HRT Dose Equivalence: Oral, Patch and Gel Estradiol

Compare approximate equivalent estradiol doses across tablets, patches and gels.

By Dr Amer Sheikh, GP Updated 17 October 2026 Clinical review pending

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Approximate equivalent doses

Dose	Oral estradiol	Patch (µg/24 h)	Oestrogel	Sandrena
Low	1 mg	25	1 pump	0.5 mg
Standard	2 mg	50	2 pumps	1 mg
Moderate	3 mg	75	3 pumps	1.5 mg
High	4 mg	100	4 pumps	2 mg

Absorption varies between people. Titrate to symptoms.

Progestogen

Anyone with a uterus needs a progestogen for endometrial protection. The 52 mg LNG-IUS (Mirena) can provide this; check the licensed duration.

Frequently asked questions

What patch strength equals 2 mg oral estradiol?

About 50 micrograms per 24 hours.

How many pumps of Oestrogel equal a 50 microgram patch?

About 2 pumps.

Do higher oestrogen doses need more progestogen?

Possibly. Seek advice for doses above standard.

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References

British Menopause Society. HRT preparations and equivalent alternatives. thebms.org.uk
NICE. Menopause: identification and management. NG23. nice.org.uk/guidance/ng23

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