estradiol, Alora, Climara, Delestrogen, Depo-Estradiol, Divigel, Elestrin, Estrace, and Others

  • Pharmacy Author:
    Eni Williams, PharmD, PhD

    Dr. Eni Williams graduated from Creighton University in 1988 with a B.S. degree in pharmacy and a Doctor of Pharmacy from Howard University in 1994. She also obtained a Ph.D. in Public Policy in 2009 at the University of Maryland, Baltimore County.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is estradiol, and how does it work (mechanism of action)?

Estrogen is one of the major female hormones, the other one being progesterone. Estrogens occur in nature in several chemical forms. In women with active menstrual cycles, the ovaries produce between 70 and 500 micrograms of estradiol daily. This is converted to estrone and to a lesser extent estriol. After menopause, estrone made in the adrenal glands, is the most active circulating estrogen. Estrogens cause growth and development of female sex organs and maintain sex characteristics, including underarm and pubic hair and the shape of body contours and skeleton. Estrogens also increase secretions from the cervix and growth of the inner lining of the uterus (endometrium). Estrogens reduce LDL-cholesterol ("bad" cholesterol) and increase HDL-cholesterol ("good" cholesterol) concentrations in the blood. Estrogens, when taken alone or in combination with a progestin (progesterone), have been shown to reduce the risk for hip fracture due to osteoporosis by 25%.

What brand names are available for estradiol?

Alora, Climara, Delestrogen, Depo-Estradiol, Divigel, Elestrin, Estrace, Estrasorb, Estrogel, Evamist, Femring, Menostar, Minivelle, Vivelle, Vivelle-Dot

Is estradiol available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for estradiol?

Yes

What are the side effects of estradiol?

  • Among the most common endocrine side effects are:
    • break-through bleeding or spotting,
    • loss of periods or excessively prolonged periods,
    • breast pain,
    • breast enlargement, and
    • changes in sexuality (increase or decrease in libido).
  • Abdominal pain may indicate the development of gallstones or occasionally hepatitis.
  • Migraine headaches have been associated with estrogen therapy.
  • Estrogens can cause sodium and fluid retention leading to edema.
  • Melasma, tan or brown patches, may develop on the forehead, cheeks, or temples. These may persist even after the estrogen is stopped.
  • Conjugated estrogens may cause an increase in the curvature of the cornea. Patients with contact lenses may develop intolerance to their lenses.
  • Blood clots are an occasional but serious adverse effect and are dose-related. (The higher the dose of estradiol, the more likely blood clots are to form.) Cigarette smokers are at a higher risk for clots, and, therefore, patients requiring estrogen therapy are strongly encouraged to quit smoking.
  • Estrogens can increase the risk of endometrial cancer. This risk may be decreased if estrogens are combined with progestin.
  • Some people also have a higher chance of developing breast cancer while taking estrogens. Sometimes people who have breast cancer when they are taking estrogens may have increased calcium in the blood. If this happens, the estrogen should be stopped.

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Menopause & Perimenopause: Symptoms, Signs
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