Estriol Hormone: Uses, Benefits, and Side Effects Explained

Summary of Key Points

Estriol is a form of estrogen commonly used to address various conditions related to hormonal imbalances, such as menopausal symptoms, vaginal dryness, and osteoporosis. It may also be prescribed for conditions like atrophic vaginitis and urinary incontinence. Estriol is available in several forms, including creams and tablets. Always consult your healthcare provider before making any changes to your dosage, and consider scheduling a telemedicine appointment with our providers for personalized care.

Names of Medication

US Brand Name: Estriol

Generic Name: Estriol

The generic name refers to the active ingredient in the medication, which is listed in parentheses. This is the non-branded name commonly used across different brands and formulations.

Pharmacologic Category

Estrogens, Exogenous

Hormone Replacement Therapy (HRT)

Estriol Dosing Guidelines

Estriol is prescribed for a variety of conditions, and the dosage will depend on the specific condition being treated. Always follow your healthcare provider’s instructions carefully, and never adjust your dose without consulting them first. If you need further guidance, you can also schedule a telemedicine appointment with one of our providers.

Common Estriol Dosages for Specific Conditions

1. Menopausal Symptoms: 0.5 mg to 2 mg taken orally once daily. The duration of treatment varies depending on the severity of symptoms and response to therapy.
2. Atrophic Vaginitis: 0.5 mg to 1 mg applied vaginally once daily for 2 to 3 weeks, followed by a maintenance dose of 1 to 2 times per week.
3. Osteoporosis (Prevention): 0.5 mg to 2 mg taken orally once daily. Long-term use may be necessary, depending on bone density results.
4. Hormonal Imbalance: 1 mg to 2 mg taken orally once daily. The duration of treatment depends on the underlying cause of the imbalance.
5. Vaginal Dryness: 0.5 mg to 1 mg applied vaginally once daily for 2 to 3 weeks, then reduced to 1 to 2 times per week.
6. Urinary Incontinence: 0.5 mg to 1 mg applied vaginally once daily for 2 to 3 weeks, then reduced to 1 to 2 times per week.
7. Breast Cancer (Adjuvant Therapy): 1 mg to 2 mg taken orally once daily. The duration of treatment is determined by your oncologist.
8. Endometrial Hyperplasia: 0.5 mg to 2 mg taken orally once daily. The length of treatment varies based on the response to therapy.
9. Hypoestrogenism: 1 mg to 2 mg taken orally once daily. The duration of treatment depends on the underlying cause of estrogen deficiency.
10. Postmenopausal Syndrome: 0.5 mg to 2 mg taken orally once daily. Long-term use may be required depending on symptom management.

Dosage Forms and Strengths of Estriol

Oral Tablets: 1 mg, 2 mg

Vaginal Cream: 0.1%, 0.5%

Contraindications for Estriol Use

A contraindication is a specific situation in which a drug should not be used because it may be harmful to the patient. If you have any of the following conditions, taking Estriol may not be safe for you. Always consult with your healthcare provider before starting any new medication, including Estriol.

Conditions That May Prevent Estriol Use

1. Breast cancer: Estriol is a form of estrogen, and in some cases, estrogen can stimulate the growth of certain types of breast cancer. If you have a history of breast cancer or are currently undergoing treatment, Estriol may not be safe for you.
2. Endometrial cancer: Estriol can increase the risk of endometrial hyperplasia, which may lead to endometrial cancer. If you have a history of this type of cancer, Estriol should be avoided.
3. Undiagnosed vaginal bleeding: Any unexplained vaginal bleeding should be evaluated by a healthcare provider before starting Estriol, as it could be a sign of a more serious condition, such as cancer.
4. Blood clotting disorders: Estrogen can increase the risk of blood clots. If you have a history of deep vein thrombosis (DVT), pulmonary embolism, or other clotting disorders, Estriol may not be safe for you.
5. Liver disease: Estriol is metabolized by the liver. If you have liver disease, your body may not be able to process the medication effectively, which could lead to potential side effects or complications.
6. Pregnancy: Estriol is not recommended during pregnancy (see more details below).

