What is Estradiol?
Estradiol is used as part of Menopause Hormone Therapy (MHT), which used to be known as Hormone Replacement Therapy (HRT).
Estradiol is a replacement hormone used to treat women that are experiencing menopausal symptoms (i.e., hot flashes and night sweats, as well as dryness, itching or burning around the vagina).
In some cases, Estradiol is also used in combination with other treatments to help prevent osteoporosis that can develop due to low levels of estrogen, when combined with other important therapeutics (i.e., diet, calcium and vitamin D intake, smoking cessation, and regular physical weight bearing exercise).
For more resources, including a full list of the risks and benefits of Estradiol, please review the product monograph.
How does Estradiol work?
Estradiol contains 17β-estradiol, which is a replacement hormone that’s very similar to the natural estrogen hormone produced in the body of women.
Estradiol works by helping to reduce the severity of symptoms for both menopausal and postmenopausal women, by replacing some of the missing estrogen their bodies are no longer naturally producing.
Also, because it’s known that low estrogen levels can increase the risks of osteoporosis in women, taking Estradiol, in combination with other treatments, can reduce the risk of it occurring.
What is Estradiol used to treat?
Estradiol has been indicated for two uses
The first use for Estradiol is as a method for managing menopause or postmenopause symptoms, which can be quite severe for some people.
The second use for Estradiol is as part of an ongoing treatment plan alongside other factors (i.e., proper diet, more calcium and vitamin D intake, regular exercise, quitting smoking), to reduce the risks of osteoporosis.
How do you take Estradiol?
Estradiol tablets are to be taken orally, once per day, or as prescribed. To help the medication function most effectively, it’s important to take your dose of Estradiol around the same time each day.
Estradiol tablets can be taken with or without food, but should be swallowed whole. Don’t break, chew, or dissolve the tablets for use.
Follow the Estradiol dosing instructions given to you by your healthcare practitioner, and never take Estradiol at a higher dosage or more frequently than has been prescribed to you.
How long does Estradiol last after you take it?
What are the common side effects of Estradiol?
Some people may not experience side effects when taking Estradiol, or the side effects may diminish or vanish over time as their bodies get used to the medication.
Some side effects of Estradiol that can occur include:
- Acne
- Rashes or hives (allergic reaction)
- Breast pain or swelling
- Changes in blood pressure
- Changes in cholesterol or triglyceride levels
- Changes in libido
- Changes in weight or appetite
- Constipation
- Dark patches on the face
- Dizziness (mild)
- Hair loss or abnormal hair growth
- Headaches (mild)
- Increased blood sugar levels
- Irritation to contact lenses
- Nervousness or irritability
- Stomach cramps
- Fatigue
- Vaginal bleeding or spotting
- Vaginal itching, discharge, or pain
If any of these side effects start to become severe, you should talk to your healthcare practitioner right away. They may be able to suggest an alternative Estradiol dosage or other medication that may work better for you.
MHT is the most effective treatment for menopausal symptoms and has been shown to prevent bone loss.
In menopausal women who start appropriately-dosed MHT prior to age 60 OR within 10 years of their last period, the health benefits outweigh the risks.
Risks of MHT are considered very rare (~1 case per 1000 to 10,000 women on MHT per year) and may include:
- risks of stroke or blood clots in legs or lungs with oral estrogen (much lower risk with estrogen gel or patch)
- risks of dementia in women older than 65 years,
- risk of breast cancer (less than ~1 case per 1000 women on MHT per year)
These conditions are all rare, but they highlight the importance of having a full discussion with your healthcare practitioner; especially if you’re experiencing moderate to severe side effects.
Individualization is key, and your MHT treatment plan should be reassessed (at least) once a year to monitor your health, as well as ensure that you are on the correct dosage and formulation. Your practitioner can help you find balance between treating your symptoms safely, and avoiding increased risks.
Who shouldn't take Estradiol?
There are a number of people that shouldn’t take Estradiol, including:
- People who have liver disease
- People who have or are suspected to have an estrogen-dependent cancer, such as cancer of the uterus
- People with excessive thickening of the womb lining (endometrial hyperplasia)
- People who have or have had breast cancer
- People with unusual or unexplained vaginal bleeding
- People who are pregnant, may be pregnant, or are breastfeeding
- People who have or have had blood clots in their arteries (i.e., heart attack, stroke, or angina)
- People that experience migraines
- People that have or have had blood clotting disorders
- People that have vision issues due to blood vessel disease in their eye(s)
- People that are allergic to Estradiol or any of its other ingredients
In addition to these people, there are others that should be extra cautious about taking Estradiol, as it could have negative side effects. These include:
- People that have a history of allergies or intolerances to other medications or substances
- People with a history of breast disease, abnormal mammograms, breast biopsies, or a family history of breast cancer
- People experiencing any unusual or undiagnosed vaginal bleeding
- People with a history of fibroids inside the womb, growth of the womb lining on the womb’s exterior (endometriosis)
- People with a history of itching related to estrogen use or during pregnancy
- People with a history of liver disease and/or jaundice
- People with a history of high blood pressure
- People with a history of heart disease, heart attacks, or strokes
- People with a history of migraines
- People with a history of kidney disease
- People with or a history of having asthma
- People that have or have had seizures
- People with a history of bone disease
- People with diabetes
- People with porphyria (a blood pigment disease)
- People with high triglycerides or cholesterol levels
- People taking thyroid replacement therapy
- People that have had a hysterectomy
- People that have recently had surgery, or are planning to have surgery
- People who are pregnant or may become pregnant
- People who smoke
If you believe any of these conditions apply to you, then you should talk to your healthcare practitioner. They may be able to suggest alternative Estradiol dosages or other medications that could work better for you.
Further reading
