What is Estradiol?

Estradiol Transdermal

Estradiol is a form of estrogen, a female sex hormone the regulates many processes in the body.
Estradiol transdermal skin patches are used to treat certain symptoms of menopause such as dryness, burning, and itching of the vaginal area. Estradiol transdermal also reduces urgency or irritation of urination.
Estradiol skin patches are also used to treat ovarian disorders, infertility, and abnormal vaginal bleeding. Some estradiol skin patches are used to prevent postmenopausal osteoporosis. Transdermal skin patches release the drug slowly, and it is absorbed through your skin.
Estradiol transdermal may also be used for other purposes not listed in this medication guide.

Estradiol Oral

Estradiol is a form of estrogen, a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.
Estradiol is used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Other uses include prevention of osteoporosis in postmenopausal women, and replacement of estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body. Estradiol is sometimes used as part of cancer treatment in women and men.
Estradiol may also be used for other purposes not listed in this medication guide.

Estradiol Vaginal (Systemic)

Estradiol is a form of estrogen. Estrogen is a female sex hormone necessary for many processes in the body.
Estradiol vaginal (systemic) is used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation.
Some estradiol products placed directly into the vagina are used for “local” treatment of vaginal menopause symptoms involving the secretions and surrounding tissues of the vagina. Other vaginal estradiol products are used for treating menopause symptoms affecting the vagina as well as other parts of the body (such as hot flashes). This type of vaginal estradiol has “systemic” effects, meaning that it can affect parts of the body other than where the medicine is placed or applied.
The information in this leaflet is specific to estradiol vaginal products used for systemic treatment of symptoms.
Estradiol vaginal (systemic) may also be used for other purposes not listed in this medication guide.

Estradiol Topical (For Use On Skin)

Estradiol is a form of estrogen, a female sex hormone that regulates many processes in the body.
Estradiol topical is used to treat certain symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation.
Estradiol topical may also be used for other purposes not listed in this medication guide.

Estradiol Injection

Estradiol is a form of estrogen. Estrogen is a female sex hormone necessary for many processes in the body.
Estradiol injection is used to treat symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. It is also used to treat a lack of estrogen that is caused by ovarian failure or a condition called hypogonadism. Some forms of estradiol injection are used in men to treat the symptoms of prostate cancer.
Estradiol injection may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Estradiol?

Estradiol Transdermal

Do not use this medication if you have any of the following conditions: a history of stroke or blood clot, circulation problems, a bleeding disorder, a hormone-related cancer such as breast or uterine cancer, or abnormal vaginal bleeding.
This medication can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.
Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol transdermal.
Long-term estradiol treatment may increase your risk of breast cancer, heart attack, or stroke. Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol transdermal.

Estradiol Oral

Estradiol can harm an unborn baby or cause birth defects. Do not use estradiol if you are pregnant.
You should not take estradiol if you have abnormal vaginal bleeding, liver disease, breast or uterine cancer, hormone-dependent cancer, a recent history of heart attack or stroke, if you are pregnant, if you have ever had a blood clot (especially in your lung or your lower body), or if you are allergic to any medicines or food dyes.
Taking hormones can increase your risk of blood clots, stroke, or heart attack, especially if you have diabetes, high blood pressure, high cholesterol or triglycerides, if you smoke, or if you are overweight.
Long-term estradiol treatment may increase your risk of breast cancer, ovarian cancer, or uterine cancer. Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress every 3 to 6 months to determine whether you should continue this treatment.
Taking progestin while using estradiol may lower your risk of uterine cancer. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol.
Estradiol should not be used to prevent heart disease, stroke, or dementia, because this medication may actually increase your risk of developing these conditions.
Have regular physical exams and mammograms, and self-examine your breasts for lumps on a monthly basis while using estradiol.

