Estradiol 1mg, 2mg
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Alternate names of Estrace
Absorlent, Activella, Activelle, Aerodiol, Agofollin, Akrofolline, Alcis, Allurene, Alora, Angeliq, Angemin, Armistor, Armonil, Avaden, Avadène, Avicis, Avixis, Bedol, Benzo-Ginestryl, Benzo-Ginoestril, Benzo-Gynoestryl, Benzo-ginestryl, Benztrone, Bisteron, Bothermon, Calidiol, Cerella, Cliane, Climaderm, Climagest, Climara, Climaval, Climen, Climene, Climesse, Climodien, Clinorette, Cliogan, Clionara, Cliovelle, Combipatch, Compudose, Convadien, Crinohermal, Cutanum, Cyclacur, Cyclo-progynova, Cyclocur, Cyclofemina, Deladiol, Delestrogen, Delidose, Depo-estradiol, Depogen, Dermestril, Despamen, Di-pro, Dihormon, Dilena, Dimenformon, Dioval, Divigel, Divina, Diviplus, Diviseg, Diviseq, Divitren, Diviva, Duofemme, Duokliman, Dura-Estrin, Duragen, Délidose, E-Cypionate, Elestrin, Elleste, Elleste solo, Emmenovis, Enadiol, Encore, Endomina, Ep hormone, Ephelia, Epiestrol, Esclim, Esclima, Esjin, Esotran, Esprasone, Essventia, Estalis, Estolmon, Estopause, Estra-D, Estra-L, Estrabeta, Estracomb, Estracomb tts, Estracombi, Estradelle, Estraderm, Estraderm TTS, Estradiol cypionate, Estradiolo, Estradiolum, Estradot, Estragest tts, Estrahexal, Estramon, Estrana, Estranova e, Estrapatch, Estrasorb, Estrena, Estreva, Estrifam, Estrimax, Estring, Estro-Cyp, Estro-pause, Estroclim, Estrodose, Estrofem, Estroffik, Estrogel, Estroject, Estronar, Estronorm, Estroplast, Esumon, Etrosteron, Eutocol, Evafilm, Evamist, Eviana, Evopad, Evorel, Exuna, Fem 7, FemPatch, FemSeven, Femalon, Femanest, Femanor, Femasekvens, Fematab, Fematrix, Femiderm tts, Femidot, Femiest, Femilar, Feminova, Femogex, Femoston mono, Femring, Femsept, Femsete, Femtrace, Femtran, Femvulen, Filena, Folivirin, Gelestra, Ginaikos, Ginatex, Ginediol, Ginedisc, Ginoderm, GynPolar, Gynamon, Gynodian depot, Gynodiol, Gynogen, Gynokadin, Gynokadin gel, Gynovel, Gynpolar, Hormodiol, Hormodose, Hormonin, Innofem, Kliane, Klimapur, Klimodien, Kliofem, Kliogest, Kliovance, Lafamme, Lindisc, Linoladiol, Linoladiol N, Lutes, Menaval, Menest, Menformon-k, Meno implant, Meno-Implant, Menodin, Menorest, Menostar, Menovis, Mericomb, Meriestra, Merigest, Merimono, Mesalin, Mesigyna, Mevaren, Mirion, Naemis, Natazia, Natifa, Neofollin, Nofertyl, Nomagest, Nomestrol, Noviana, Novofem, Novofemme, Novular, Octodiol, Oesclim, Oestraclin, Oestradiol, Oestring, Oestro, Oestro Gel, Oestrodose, Oestrogel, Oromone, Osmil, Ovahormon, Ovestal, Pausene, Pausigin, Pausogest, Pelanin, Perifem, Perikliman, Perlutal, Postoval, Prid, Pridoestrol, Primaquin, Primodian, Primogyn, Primogyn Depot, Primogyna, Progro, Progyluton, Progynon, Progynon B, Progynon Depot, Progynon Depot 10, Progynon Depot 100, Progynon Depot 40, Progynova, Prosu, Provames, Qlaira, Reglovar, Renodiol, Replasyn, Revalor, Riselle, Ronfase, Rontagel, Sandrena, Sequidot, Sisare, Sisare mono, Sprediol, Synapause-e3, Syncro mate b, Synovex, Synovular, Systen, Thais, Topasel, Tradelia, Transdiol, Transvital, Trevina, Triaklim, Trial, Trial Gel, Trial Sat, Triaval, Tridestra, Trisekvens, Trisequens, Trivina, Tulita, Vagifem, Valergen, Vermagest, Vivelle, Vivelle Dot, Vivelledot, Yectames, Zerella, Zumenon, depGynogen
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What Is Estradiol?
