Estrace is a prescription medication containing estradiol, a bioidentical form of estrogen, designed to effectively manage symptoms of menopause and prevent osteoporosis in postmenopausal women. As a trusted hormone replacement therapy (HRT), it replenishes declining estrogen levels, offering targeted relief from vasomotor symptoms, vulvovaginal atrophy, and other estrogen-deficiency conditions. Manufactured under stringent quality controls, Estrace provides a reliable option for patients and clinicians seeking evidence-based treatment for hypoestrogenic states, with formulations available in oral tablets and topical creams for tailored therapeutic approaches.

Features

• Contains 17β-estradiol, a bioidentical estrogen identical to endogenous human estrogen
• Available in multiple strengths: oral tablets (0.5 mg, 1 mg, 2 mg) and vaginal cream (0.1 mg/g)
• Micronized formulation for enhanced absorption and bioavailability
• FDA-approved for treatment of moderate to severe vasomotor symptoms associated with menopause
• Indicated for prevention of postmenopausal osteoporosis
• Effective for treating vulvar and vaginal atrophy
• May be used as part of hormonal management in hypoestrogenism due to hypogonadism, castration, or primary ovarian failure

Benefits

• Significantly reduces frequency and severity of hot flashes and night sweats
• Restores vaginal tissue health, alleviating dryness, itching, and discomfort during intercourse
• Helps prevent bone loss and reduces fracture risk in postmenopausal women
• Improves overall quality of life by managing disruptive menopausal symptoms
• Provides flexible dosing options with both systemic and localized treatment formulations
• Bioidentical structure may offer improved tolerability compared to synthetic estrogens

Common use

Estrace is primarily prescribed for menopausal symptom management in women experiencing natural menopause or surgical menopause due to oophorectomy. It is commonly used when vasomotor symptoms significantly impact daily functioning or sleep quality. The vaginal cream formulation is specifically indicated for women experiencing urogenital symptoms without requiring systemic estrogen effects. Additionally, clinicians may prescribe Estrace for younger women with premature ovarian insufficiency or those with estrogen deficiency resulting from medical treatments.

Dosage and direction

Oral Tablets:
Initial dosage typically ranges from 0.5 mg to 2 mg daily, administered cyclically (21-25 days on followed by 4-7 days off) or continuously. Dosage should be individualized to the lowest effective dose based on symptom control and patient response.

Vaginal Cream:
The usual dosage is 2-4 g daily intravaginally for 1-2 weeks, followed by a maintenance dose of 1 g 1-3 times weekly. Application should be performed using the calibrated applicator provided.

All regimens should be reassessed periodically, with treatment duration limited to the shortest duration consistent with treatment goals. Administration with or without food is acceptable, though consistent timing is recommended.

Precautions

• Regular monitoring of blood pressure is recommended during therapy
• Annual breast examinations and mammograms should be performed as appropriate for age and risk factors
• Endometrial monitoring is necessary in women with an intact uterus; unexpected bleeding should be investigated
• Liver function tests may be indicated during prolonged therapy
• Caution advised in patients with conditions that might be influenced by fluid retention (asthma, epilepsy, migraine, cardiac or renal dysfunction)
• Use with caution in patients with history of hypercalcemia, gallbladder disease, or pancreatitis
• Estrogen therapy may lead to elevated triglycerides; monitor lipid profiles periodically
• Visual abnormalities should be promptly evaluated as estrogens may cause retinal vascular thrombosis

Contraindications

• Known or suspected pregnancy (Pregnancy Category X)
• Undiagnosed abnormal genital bleeding
• Known, suspected, or history of breast cancer
• Known or suspected estrogen-dependent neoplasia
• Active or history of arterial thromboembolic disease (e.g., MI, stroke)
• Active or recent (within past year) venous thromboembolism (DVT, PE)
• Liver dysfunction or disease
• Known protein C, protein S, or antithrombin deficiency, or other known thrombophilic disorders
• Hypersensitivity to any component of Estrace formulations

Possible side effect

Common (≥1%):

• Breast tenderness or enlargement
• Headache
• Nausea
• Abdominal cramps
• Bloating
• Fluid retention
• Spotting or breakthrough bleeding
• Changes in menstrual flow
• Vaginal candidiasis

Less common:

• Melasma/chloasma
• Contact lens intolerance
• Hypertension
• Glucose intolerance
• Mood changes
• Libido changes
• Leg cramps

Serious (require immediate medical attention):

• Sudden vision changes
• Severe headache
• Chest pain or shortness of breath
• Unusual vaginal bleeding
• Breast lumps
• Jaundice
• Severe abdominal pain
• Mental/mood changes
• Swelling or tenderness in abdomen

Drug interaction

• Inducers of CYP3A4 (rifampin, carbamazepine, phenytoin, St. John’s wort) may decrease estrogen levels
• Aromatase inhibitors may interfere with therapeutic effect
• Corticosteroids may have enhanced effects
• Thyroid hormone replacement requirements may be altered
• May reduce effectiveness of anticoagulants
• May increase levels of cyclosporine
• Possible interaction with grapefruit juice
• Laboratory test interactions: increased sulfobromophthalein retention; reduced response to metyrapone test; reduced serum folate concentrations

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next dose. In that case, skip the missed dose and resume the regular schedule. Do not double doses to make up for a missed dose. For vaginal cream, apply the missed dose when remembered unless it is near the time for the next application.

Overdose

Estrogen overdose may cause nausea, vomiting, breast tenderness, abdominal pain, drowsiness, and fatigue. Withdrawal bleeding may occur in women. There is no specific antidote; treatment should be symptomatic and supportive. Medical attention should be sought immediately if overdose is suspected.

Storage

Store at controlled room temperature (20-25°C or 68-77°F), with excursions permitted to 15-30°C (59-86°F). Keep container tightly closed. Protect from light and moisture. Do not freeze. Keep out of reach of children and pets. Do not use after expiration date printed on packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting, changing, or stopping any medication. Individual treatment should be based on professional medical judgment considering the patient’s complete medical history, current health status, and risk factors. Never disregard professional medical advice or delay seeking it because of information contained in this document.

Reviews

“After struggling with severe hot flashes that disrupted my sleep and daily life, Estrace provided remarkable relief within weeks. My quality of life has significantly improved, and I appreciate having my energy back.” - Maria T., 52

“As a gynecologist, I find Estrace to be a reliable option for menopausal symptom management. The bioidentical formulation and flexible dosing allow for personalized treatment approaches that address individual patient needs effectively.” - Dr. Emily Rodriguez, MD

“The vaginal cream formulation completely resolved my vaginal dryness and discomfort during intercourse. I’ve experienced no systemic side effects, and the applicator makes application straightforward.” - Susan W., 58

“After trying several HRT options, Estrace provided the best balance of effectiveness and tolerability for my patients. The multiple strength options allow for fine-tuning dosage based on individual response.” - Dr. James Wilson, OB-GYN