Estradiol Vaginal (Systemic)

Some estradiol products placed directly into the vagina are used for “local” treatment of vaginal menopause symptoms involving the secretions and surrounding tissues of the vagina. Other vaginal estradiol products are used for treating menopause symptoms affecting the vagina as well as other parts of the body (such as hot flashes). This type of vaginal estradiol has “systemic” effects, meaning that it can affect parts of the body other than where the medicine is placed or applied.
The information in this leaflet is specific to estradiol vaginal products used for systemic treatment of symptoms.
Do not use this medication if you have any of the following conditions: a history of stroke, heart attack, or blood clot, a hormone-related cancer such as breast or uterine cancer, or abnormal vaginal bleeding that a doctor has not checked.
This medication can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.
Estradiol increases your risk of developing endometrial hyperplasia, which may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol vaginal.
Long-term estradiol treatment may increase your risk of breast cancer, heart attack, or stroke. Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol.

Estradiol Topical (For Use On Skin)

Do not use this medication if you have any of the following conditions: a history of stroke or blood clot, circulation problems, a bleeding disorder, a hormone-related cancer such as breast or uterine cancer, or abnormal vaginal bleeding.
This medication can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.
Estrogens will not prevent heart disease, heart attack, stroke, breast cancer, or dementia, and may actually increase your risk of developing these conditions. Estrogens may also increase your risk of uterine or ovarian cancer.
Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol topical.

Estradiol Injection

Do not use this medication if you have any of the following conditions: a history of stroke or blood clot, circulation problems, a hormone-related cancer such as breast or uterine cancer, or abnormal vaginal bleeding.
This medication can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.
Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol injection.
Long-term estradiol treatment may increase your risk of breast cancer, heart attack, or stroke. Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol.

What should I discuss with my healthcare provider before taking Estradiol?

Estradiol Transdermal

Do not use estradiol transdermal if you have:

• a bleeding or blood-clotting disorder
• a history of stroke or circulation problems
• abnormal vaginal bleeding that a doctor has not checked; or
• any type of breast, uterine, or hormone-dependent cancer

Before using estradiol transdermal, tell your doctor if you have:

• high blood pressure, angina, or heart disease
• high cholesterol or triglycerides
• liver disease
• kidney disease
• asthma
• epilepsy or other seizure disorder
• migraines
• diabetes
• depression
• gallbladder disease; or
• if you have had your uterus removed (hysterectomy)

If you have any of these conditions, you may need a dose adjustment or special tests to safely use estradiol transdermal.
Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol transdermal.
Long-term estradiol treatment may increase your risk of stroke. Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
FDA pregnancy category X. This medication can cause birth defects. Do not use estradiol transdermal if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.
Estradiol can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

Estradiol Oral

You should not take estradiol if you are allergic to it, or if you have:

• liver disease
• abnormal vaginal bleeding that a doctor has not checked
• any type of breast, uterine, or hormone-dependent cancer
• a recent history of heart attack or stroke
• if you are pregnant
• if you have ever had a blood clot (especially in your lung or your lower body); or
• if you are allergic to any medicines or food dyes

Taking hormones can increase your risk of blood clots, stroke, or heart attack, especially if you have risk factors such as diabetes, high blood pressure, high cholesterol or triglycerides, smoking, or being overweight.
If you have any of these other conditions, you may need a dose adjustment or special tests:

• heart disease
• kidney disease
• family history of blood clots
• a history of jaundice caused by pregnancy or taking hormones
• endometriosis
• lupus
• porphyria
• gallbladder disease
• underactive thyroid
• asthma
• epilepsy or other seizure disorder
• migraines
• low levels of calcium in your blood; or
• if you have had your uterus removed (hysterectomy)

FDA pregnancy category X. This medication can harm an unborn baby or cause birth defects. Do not use estradiol if you are pregnant. Tell your doctor right away if you become pregnant during treatment.
Estradiol can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. You should not breast-feed while you are taking estradiol.
Estradiol should not be used to prevent heart disease, stroke, or dementia, because this medication may actually increase your risk of developing these conditions.