Estradiol is a form of estrogen, which is a female sex hormone. It plays a crucial role in developing and maintaining female reproductive tissues and secondary sexual characteristics. Estradiol is the most potent and prevalent form of estrogen in the human body, and its levels fluctuate throughout the menstrual cycle.
In females, estradiol is primarily produced by the ovaries, specifically the ovarian follicles, during the reproductive years. It is also produced in smaller amounts by the adrenal glands.
The levels of estradiol vary during the menstrual cycle. They typically increase during the follicular phase (before ovulation) and decrease during the luteal phase (after ovulation).
Estradiol levels increase significantly during pregnancy, mainly produced by the placenta to support the developing fetus.
Estradiol has various functions, including promoting the development of female secondary sexual characteristics (such as breast development and body fat distribution), regulating the menstrual cycle, supporting the health of the reproductive tissues (uterus, fallopian tubes), and influencing bone health.
Estradiol is commonly used in hormone replacement therapy for postmenopausal women to alleviate symptoms of menopause, such as hot flashes and vaginal dryness. It can be administered in various forms, including pills, patches, and creams.
Combined hormonal contraceptives, such as birth control pills, often contain a synthetic form of estradiol and progestin.
Estradiol plays a role in maintaining bone density, and low levels after menopause are associated with an increased risk of osteoporosis.
Estradiol levels can be measured through blood tests, especially in evaluating menstrual irregularities, fertility issues, or during certain medical conditions.
It’s important to note that while estradiol is a key hormone in females, it is also present in males, albeit in smaller amounts. The balance of estrogen hormones is crucial for both genders’ overall health and reproductive function.
Pharmacokinetics
Estradiol and other estrogens are absorbed from the gastrointestinal tract and through the skin or mucous membranes. However, after oral doses, natural unconjugated estrogens, such as estradiol, undergo extensive first-pass metabolism in the gastrointestinal tract and liver. They are, therefore, generally not orally active, although a micronized preparation of estradiol has sufficient bioavailability (3 to 5%) to be orally active. Estradiol is metabolized to less active estrogens such as estriol and estrone.
Synthetic estrogens produced by alkylation of the C17 position, such as ethinylestradiol, are more slowly metabolized and are, therefore, orally active. Conjugated estrogens, which are essentially estrogen metabolites, are also orally active because they are hydrolyzed by enzymes in the lower gastrointestinal tract, allowing absorption of the active estrogen. Vaginal, transdermal, intranasal, or parenteral use of estrogens also avoids first-pass hepatic metabolism. Plasma-estradiol concentrations are reported to reach a peak 1.5 to 2 hours after an oral dose and again at about 8 hours due to enterohepatic recycling. Estradiol esters are rapidly hydrolyzed to free estradiol when given orally. After intramuscular injection of the esters, absorption is prolonged.
Estrogens are extensively bound to plasma proteins. Naturally occurring estrogens such as estradiol are principally bound to sex-hormone-binding globulin. Conversely, ethinylestradiol is mainly bound to albumin.
Estrogens are metabolized in the liver. Various sulfate and glucuronide conjugates are formed and excreted in the urine and the bile. Those excreted in the bile undergo enterohepatic recycling or are excreted in the feces.
