Estrace: Restore Hormonal Balance with Bioidentical Estrogen Therapy
Estrace
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Estrace (estradiol) is a prescription medication containing bioidentical 17β-estradiol, the primary estrogen hormone produced by the human ovaries. As a cornerstone of hormone replacement therapy (HRT), it is specifically formulated to address estrogen deficiency resulting from natural menopause, surgical menopause, or other medical conditions. This FDA-approved therapy provides a targeted approach to replenishing estrogen levels, alleviating disruptive symptoms, and supporting long-term physiological health in appropriate candidates. Its micronized formulation ensures effective absorption and predictable pharmacokinetics, making it a trusted option for clinicians managing hypoestrogenic states.
Features
- Contains 17β-estradiol, a bioidentical estrogen structurally identical to endogenous human estrogen
- Available in multiple dosage forms including oral tablets (0.5 mg, 1 mg, 2 mg) and topical cream (0.1 mg/g)
- Micronized formulation for enhanced bioavailability and consistent absorption
- Multiple strength options allowing for precise dose titration
- Manufactured under strict pharmaceutical quality control standards
- Clearly marked tablets with strength identification for proper dosing
Benefits
- Effectively reduces the frequency and severity of moderate to severe vasomotor symptoms (hot flashes, night sweats)
- Helps prevent postmenopausal osteoporosis by maintaining bone mineral density
- Alleviates symptoms of vulvar and vaginal atrophy (dryness, itching, burning, dyspareunia)
- Provides systemic estrogen replacement for women with hypogonadism, castration, or primary ovarian failure
- Supports urogenital health and may reduce the risk of recurrent urinary tract infections
- May improve sleep quality and mood disturbances associated with estrogen deficiency
Common use
Estrace is primarily prescribed for the management of estrogen deficiency states. The most common indication is for the treatment of moderate to severe vasomotor symptoms associated with menopause. It is also widely used for the treatment of vulvar and vaginal atrophy, which can cause significant discomfort and sexual dysfunction. Additionally, Estrace is indicated for the prevention of postmenopausal osteoporosis in women at significant risk, and as replacement therapy for women with hypogonadism, castration, or primary ovarian failure. Off-label uses may include certain fertility treatments and management of some dermatological conditions, though these applications require careful medical supervision.
Dosage and direction
Dosage must be individualized based on the patient’s condition, treatment goals, and response. For moderate to severe vasomotor symptoms or vulvar and vaginal atrophy, the usual starting dose is 1-2 mg orally daily, administered cyclically (21-25 days on followed by 4-7 days off) or continuously. For osteoporosis prevention, the typical dose is 0.5 mg daily. The vaginal cream is typically administered intravaginally at doses ranging from 2-4 g daily for one to two weeks, followed by a maintenance dose of 1 g one to three times weekly. Tablets should be taken with or without food at approximately the same time each day. Dosage adjustments should be made at 2-4 week intervals based on clinical response. The lowest effective dose should be used for the shortest duration consistent with treatment goals.
Precautions
Patients should undergo complete medical and family history evaluation before initiating therapy, with particular attention to cardiovascular risk factors, thromboembolic disorders, and cancer risk. Regular breast examinations, mammograms, and pelvic examinations should be performed as appropriate for age and risk factors. Blood pressure should be monitored regularly. Patients with conditions that might be influenced by fluid retention (such as asthma, epilepsy, migraine, or cardiac or renal dysfunction) require careful observation. Estrace should be used cautiously in patients with impaired liver function, metabolic bone diseases, or a history of hypercalcemia. Women with a history of depression should be monitored closely. The risk of endometrial cancer increases with prolonged use in women with an intact uterus; appropriate progestin therapy should be considered.
Contraindications
Estrace is contraindicated in women with known or suspected pregnancy, as estrogen use during pregnancy may cause fetal harm. Additional contraindications include undiagnosed abnormal genital bleeding; known or suspected estrogen-dependent neoplasia; active or history of deep vein thrombosis or pulmonary embolism; active or recent arterial thromboembolic disease; liver dysfunction or disease; known protein C, protein S, or antithrombin deficiency or other known thrombophilic disorders; and known hypersensitivity to estradiol or any component of the formulation. It is also contraindicated in women with known or suspected breast cancer except in specific palliative circumstances under specialist supervision.
Possible side effect
Common side effects may include headache, breast tenderness or enlargement, nausea, vomiting, abdominal cramps, bloating, changes in weight, changes in libido, nervousness, mood changes, leg cramps, and edema. Spotting or breakthrough bleeding may occur, especially during the first few months of therapy. Less common but more serious potential side effects include deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke, breast cancer, endometrial cancer, gallbladder disease, hypertension, hypercalcemia, visual abnormalities, and severe allergic reactions. Vaginal cream formulations may cause local irritation, burning, or itching. Any unusual side effects should be reported promptly to a healthcare provider.
Drug interaction
Estrace may interact with numerous medications. It may reduce the effectiveness of anticoagulants while increasing the risk of thromboembolism. Barbiturates, carbamazepine, phenytoin, rifampin, and St. John’s wort may decrease estrogen effectiveness by inducing hepatic metabolism. Estrogens may enhance the effects of corticosteroids. Thyroid hormone requirements may be altered in thyroid replacement therapy. Estrace may interfere with the metabolism of cyclosporine, leading to increased toxicity. It may also affect the efficacy of antidiabetic medications. Concurrent use with other hormone therapies may result in additive effects. Healthcare providers should review all medications, including over-the-counter products and supplements, before initiating therapy.
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, the missed dose should be skipped and the regular dosing schedule resumed. Doubling doses to make up for a missed dose is not recommended. For patients on cyclic therapy who miss consecutive doses, breakthrough bleeding may occur. Consistently missed doses may reduce therapeutic effectiveness. Patients should contact their healthcare provider for specific guidance if multiple doses are missed or if uncertainty exists about proper management of missed doses.
Overdose
Acute overdose with Estrace may cause nausea and vomiting, with women experiencing breast tenderness, abdominal pain, drowsiness, or fatigue. There is no specific antidote for estrogen overdose. Treatment should be symptomatic and supportive. Medical attention should be sought immediately if a large overdose is suspected. Chronic overdose may manifest as excessive estrogenic effects such as severe nausea, breast tenderness, fluid retention, or abnormal uterine bleeding. Dose reduction or temporary discontinuation under medical supervision is typically sufficient to manage chronic overdose situations.
Storage
Store at controlled room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container with the lid tightly closed to protect from moisture and light. Do not store in bathroom cabinets where humidity levels fluctuate. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Properly discard any unused medication that is no longer needed or has expired according to local guidelines for medication disposal.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Estrace is a prescription medication that should be used only under the supervision of a qualified healthcare provider. Individual treatment decisions must be based on professional medical evaluation of the patient’s specific circumstances. The benefits and risks of hormone therapy should be carefully considered for each individual patient. Readers should consult with their healthcare provider for diagnosis and treatment recommendations tailored to their personal medical situation.
Reviews
Clinical studies and patient reports generally indicate satisfactory symptom relief when Estrace is appropriately prescribed. Many patients report significant improvement in vasomotor symptoms within 2-4 weeks of initiation. Long-term users often note maintained effectiveness for managing menopausal symptoms and vaginal atrophy. Some patients report preferring the bioidentical nature of estradiol compared to synthetic estrogens. Critical reviews sometimes mention side effects such as breast tenderness or breakthrough bleeding, particularly during dose adjustments. Overall satisfaction appears highest when treatment is individually tailored and regularly monitored by a healthcare provider familiar with hormone therapy management.