Estradiol Vaginal (Systemic)

Do not use estradiol vaginal if you have:

• a history of stroke, heart attack, or blood clot
• abnormal vaginal bleeding that a doctor has not checked; or
• any type of breast, uterine, or hormone-dependent cancer

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use estradiol vaginal:

• angina (chest pain), heart disease
• risk factors for coronary artery disease (such as smoking, being overweight, and having high blood pressure or high cholesterol)
• liver or kidney disease
• asthma
• epilepsy or other seizure disorder
• migraines
• diabetes
• depression
• gallbladder disease
• uterine fibroids
• a narrow, short, or prolapsed vagina
• vaginal irritation or infection; or
• if you have had your uterus removed (hysterectomy)

Estradiol increases your risk of developing endometrial hyperplasia, which may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol vaginal.
Estradiol vaginal should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.
Long-term estradiol treatment may increase your risk of stroke. Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
FDA pregnancy category X. This medication can cause birth defects. Do not use estradiol vaginal if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.
Estradiol can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

Estradiol Topical (For Use On Skin)

Estrogens will not prevent heart disease, heart attack, stroke, breast cancer, or dementia, and may actually increase your risk of developing these conditions. Estrogens may also increase your risk of uterine or ovarian cancer.
Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
You should not use estradiol topical if you have:

• a bleeding or blood-clotting disorder
• liver or kidney disease
• a history of stroke or circulation problems
• abnormal vaginal bleeding that a doctor has not checked; or
• any type of breast, uterine, or hormone-dependent cancer

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Tell your doctor if you have:

• high blood pressure, angina, or heart disease
• high cholesterol or triglycerides
• kidney disease
• asthma
• epilepsy or other seizure disorder
• migraines
• diabetes
• depression
• gallbladder disease; or
• if you have had your uterus removed (hysterectomy)

FDA pregnancy category X. This medication can cause birth defects. Do not use estradiol topical if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.
Estradiol can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.
Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol topical.

Estradiol Injection

Do not use estradiol injection if you have:

• a bleeding or blood-clotting disorder
• a history of stroke or circulation problems
• abnormal vaginal bleeding that a doctor has not checked; or
• any type of breast, uterine, or hormone-dependent cancer

Before using estradiol injection, tell your doctor if you have:

• high blood pressure, angina, or heart disease
• high cholesterol or triglycerides
• liver disease
• kidney disease
• asthma
• epilepsy or other seizure disorder
• migraines
• diabetes
• depression
• gallbladder disease; or
• if you have had your uterus removed (hysterectomy)

If you have any of these conditions, you may need a dose adjustment or special tests to safely use estradiol injection.
Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol injection.
Long-term estradiol treatment may increase your risk of stroke. Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
FDA pregnancy category X. This medication can cause birth defects. Do not use estradiol injection if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.
Estradiol can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

What is Estrace Vaginal Cream (Estradiol Topical)?

Estradiol is a form of estrogen, a female sex hormone the regulates many processes in the body.
Estradiol vaginal (local) is used to treat certain symptoms of menopause such as dryness, burning, and itching of the vaginal area. Estradiol vaginal also reduces urgency or irritation of urination.
Estradiol vaginal (local) may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Estrace Vaginal Cream (Estradiol Topical)?

Some estradiol products placed directly into the vagina are used for “local” treatment of vaginal menopause symtoms involving the secretions and surrounding tissues of the vagina. Other vaginal estradiol products are used for treating menopause symptoms affecting the vagina as well as other parts of the body (such as hot flashes). This type of vaginal estradiol has “systemic” effects, meaning that it can affect parts of the body other than where the medicine is placed or applied.
The information in this leaflet is specific to estradiol vaginal products that are used for local treatment of symptoms.
Do not use this medication if you have any of the following conditions: a history of stroke or blood clot, circulation problems, a hormone-related cancer such as breast or uterine cancer, or abnormal vaginal bleeding.
This medication can cause birth defects in an unborn baby. Do not use if you are pregnant. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.
Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol vaginal.
Long-term estradiol treatment may increase your risk of breast cancer, heart attack, or stroke. Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol.

What should I discuss with my healthcare provider before taking Estrace Vaginal Cream (Estradiol Topical)?