Uses and Administration
Estradiol is the most active of the naturally occurring estrogens (for further details). Estradiol, semisynthetic esters, and other natural estrogens are primarily used as menopausal HRT. In contrast, synthetic derivatives such as ethinylestradiol and mestranol have a significant role as components of combined oral contraceptives (see Hormonal Contraceptives). Estradiol may also be used as replacement therapy for female hypogonadism or primary ovarian failure. Replacement therapy (add-back therapy) may also be given to women in whom the pituitary-ovarian axis is suppressed by therapy with gonadorelin or its analogs.
Estradiol hemihydrate 1.03 mg is equivalent to 1 mg of the anhydrous substance.
For menopausal HRT, oral preparations or transdermal patches of estradiol are commonly used. Other transdermal formulations, subcutaneous implants, and a nasal spray are also available. Intramuscular injections were formerly used. A progestogen is also required in women with a uterus, given cyclically or continuously, usually by mouth, although some combined transdermal preparations are available. Local vaginal estradiol preparations are explicitly used to treat menopausal atrophic vaginitis. These are generally recommended for short-term use only if given without a progestogen in women with a uterus, although specific recommendations vary between products.
For oral use, estradiol or estradiol valerate is usually given in doses of 1 or 2 mg daily cyclically or more often continuously. Estradiol acetate may be given in an initial dose of 450 micrograms daily, increasing to 0.9 or 1.8 mg once daily if necessary.
Estradiol may be used topically as transdermal skin patches to provide a systemic effect. Various patches are available, which release between 25 and 100 micrograms of estradiol every 24 hours. A low-dose patch supplying 14 micrograms daily is also available specifically for preventing postmenopausal osteoporosis in women at significant risk with this low dose. The addition of a 14-day course of progestogen in women with a uterus is only required once every 6 to 12 months. Depending on the preparation, patches are replaced once or twice weekly. Each new patch is applied to a different area of skin in rotation, usually below the waistline. Patches should not be applied on or near the breasts.
Topical gel preparations are also used for systemic effect. The usual applied dose is 0.25 to 1.5 mg of estradiol daily, depending on the preparation. Still, up to 3 mg daily may be required to control menopausal symptoms in some women. The gel should not be applied on the face or on or near the breasts, vagina, or vulval region. A topical emulsion is also available; estradiol hemihydrate 8.7 mg is applied daily to provide a systemic estradiol dose of about 50 micrograms. A transdermal spray has also been developed, delivering a single dose of estradiol 1.53 mg onto the skin. It should be applied to the skin of the inner surface of the forearm, and the dose may be increased up to 3 sprays once daily in the morning at separate sites on the forearm, according to the response.
A nasal spray is available, delivering 150 micrograms of estradiol hemihydrate per spray. The usual initial dose is 150 micrograms daily (1 spray in 1 nostril). After 2 or 3 cycles, the dose may be adjusted according to response. The usual maintenance dose is 300 micrograms daily (1 spray in each nostril once daily) but may range from 150 micrograms once daily up to 450 to 600 micrograms daily in 2 divided doses.
To prolong the action duration, subcutaneous estradiol implants may be used. The dose of estradiol is generally 25 to 100 mg, with a new implant given after about 4 to 8 months, according to estrogen concentrations.
Estradiol may be used locally either as 25-microgram vaginal tablets, at an initial dose of one tablet daily for two weeks followed by a maintenance dose of one tablet twice a week, or as a 0.01% vaginal cream, in initial amounts of 2 to 4 g of cream daily for 1 to 2 weeks followed by half the initial dose for a similar period, then a maintenance dose of 1 g up to 3 times weekly. A local delivery system using a 3-month vaginal ring contains 2 mg of estradiol hemihydrate and delivers about 7.5 micrograms per 24 hours.
Another 3-month vaginal ring system, which contains estradiol acetate, releases either 50 or 100 micrograms of estradiol daily and is used to relieve both local and systemic postmenopausal symptoms. Intramuscular injections of estradiol benzoate or valerate esters have been used as oily depot solutions, usually given once every 3 to 4 weeks. The cipionate, di-propionate, enantate, hexyl benzoate, phenylpropionate, and undecylate esters have been used similarly. The enanthate and cipionate esters are used as the estrogen component of combined injectable contraceptives.