Drug Interactions with Estriol

Estriol can interact with certain medications, potentially reducing its effectiveness or increasing the risk of side effects. Be sure to inform your healthcare provider about all the medications you are currently taking, including over-the-counter drugs and supplements.

Common Drug Interactions with Estriol

1. Warfarin (Coumadin): Estriol may reduce the effectiveness of blood thinners like warfarin, increasing the risk of blood clots.
2. Rifampin (Rifadin): This antibiotic can reduce the effectiveness of Estriol by speeding up its metabolism in the liver.
3. Carbamazepine (Tegretol): This anti-seizure medication can decrease the effectiveness of Estriol by increasing its breakdown in the liver.
4. Phenytoin (Dilantin): Another anti-seizure medication that can reduce the effectiveness of Estriol by speeding up its metabolism.
5. St. John’s Wort: This herbal supplement can reduce the effectiveness of Estriol by increasing its breakdown in the liver.

Estriol in Pregnancy

Is it safe to take Estriol when pregnant?

No, Estriol is not recommended during pregnancy. As a form of estrogen, taking Estriol can interfere with the natural hormonal balance that is crucial for a healthy pregnancy. If you are pregnant or planning to become pregnant, it’s important to consult your healthcare provider to discuss safer alternatives.

Estriol while Breastfeeding

Is it safe to take Estriol while breastfeeding?

Estriol is generally not advised during breastfeeding. Estrogen can pass into breast milk, potentially affecting milk production or having unknown effects on the nursing infant. If you are breastfeeding, speak with your healthcare provider to explore safer options for both you and your baby.

Estimated Cost of Estriol Medication

The cost of a 30-day supply of Estriol can vary depending on the pharmacy and your location. Without insurance, using a GoodRx coupon, the estimated price for a compounded Estriol cream prescription typically ranges from $50 to $70. For the most accurate pricing, check with your local pharmacy.

Possible Alternatives to Estriol

Depending on your condition, several alternatives to Estriol may be more appropriate. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to help you explore these alternatives.

Menopausal Symptoms

Alternatives may include hormone replacement therapy (HRT) with other forms of estrogen or progesterone, lifestyle changes such as regular exercise, and non-hormonal medications like selective serotonin reuptake inhibitors (SSRIs).

Atrophic Vaginitis

Non-hormonal vaginal moisturizers or lubricants, as well as other localized estrogen therapies, can be effective alternatives for managing symptoms.

Osteoporosis

Bisphosphonates (e.g., alendronate), calcium and vitamin D supplements, and weight-bearing exercises are commonly recommended to help manage osteoporosis.

Hormonal Imbalance

Depending on the underlying cause, alternatives may include other forms of hormone replacement therapy, lifestyle modifications, or medications that target specific hormonal pathways.

Vaginal Dryness

Over-the-counter vaginal moisturizers and lubricants, as well as other localized estrogen treatments, can provide relief from vaginal dryness.

Urinary Incontinence

Pelvic floor exercises (Kegels), bladder training, and medications such as anticholinergics may help manage urinary incontinence symptoms.

Breast Cancer (Adjuvant Therapy)

Tamoxifen or aromatase inhibitors are commonly used as alternatives to estrogen therapy for hormone-sensitive breast cancer.

Endometrial Hyperplasia

Progestin therapy or a progestin-releasing intrauterine device (IUD) may be recommended as alternatives to estrogen therapy for managing endometrial hyperplasia.

Hypoestrogenism

Other forms of estrogen replacement therapy, such as estradiol, may be considered depending on your specific condition and needs.

Postmenopausal Syndrome

Lifestyle changes, non-hormonal medications, and other forms of hormone replacement therapy can help manage postmenopausal symptoms effectively.

Recent Updates on Estriol Research

Recent studies have explored the potential benefits of Estriol in treating autoimmune diseases like multiple sclerosis (MS). Early research suggests that Estriol may have anti-inflammatory properties that could help reduce MS relapses. However, more research is needed to confirm these findings and establish safe dosing guidelines. Additionally, ongoing studies are investigating Estriol’s potential role in improving cognitive function in postmenopausal women, though these results are still preliminary.

As always, consult your healthcare provider before starting or changing any treatment. If you have questions about Estriol or other medications, our telemedicine providers are available to help you make informed decisions about your health.

James Kingsley

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