whether the benefits still outweigh the risks at least once a year, using the lowest dose that helps. Attend breast screening when invited, tell the screening team you take HRT, and report a breast lump, skin dimpling or nipple change promptly.
Tell your surgical team you use Sandrena. If you will be less mobile, they may advise a pause 4–6 weeks before surgery. Agree any interruption and restart with them; do not change treatment yourself.

Common side effects

May affect up to 1 in 10 people: breast pain, headache, dizziness, nausea, stomach discomfort, wind, changes in bleeding, swelling, weight changes and low mood or nervousness.
Other side effects

Other effects, including less common reactions, are listed in the leaflet. New migraine, liver symptoms, suspected clots or a severe allergic reaction need urgent help; do not assume they are settling-in effects.
Contact LIVVE if

Side effects persist, affect everyday life or include new or worsening mood symptoms. Ask for prompt advice about heavy, prolonged or concerning bleeding.
Reporting side effects

You can report suspected side effects to the MHRA Yellow Card scheme at https://yellowcard.mhra.gov.uk. Reporting does not replace medical care.

Discuss changes with your clinician

If symptoms remain troublesome, we can review the dose, route, bleeding pattern and any progestogen side effects. Do not increase, combine or switch medicines yourself. If you wish to stop, discuss a plan; symptoms may return. Stop immediately and seek help for the warning signs in Safety first.

What pack sizes of Sandrena does LIVVE offer?

Sandrena 1 mg comes in packs of 28 or 91 sachets. The quantity supplied and daily dose are shown on your prescription; not all pack sizes may be available.

Why might I choose Sandrena sachets?

Sandrena provides oestrogen in individual sachets containing a pre-measured amount of gel. This may suit people who prefer a sachet rather than measuring full pump doses or using a spray. The most appropriate format will depend on your prescribed dose, routine and preferences.

How long does Sandrena take to work?

Some people notice fewer hot flushes or night sweats within a few weeks, but it can take up to 3 months to judge the full effect. Other symptoms may take longer.

Will I need progesterone with Sandrena?

If you still have your womb, you will normally need progesterone or another progestogen alongside Sandrena to protect the womb lining.

How is Sandrena different from Oestrogel?

Both contain estradiol and are absorbed through the skin. Sandrena is supplied in single-use sachets, while Oestrogel is measured from a pump. Application areas and dosing instructions differ.

Where should I apply Sandrena?

Apply it to clean, dry skin on the lower body or thighs, using a different side each day. Do not apply it to the breasts, face or irritated skin.

Can Sandrena help vaginal dryness?

It may help, but vaginal and urinary symptoms sometimes need an additional local vaginal treatment.

What should I do if I miss a dose?

Apply the missed dose when remembered if you are no more than 12 hours late. If more than 12 hours late, skip it and continue as normal. Do not apply a double dose.

Can I switch to Sandrena from another HRT?

Yes, where clinically appropriate. Your clinician will explain when to stop your existing treatment, when to start Sandrena and whether your progesterone plan also needs to change.

Ready to explore your HRT options

A LIVVE clinician can help you understand where Sandrena may fit and find a treatment plan for your symptoms, health and everyday life.

Start your consultation View product facts

This page provides general information and does not replace individual medical advice. Sandrena is a prescription-only medicine and is supplied only when clinically appropriate after assessment. Read the leaflet supplied with your medicine and follow your prescriber’s instructions.

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