Do not use estradiol vaginal if you have:

• a bleeding or blood-clotting disorder
• a history of stroke or circulation problems
• abnormal vaginal bleeding that a doctor has not checked; or
• any type of breast, uterine, or hormone-dependent cancer

Before using estradiol vaginal, tell your doctor if you have:

• high blood pressure, angina, or heart disease
• high cholesterol or triglycerides
• liver disease
• kidney disease
• asthma
• epilepsy or other seizure disorder
• migraines
• diabetes
• depression
• gallbladder disease; or
• if you have had your uterus removed (hysterectomy)

If you have any of these conditions, you may not be able to use estradiol vaginal, or you may need a dosage adjustment or special tests during treatment.
Estradiol increases your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using estradiol may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol vaginal.
Long-term estradiol treatment may increase your risk of stroke. Talk with your doctor about your individual risks before using estradiol long-term. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.
FDA pregnancy category X. This medication can cause birth defects. Do not use estradiol vaginal if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use an effective form of birth control while you are using this medication.
Estradiol may decrease breast milk flow and have other effects on milk composition. Do not use estradiol without first talking to your doctor if you are breast-feeding a baby.

Vaginal Cream (Estradiol Topical)?

Do not use estradiol vaginal if you have:

• a bleeding or blood-clotting disorder

Estradiol Side Effects

What are the possible side effects of Estradiol?

Estradiol Transdermal

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling
• sudden numbness or weakness, especially on one side of the body
• sudden headache, confusion, problems with vision, speech, or balance
• pain or swelling in your lower leg
• abnormal vaginal bleeding
• pain, swelling, or tenderness in your stomach
• jaundice (yellowing of the skin or eyes); or
• a lump in your breast

Less serious side effects may include:

• nausea, vomiting, loss of appetite
• swollen breasts
• acne or skin color changes
• decreased sex drive, impotence, or difficulty having an orgasm
• migraine headaches or dizziness
• vaginal pain, dryness, or discomfort
• swelling of your ankles or feet
• depression; or
• changes in your menstrual periods, break-through bleeding

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Estradiol Oral

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using estradiol and call your doctor at once if you have a serious side effect such as:

• unusual vaginal bleeding (especially if you are past menopause)
• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling
• sudden numbness or weakness, especially on one side of the body
• sudden severe headache, confusion, problems with vision, speech, or balance
• stabbing chest pain, sudden cough, wheezing, rapid breathing, fast heart rate
• pain, swelling, warmth, or redness in one or both legs
• nausea, vomiting, loss of appetite, increased thirst, muscle weakness, confusion, and feeling tired or restless
• a lump in your breast
• feeling like you might pass out
• pain, swelling, or tenderness in your stomach; or
• jaundice (yellowing of the skin or eyes)

Less serious side effects may include:

• mild nausea, vomiting, bloating, stomach cramps
• breast pain, tenderness, or swelling
• freckles or darkening of facial skin
• loss of scalp hair
• vaginal itching or discharge; or
• changes in your menstrual periods, break-through bleeding

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Estradiol Vaginal (Systemic)

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Remove the vaginal ring and seek emergency medical attention if you have fever with nausea, vomiting, diarrhea, muscle pain, dizziness, fainting, and/or sunburn-like skin rash. These may be signs of a life-threatening disease called toxic shock syndrome.
Call your doctor at once if you have any of these serious side effects:

• chest pain or heavy feeling, pain spreading to the arm or shoulder, sweating, general ill feeling
• sudden numbness or weakness, especially on one side of the body
• sudden headache, confusion, problems with vision, speech, or balance
• pain or swelling in your lower leg (calf)
• heavy or unusual vaginal bleeding
• severe constipation
• symptoms of depression (sleep problems, weakness, mood changes)
• loss of appetite, increased thirst, muscle weakness, feeling tired or restless
• pain, swelling, or tenderness in your stomach, jaundice (yellowing of the skin or eyes); or
• a lump in your breast

Less serious side effects may include:

