estradiol at a glance
Medicine class
Systemic oestrogen hormone replacement therapy
Formats
Transdermal gel and self-adhesive skin patches
Womb protection
People who still have a womb usually also need a progestogen to protect its lining.
Contraception
Estradiol HRT does not prevent pregnancy.
What is estradiol used for?
Licensed uses vary by formulation and include:
Relief of symptoms caused by oestrogen deficiency around or after menopause.
Prevention of osteoporosis in certain high-risk postmenopausal women who cannot use other licensed treatments; this applies only to selected Evorel patch presentations.
How does estradiol work?
Estradiol replaces oestrogen lost during menopause. It activates oestrogen receptors, helping reduce symptoms such as hot flushes and maintain bone tissue. Delivery through the skin largely avoids first-pass metabolism in the liver.
estradiol preparations and strengths
Gel
Route: Cutaneous
Strengths: 750 micrograms/actuation
How to take estradiol
Follow the instructions for the prescribed product; gel and patches are applied differently.
Apply patches to clean, dry, intact skin on the trunk below the waist. Avoid breasts, irritated skin and areas rubbed by tight clothing; rotate application sites.
Apply Evorel Gel to clean, dry, intact skin on the arms and shoulders or inner thighs. Do not apply it on or near the breasts or vulva.
Let the gel dry before dressing, wash your hands afterwards and do not wash the application area for at least an hour.
Cover dried gel with clothing where skin contact may occur. Keep children and others away from uncovered application sites to prevent transfer.
estradiol side effects
Common or expected effects
- Headache
- Breast pain or tenderness
- Unexpected vaginal bleeding or spotting
- Nausea or abdominal discomfort
- Mood changes
- Rash, itching or local skin irritation
- Dizziness
- Fluid retention
Get urgent medical advice
- Pain, redness or swelling in one leg, which may indicate deep-vein thrombosis
- Chest pain with breathlessness, which may indicate pulmonary embolism or a heart problem
- Facial drooping, speech difficulty or limb weakness, which may indicate stroke
- Swelling of the mouth or throat or severe breathing difficulty, which may indicate anaphylaxis
- A breast lump or persistent breast or nipple change
- Heavy, persistent or newly changed vaginal bleeding requiring clinical assessment
estradiol in pregnancy
Estradiol HRT is not indicated during pregnancy. If pregnancy occurs, contact the prescriber. Available evidence does not suggest that inadvertent early exposure causes fetal harm.
estradiol while breastfeeding
Systemic estradiol HRT is not usually prescribed while breastfeeding because evidence is limited. Use should be considered only with specialist advice.
estradiol interactions
Tell the prescriber or pharmacist about all medicines and herbal products. Important examples include:
Carbamazepine, phenytoin and phenobarbital
They can increase estradiol metabolism, reducing symptom control or altering bleeding.
Rifampicin, rifabutin, nevirapine and efavirenz
They can increase estradiol metabolism and reduce its effect.
Common questions about estradiol
Answers are fully visible for fast scanning and source review.
Why is a progestogen often prescribed with estradiol?
In someone who still has a womb, systemic estradiol can thicken its lining. A progestogen usually protects against endometrial hyperplasia and cancer.
Does estradiol work as contraception?
No. Pregnancy can still occur, so discuss suitable contraception if needed.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.