Estradiol

What is estradiol

Estradiol (a form of estrogen) is a female sex hormone necessary for many processes in the body. Estradiol vaginal products release estrogen that is absorbed directly through the skin of the vaginal wall.

Estradiol topical is used to treat certain symptoms of menopause such as dryness, burning, and itching of the vaginal area and urgency or irritation with urination.

Estradiol may also be used for purposes other than those listed in this medication guide.

General medical information about estradiol

Estradiol increases the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, another hormone drug, while using estradiol lowers the risk of developing this condition. Therefore, if your uterus has not been removed, your doctor may prescribe a progestin for you to take together while using estradiol. Visit your doctor regularly and report any unusual vaginal bleeding right away.

Have yearly physical exams and examine your breasts for lumps on a monthly basis while using estradiol.

Do not use this medication if you are pregnant.

Who should not use estradiol

Do not use estradiol without first talking to your doctor if you have
- a circulation, bleeding, or blood-clotting disorder;
- undiagnosed, abnormal vaginal bleeding; or
- any type of breast, uterine, or hormone-dependent cancer.

Using estradiol may be dangerous in some cases if you have any of the conditions listed above.

Before using estradiol, tell your doctor if you have:
- high blood pressure, angina, or heart disease;
- high levels of cholesterol or triglycerides in your blood;
- liver disease;
- kidney disease;
- asthma;
- epilepsy;
- migraines;
- diabetes;
- depression;
- gallbladder disease;
- uterine fibroids;
- had a hysterectomy (uterus removed);
- a narrow, short, or prolapsed vagina;
- vaginal irritation; or
- a vaginal infection.

You may not be able to use estradiol, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Estradiol is in the FDA pregnancy category X. This means that estradiol will cause birth defects in an unborn baby. Do not use estradiol if you are pregnant or are planning a pregnancy.

Estradiol may decrease 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.

How should you use estradiol

Use estradiol exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

To use the Estring vaginal ring:
- Squeeze the sides of the ring together and insert it into the vagina as far as possible (into the upper 1/3 of the vagina). You should not be able to feel the ring once it is in position. If you can feel it, use a finger to push it further into the vagina. It is not possible for the ring to go too far in or become lost.
- The ring should remain in place for 90 days. It should then be removed and replaced by a new ring, if prescribed by your doctor. If at any time the ring 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 reinsert it.
- The ring does not need to be removed during sexual intercourse. It should not be felt by either partner. If it is bothersome, it can be removed, rinsed with warm water, and reinserted following intercourse.
- To remove the ring, loop a finger through the ring and gently pull it from the vagina.

To use the estradiol vaginal cream:
- Using the marked applicator provided, measure the prescribed dose of cream.
- Lie on your back with your knees drawn up, sit, or stand in a position that allows you comfortable access to the vaginal area. To deliver the medication, gently insert the applicator deeply into your vagina and press the plunger downward to its original position.
- Clean the applicator by pulling the plunger to remove it from the barrel. Wash it with mild soap and warm water.

Have yearly physical exams and examine your breasts for lumps on a monthly basis while using estradiol.

Store the vaginal rings and cream at room temperature away from moisture and heat.

If you miss a dose:

Insert the next dose of cream or ring as soon as you remember. Continue to follow your regular schedule. Do not use two doses simultaneously unless your doctor directs otherwise.

If at any time the ring 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 reinsert it.

What happens if you overdose:

An overdose of estradiol is unlikely to occur and is not likely to threaten life. If you do suspect an overdose, or if the medication has been ingested, call an emergency room or poison control center for advice.

What should you avoid while using estradiol

There are no restrictions on food, beverages, or activity while using estradiol unless your doctor directs otherwise.

Possible side effects of estradiol

If you experience any of the following serious side effects, stop using estradiol and seek emergency medical attention:
- an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
- shortness or breath or pain in your chest;
- a painful, red, swollen leg;
- abnormal vaginal bleeding;
- pain, swelling, or tenderness in the abdomen;
- severe headache or vomiting, dizziness, faintness or changes in vision or speech;
- yellowing of the skin or eyes; or
- a lump in a breast.

Other, less serious side effects may be more likely to occur. Continue to use estradiol and talk to your doctor if you experience
- decreased appetite, nausea, or vomiting;
- swollen breasts;
- acne or skin color changes;
- decreased sex drive;
- migraine headaches or dizziness;
- vaginal pain, dryness, or discomfort;
- water retention (swollen hands, feet, or ankles);
- depression; or
- changes in your menstrual cycle or break-through bleeding.

Estradiol increases the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, another hormone drug, while using estradiol lowers the risk of developing this condition. Therefore, if your uterus has not been removed, your doctor may prescribe a progestin for you to take while using estradiol. Visit your doctor regularly and report any unusual vaginal bleeding right away.

It is unclear to what extent estrogen treatments may affect the risk of breast cancer.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect estradiol

Before using estradiol, tell your doctor if you are taking any of the following medicines:
- an anticoagulant (blood thinner) such as warfarin (Coumadin); or
- insulin or an oral diabetes medicine such as glipizide (Glucotrol) and glyburide (Diabeta, Micronase).

A dosage adjustment or special monitoring may be required during treatment if you are taking any of the medicines listed above.

Do not use other vaginal products at the same times as estradiol without first talking to your doctor.

Drugs other than those listed here may also interact with estradiol. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.