• swollen breasts
• acne or skin color changes
• decreased sex drive, impotence, or difficulty having an orgasm
• migraine headache
• vaginal pain, itching, or discharge
• swelling of your ankles or feet; or
• changes in your menstrual periods, break-through bleeding

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Estradiol Topical (For Use On Skin)

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling
• sudden numbness or weakness, headache, confusion, or problems with vision, speech, or balance
• pain or swelling in your lower leg
• abnormal vaginal bleeding
• pain, swelling, or tenderness in your stomach
• jaundice (yellowing of the skin or eyes); or
• a lump in your breast

Less serious side effects may include:

• nausea, vomiting, loss of appetite
• swollen breasts
• acne or skin color changes
• vaginal pain, dryness, or discomfort, decreased sex drive, impotence, or difficulty having an orgasm
• swelling, weight gain
• migraine headaches, dizziness, depression; or
• break-through bleeding, vaginal itching or discharge

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Estradiol Injection

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling
• sudden numbness or weakness, especially on one side of the body
• sudden headache, confusion, problems with vision, speech, or balance
• pain or swelling in your lower leg
• abnormal vaginal bleeding
• pain, swelling, or tenderness in your stomach
• jaundice (yellowing of the skin or eyes); or
• a lump in your breast

Less serious side effects may include:

• nausea, vomiting, loss of appetite
• swollen breasts
• acne or skin color changes
• decreased sex drive, impotence, or difficulty having an orgasm
• migraine headaches or dizziness
• vaginal pain, dryness, or discomfort
• swelling of your ankles or feet
• depression; or
• changes in your menstrual periods, break-through bleeding

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Estradiol Interactions

What other drugs affect Estradiol?

Estradiol Transdermal

Before using estradiol transdermal, tell your doctor if you are using any of the following drugs:

• St. John’s wort
• phenobarbital (Luminal, Solfoton)
• a blood thinner such as warfarin (Coumadin)
• ritonavir (Norvir)
• carbamazepine (Carbatrol, Tegretol)
• an antibiotic such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), or rifampin (Rifadin, Rifater, Rifamate, Rimactane); or
• an antifungal medication such as ketoconazole (Nizoral) or itraconazole (Sporanox)

This list is not complete and there may be other drugs that can interact with estradiol transdermal. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Estradiol Oral

Tell your doctor about all other medicines you use, especially:

• a blood thinner such as warfarin (Coumadin)
• cimetidine (Tagamet)
• carbamazepine (Carbatrol, Tegretol)
• phenobarbital (Luminal, Solfoton)
• phenytoin (Dilantin)
• rifampin (Rifadin, Rifater, Rifamate, Rimactane); or
• ritonavir (Norvir)
• St. John’s wort
• an antibiotic such as clarithromycin (Biaxin) or erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab); or
• antifungal medication such as ketoconazole (Extina, Ketozole, Nizoral, Xolegal)

This list is not complete and other drugs may interact with estradiol. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Estradiol Vaginal (Systemic)

Before using estradiol vaginal, tell your doctor if you are using any of the following drugs:

• St. John’s wort
• carbamazepine (Carbatrol, Tegretol)or phenobarbital (Luminal, Solfoton)
• a blood thinner such as warfarin (Coumadin)
• ritonavir (Norvir)
• rifampin (Rifadin, Rifater, Rifamate, Rimactane)
• thyroid replacement medication such as levothyroxine (Synthroid) and others
• an antibiotic such as clarithromycin (Biaxin) or erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab); or
• an antifungal medication such as ketoconazole (Nizoral) or itraconazole (Sporanox)

This list is not complete and there may be other drugs that can interact with estradiol vaginal. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Estradiol Topical (For Use On Skin)

Tell your doctor about all other medications you use, especially:

• St. John’s wort
• a blood thinner such as warfarin (Coumadin)
• ritonavir (Norvir)
• carbamazepine (Carbatrol, Tegretol) or phenobarbital (Luminal, Solfoton)
• an antibiotic such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), or rifampin (Rifadin, Rifater, Rifamate, Rimactane)
• an antifungal medication such as ketoconazole (Nizoral) or itraconazole (Sporanox)

