Estrogen
Estrogen
What Is Estrogen Therapy?
Estrogen therapy uses estradiol to replace estrogen that declines during the menopause transition. It is available in several forms. Systemic options, the patch, oral tablet, and gel, are used primarily for hot flashes, night sweats, and related sleep disruption. Low-dose vaginal cream acts mainly in vaginal and urinary tissues and results in much lower systemic exposure than systemic estrogen therapy.
Your provider will determine whether estrogen therapy is appropriate for you, which form fits your health history, and the dose.
Who it may be prescribed for:
• Women with moderate to severe hot flashes or night sweats
• Women with sleep disruption related to nighttime symptoms
• Women with vaginal dryness, burning, irritation, or painful intercourse
• Women with urinary urgency or frequency related to menopause
• Women with menopause before age 45 or premature ovarian insufficiency
Estradiol, in the form your provider selects
Patch & GelThrough the skin
Oral TabletOnce daily
Vaginal CreamLocal, low dose
Used as prescribed, in the form your provider selects
Hormone therapy designed around you.
Get your medications in 3 simple steps
Take the health questionnaire
Our doctors will review your answers
Get your meds
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Frequently asked questions
What is estrogen therapy?
Estrogen therapy uses estradiol to replace estrogen that declines during the menopause transition. It is available as a patch, oral tablet, gel, or low-dose vaginal cream. A licensed provider determines whether it is appropriate for you and which form to use.
How do I know which form is right for me?
You don’t need to decide on your own. Your provider reviews your symptoms, health history, and risk factors and recommends the form and dose. For example, transdermal options avoid first-pass liver metabolism and may be preferred for some women after provider review, while vaginal cream is used mainly for local symptoms.
What is the difference between systemic and vaginal estrogen?
Systemic estrogen (patch, oral tablet, gel) is used primarily for hot flashes, night sweats, and related sleep disruption. Low-dose vaginal estrogen acts mainly in vaginal and urinary tissues and results in much lower systemic exposure. It is used primarily for vaginal and urinary symptoms rather than hot flashes.
Do I also need progesterone?
Women who still have a uterus generally need progesterone with systemic estrogen to protect the uterine lining. Women who have had a hysterectomy may be able to use estrogen alone, depending on their history. For vaginal estrogen, your provider determines whether progesterone is needed.
What side effects may occur?
During adjustment, some women notice breast tenderness, bloating or fluid retention, spotting or irregular bleeding, headache, nausea, or skin irritation with topical products. Tell your provider about any side effects that continue.
When should I seek urgent care?
Seek urgent medical attention for chest pain, sudden shortness of breath, coughing blood, one-sided leg swelling, sudden weakness or difficulty speaking, a severe new headache, or signs of a serious allergic reaction. Any new or persistent vaginal bleeding after menopause needs prompt evaluation.
What can I expect after starting?
In the first few weeks, temporary breast tenderness, bloating, or spotting may occur as your body adjusts. Over weeks 4 to 12, your provider may adjust the dose or form if needed. Benefits and risks are reviewed periodically, and continued use stays individualized.
Do I need lab tests?
Routine hormone-level testing isn’t required for everyone using standard menopause hormone therapy. Your provider may order labs if your diagnosis is unclear, your symptoms are atypical, or your response to treatment is unexpected.
What should I do if I miss a dose?
Do not take extra medication to make up for a missed dose. Follow your provider’s instructions, and contact your provider or pharmacist if you are unsure.