Estradiol

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

HRT = [tablets] Estro-pause, Estrofem; [patches] Climara, Estradot, Evorel; [gel] Femigel; [vaginal tablets] Vagifem; [vag ring] Estring.

COC = Zoely

Popular combinations:

[tablets] Activelle, Angeliq, Climen, Estro-pause N, Femoston/Femoston conti, Kliogest, Novofem, Trisequens

[patches] Estalis, Evorel (TDS conti patch/Sequi TDS patch)

Drug group:

Female sex hormone

Prescription needed?

Yes

What does it do?

Estradiol is a naturally occurring oestrogen (female sex hormone) used as hormone replacement therapy (HRT) in women with menopausal symptoms:

• Women with a uterus: combined with a progestogen to reduce the risk of uterine cancer
• Women who have had a hysterectomy: can be used alone

Estradiol is also used in combined oral contraceptives.

How should it be used?

• Estradiol as HRT is usually only advised for short-term use around the menopause
• Patches should not be applied on or near the breasts

What is the typical dosage?

Your doctor will recommend a dosage tailored to your need, but typically:

• Tablets: 1–2mg once daily
• Patches: 25–100mcg applied every 1–7 days
• Skin gel: 2–4 measures once daily

How quickly will it start to work?

10–20 days
                         

How long will the effects last?

24 hours or more

When should I stop using it?

Do not stop the drug without consulting your doctor
                                 

Is it safe for prolonged use?

Long-term use increases the risk of breast cancer, venous thrombosis, heart attack, and stroke. Regular blood pressure checks, physical examinations, and mammograms are required.

What are the possible side effects?

The following have been reported:

• More common: nausea, vomiting, breast swelling/tenderness, weight gain
• Less common: headaches, depression
• Report to your doctor before taking your next dose if you experience: sudden/sharp pain in the chest/groin/legs

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: liver disease, gallstones, heart/circulation problems, porphyria, previous blood clots or stroke, diabetes, recurrent migraines, epilepsy
• Other medicines: anticonvulsants (eg topiramate, carbamazepine, phenytoin, phenobarbital, lamotrigine), anticoagulant drugs, St John’s wort, rifampicin
• Pregnancy and breast-feeding: Not prescribed
• Children: Not usually prescribed
• Over 60: No special problems
• Driving and hazardous work: No problems expected
• Alcohol: No known problems
• Tobacco smoking: Not recommended, increased risk of serious adverse effects on the heart and circulation
• Surgery and general anaesthetics: You may need to stop taking estradiol several weeks before having major surgery