This list is not complete and there may be other drugs that can interact with estradiol topical. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Estradiol Injection

Before using estradiol injection, tell your doctor if you are using any of the following drugs:

• St. John’s wort
• phenobarbital (Luminal, Solfoton)
• a blood thinner such as warfarin (Coumadin)
• ritonavir (Norvir)
• carbamazepine (Carbatrol, Tegretol)
• rifampin (Rifadin, Rifater, Rifamate, Rimactane); or
• antibiotics such as clarithromycin (Biaxin), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), ketoconazole (Nizoral), or itraconazole (Sporanox)

This list is not complete and there may be other drugs that can interact with estradiol injection. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

What should I avoid while taking Estradiol?

Estradiol Transdermal

Avoid using other estrogen products without your doctor’s advice.

Estradiol Oral

Do not smoke while using this medication. Smoking can increase your risk of blood clots, stroke, or heart attack caused by conjugated estrogens.

Estradiol Vaginal (Systemic)

Avoid using other vaginal products without your doctor’s advice.

Estradiol Topical (For Use On Skin)

Do not apply sunscreen to your skin at the same time you apply estradiol topical.
Avoid getting this medication in your eyes, and rinse thoroughly with water if this does happen.
Grapefruit and grapefruit juice may interact with estradiol and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Estradiol Injection

Follow your doctor’s instructions about any restrictions on food, beverages, or activity while you are using estradiol injection.

Estradiol Dosage

How should I take Estradiol?

Estradiol Transdermal

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.
Apply the skin patch to clean, dry skin on your stomach, lower back, or buttocks. Choose a different spot within these skin areas each time you apply a new patch. Avoid skin that is oily, irritated, or damaged.
Press the patch in place firmly for about 10 seconds, especially around the edges.
Do not apply a skin patch to your breasts. Do not apply a patch where it might be rubbed off by tight clothing, such as under an elastic waistband.
If a patch falls off, try putting it back on to a different skin area, pressing the patch into place for 10 seconds. If the patch will not stick you may apply a new one.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol transdermal.
Store this medication at room temperature away from moisture and heat.

Estradiol Oral

Take this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor.
Long-term estradiol treatment may increase your risk of breast cancer, ovarian cancer, or uterine cancer. Talk with your doctor about your individual risks before using estradiol long-term.
Taking progestin while using estradiol may lower your risk of uterine cancer. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using estradiol.
Have regular physical exams and mammograms, and self-examine your breasts for lumps on a monthly basis while using estradiol. Your doctor should check your progress every 3 to 6 months to determine whether you should continue this treatment.
If you need medical tests or surgery, or if you will be on bed rest, you may need to stop using this medication for a short time. Any doctor or surgeon who treats you should know that you are taking estradiol.
Store at room temperature away from moisture, heat, and light.

Estradiol Vaginal (Systemic)

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label.
Wash your hands before and after inserting the vaginal ring.
To insert the estradiol vaginal ring:

• Squeeze the sides of the ring together and insert it into the vagina as far as possible. You should not be able to feel the ring once it is in place. If you can feel it, use a finger to push it in farther. It is not possible for the ring to go too far in or become lost
• Leave the ring in place for 90 days. If the ring ever falls out, rinse it with warm water and reinsert it. If it slides down into the lower part of the vagina, use a finger to push it in farther. After 90 days, remove the ring. Your doctor may want you to replace it with a new ring
• The ring does not need to be removed during sexual intercourse. Neither partner should be able to feel the ring when it is in place. If the ring is bothersome, you may remove it, rinse it with warm water, and reinsert it after intercourse
• The estradiol vaginal ring does not prevent pregnancy and should not be used in place of effective birth control

To remove the ring, loop a finger through the ring and gently pull it from the vagina. Call your doctor if you have trouble removing a vaginal ring.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol vaginal.
If you need to have any type of surgery or be on bed rest, tell your surgeon or doctor ahead of time that you are using the estradiol vaginal ring. You may need to remove the ring 4 to 6 weeks before your surgery.
Keep the vaginal ring in its protective pouch until you are ready to use it. Store the pouch at room temperature away from moisture and heat.