Estradiol and other estrogens have sometimes been used in higher doses for palliative prostate and breast cancer treatment in men and postmenopausal women.
Buccal and Sublingual Administration
Estradiol is absorbed through the buccal route and has been reported to improve postmenopausal vasomotor symptoms. A pharmacokinetic study of micronized estradiol found the sublingual route resulted in more rapid absorption, a higher peak concentration, and more rapid elimination than oral dosage. Sublingual micronized estradiol has been studied for the management of postpartum depression.
Implants
There may be a striking interpatient variation in blood-estradiol concentrations in women receiving estradiol implants, and symptoms of estrogen deficiency have re-appeared in some patients even though serum-estradiol concentrations were within or above the physiological range. After debate on the appropriateness of using serum concentrations of estradiol as a guide to implant use rather than symptoms, it is now recommended that estradiol concentration should be monitored during therapy.
Cyclical progestogen may be required for a prolonged period after removing estradiol implants in women with a uterus.
Intranasal Administration
The intranasal route for estradiol HRT has been reviewed. It appears to be comparable in efficacy to oral or transdermal use in treating menopausal symptoms. As with transdermal application, the intranasal route avoids intestinal and hepatic first-pass metabolism.
Transdermal Administration
Transdermal estradiol given via patches applied to the skin has been reviewed. This method of delivery has certain advantages over the oral route in that gastrointestinal and hepatic first-pass metabolism is avoided, liver enzymes are not stimulated (although this may also mean that beneficial effects on serum lipids are absent), and the prolonged drug release from the patch means less frequent application is necessary and hence patient compliance may be improved.
For estrogen replacement in menopausal and postmenopausal women, estradiol patches are used continuously or cyclically, with added progestogen for part of the cycle in those women with an intact uterus. This does not lead to drug accumulation and produces blood-estradiol concentrations and estradiol-to-estrone ratios similar to those typically observed in premenopausal women. The patch is well tolerated, with skin irritation being the main problem. Patches are as effective as oral estrogens in treating menopausal and postmenopausal symptoms such as flushing and vaginal atrophy and preventing osteoporosis. Combined HRT patches have also been developed, providing both estradiol and a progestogen.
Estradiol is also effective when applied topically to the skin as a gel or emulsion.
Depression
The use of estrogen therapy in the treatment of premenopausal women with postnatal depression is effective. However, although such therapy could be a helpful adjunct to conventional treatment, the risk of serious adverse effects, including thrombosis, may limit its value.
Whether estrogens benefit older women, typically with depression associated with menopause, is less clear. Some studies of transdermal estradiol have reported its benefits, whereas other transdermal or oral dosage studies have not found it effective. Whether the presence of a progestogen in combination with HRT would reduce any purported benefit is also unclear. Antidepressants remain the standard of care in perimenopausal or postmenopausal women with clinical depression.
Gender Reassignment
Estrogens are used in male-to-female transsexuals to develop and maintain secondary sexual characteristics. Although ethinylestradiol and conjugated estrogens have been used for this purpose, and there is some evidence that such use can improve vascular function, others consider ethinylestradiol too thrombogenic at the doses required [typically 50 to 100 micrograms daily or more] and suggest that estradiol, as the valerate in oral doses of 2 to 4 mg daily, or transdermally as a patch supplying 100 micrograms daily, is the estrogen of choice. Cyproterone acetate is usually also given for its anti-androgenic effect.
Growth Disorders
Supraphysiological doses of estrogens inhibit somatic growth and have been used, with a cyclical progestogen, to reduce final height in girls with constitutional tall stature. However, such treatment has declined markedly with changing social norms. In early reports, diethylstilbestrol was used, but this is an unsuitable choice because of the increased cancer risk. Ethinylestradiol has been given in doses of up to 500 micrograms daily, but doses of 50 to 100 micrograms daily came to be preferred, although lower doses may be equally effective. Conjugated estrogens have also been used, and a study reported that doses of 7.5 to 11.25 mg daily resulted in an average decrease of about 5 cm from the final predicted height.
