Drug reference

Estriol

Estrogen · Hormone Replacement Therapy

Also known as oestriol

EstrogenHormone Replacement Therapy

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

—

none in our sources

PREGNANCY

Not known to be harmful.

FDA category + note

Mechanism

Oestrogens are necessary for the development of female secondary sexual characteristics and stimulate myometrial hypertrophy with endometrial hyperplasia. Natural oestrogens like estriol have an appropriate profile for hormone replacement therapy (HRT).

Indications

Vaginal atrophy in postmenopausal womenVaginal surgery for prolapse when there is epithelial atrophy in postmenopausal women (before surgery)

Dosing

Adult: Vaginal atrophy (vaginal cream/gel): Apply 1 applicatorful daily for 3–4 weeks, then reduced to 1 applicatorful twice weekly at bedtime; treatment should be evaluated after 12 weeks. Vaginal atrophy (pessaries): 1 pessary daily for 3 weeks, then 1 pessary twice weekly, inserted at bedtime.…
Hepatic adjustment: Manufacturer advises caution; avoid in acute or active disease.

Contraindications

Acute porphyrias
Diabetes (increased risk of heart disease)
Factors predisposing to thromboembolism
History of breast nodules (risk of breast cancer, requires close monitoring)
History of endometrial hyperplasia
History of fibrocystic disease (risk of breast cancer, requires close monitoring)
Hypophyseal tumours
Increased risk of gall-bladder disease
Migraine or migraine-like headaches
Presence of antiphospholipid antibodies (increased risk of thrombotic events)
Prolonged exposure to unopposed oestrogens (increased risk of endometrial cancer)
Risk factors for oestrogen-dependent tumours (e.g., breast cancer in first-degree relative)
Symptoms of endometriosis may be exacerbated
Uterine fibroids may increase in size
Lactation suppression (due to association with thromboembolism)
Acute or active hepatic disease