Estradiol Topical (For Use On Skin)

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the instructions on your prescription label.
This medication comes with patient instructions for safe and effective use, and directions for priming the spray or gel pump if needed. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
Apply estradiol topical only to clean, dry, unbroken skin. Do not apply to skin that is red or irritated. Never apply this medicine to the breasts.
To use the topical gel (such as Estrogel):

• Apply estradiol topical gel to the outside of your arm, from wrist to shoulder. Use the gel at the same time each day
• Do not rub the gel in, but allow it to dry on your skin for at least 5 minutes before you dress
• This medication is flammable. Avoid smoking or being near an open flame until the medicine has dried completely

To use the topical emulsion (such as Estrasorb):

• Apply this medicine while you are sitting down. You will use two foil pouches each time you apply this medication, unless your doctor has told you otherwise
• Cut or tear open the foil pouch and place the pouch on top of your left thigh, with the open end of the pouch pointing toward your knee
• Hold the pouch with one hand and use the fingers of your other hand to gently push all of the medicine out of the pouch and onto your thigh
• Spend at least 3 minutes rubbing the gel into your entire left thigh and calf. Rub any excess medicine onto your buttocks
• Cut or tear open the second pouch and apply the medicine to your right leg using the same method described above

To use the topical spray (such as Evamist):

• Apply the spray to the skin on the inside of your forearm, just below the elbow. Use the spray at the same time each day
• Place the cone of the spray applicator directly to your skin and hold the pump upright. Press the pump fully one spray. If your doctor has prescribed more than one spray, choose a different place on your inside forearm for the second spray. Use only the number of sprays your doctor has recommended
• Do not rub the spray in, but allow it to dry on your skin for at least 2 minutes before you dress. Do not wash your arm for at least 30 minutes after applying the spray

Wash your hands with soap and water after applying the gel or emulsion.
Avoid allowing other people to get this medicine on their skin. If this happens, wash the area thoroughly with soap and water.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol topical.
Store this medication at room temperature away from moisture and heat.

Estradiol Injection

Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label.
Estradiol injection is given as an shot into a muscle. You may be shown how to inject your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.
This medicine is usually given once every 4 weeks. Follow your doctor’s instructions.
Do not draw your estradiol dose into a syringe until you are ready to give yourself an injection. Do not use the medication if it has changed colors or has any particles in it. Call your doctor for a new prescription.
Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.
Have regular physical exams and self-examine your breasts for lumps on a monthly basis while using estradiol injection.
Store this medication at room temperature away from moisture and heat.

What happens if I overdose on Estradiol?

Estradiol Transdermal

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, and vaginal bleeding.

Estradiol Oral

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose can cause nausea, vomiting, or vaginal bleeding.

Estradiol Vaginal (Systemic)

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include breast tenderness, drowsiness, dizziness, nausea, vomiting, stomach pain, or vaginal bleeding.

Estradiol Topical (For Use On Skin)

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, stomach pain, breast tenderness, drowsiness, and vaginal bleeding.

Estradiol Injection

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, or vaginal bleeding.

What happens if I miss a dose of Estradiol?

Estradiol Transdermal

Apply a skin patch as soon as you remember. If it is almost time to apply your next patch, skip the missed dose and apply a patch at the next regularly scheduled time. Do not use extra patches to make up the missed dose.

Estradiol Oral

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Estradiol Vaginal (Systemic)

Remove the vaginal ring and insert a new one as soon as you remember. Do not use an extra vaginal ring to make up the missed wearing time.
If a vaginal ring falls out, rinse it with warm water and reinsert it. If it slides down into the lower part of the vagina, use your finger to push it in farther.

Estradiol Topical (For Use On Skin)

Use the medication as soon as you remember. If your next dose is less than 12 hours away, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.

Estradiol Injection

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and use the medicine at the next regularly scheduled time. Do not use extra medicine to make up the missed dose.
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