In practice, doses as low as 625 micrograms daily have been used. Reported height reductions have ranged from 2 to 10 cm, but studies are difficult to compare. Treatment has generally been continued until the closure of the epiphyses. Still, the effects of estrogen therapy may be influenced by chronological and bone age at the onset of treatment, duration of treatment, the estrogen used and its dose, and the point of final height assessment. High-dose estrogen therapy is also associated with adverse effects such as weight gain, headache, nausea, and pigmentation of the areolae or nipples, and there can be adverse changes to hemostatic and lipid measures. A retrospective cohort review has also reported that girls who had been treated with high-dose estrogens were more likely to report fertility problems in later life than similar girls who had not been treated.
Estrogen therapy has occasionally been used to help promote growth in girls with constitutional delayed puberty.
Hemorrhagic Disorders
Limited evidence supports the use of estrogens in various bleeding disorders. There have been mixed results from small studies of estrogens, given alone or with a progestogen in patients with hereditary hemorrhagic telangiectasia; a combined oral contraceptive has been suggested as a suitable option for fertile women with symptomatic epistaxis. There are also some reports of reduced bleeding in patients with gastrointestinal vascular malformations from other causes. Conjugated estrogens have been used in hemorrhagic disorders associated with chronic renal failure and hemorrhagic cystitis.
Lactation Inhibition
Synthetic estrogens (e.g., quinestrol) and nonsteroidal estrogens (e.g., diethylstilbestrol) were historically used to suppress lactation. However, this use is now considered inappropriate because of an increased risk of puerperal thromboembolism.
Premenstrual Syndrome
Premenstrual syndrome (PMS) presents as a variable combination of psychological and somatic symptoms occurring during the luteal phase of the menstrual cycle, which resolves during and immediately after menstruation. Another term, premenstrual dysphoric disorder, has been proposed to cover severe cyclical mood disorder that is functionally incapacitating. Whereas about 20 to 40% of women have complaints that may be classified as PMS, only 3 to 8% meet the criteria for premenstrual dysphoric disorder.
Premenstrual tension (PMT) has sometimes been applied to the psychological symptoms. Many symptoms of PMS are the same as typical premenstrual symptoms but are more severe. The etiology of PMS is not fully understood, although it is thought that affected women may be more sensitive to the effects of normal hormonal fluctuations on CNS neurotransmitter function.
Initial management includes non-medical interventions such as education and support, counseling, stress management, relaxation techniques, and exercise caffeine and salt restriction are of unproven benefit. The herbal remedy agnus castus is of benefit. Several drugs have been tried with varying degrees of success for patients with moderate to severe symptoms. Objective efficacy assessment has been hampered by varying diagnostic criteria, a marked placebo response, and difficulty obtaining reproducible responses. Treatment may be aimed at modifying the menstrual cycle or treating specific symptoms.
In women with mainly psychological symptoms, SSRIs can be helpful. Fluoxetine and sertraline have been shown in controlled studies to alleviate psychological and somatic symptoms in women with PMS. They may be given intermittently (only in the luteal phase) or continuously. If treatment with one SSRI is ineffective or not tolerated, another SSRI or venlafaxine may be substituted. ‘e There is limited information on the use of S S-RIs for PMS in adolescents, and precautions regarding suicidal ideation in young adults should be considered. Clomipramine, a nonselective serotonin reuptake inhibitor, has been tried for PMS with some success. The anxiolytic alprazolam has also been used. However, this and other benzodiazepines should be restricted to the cycle’s luteal phase in selected patients to minimize the risk of dependence and tolerance.
Abdominal bloating and swelling associated with PMS have traditionally been thought to be due to sodium and water retention. However, in most women with these symptoms, there is no evidence of an increase in body weight, body sodium, or total water. Therefore, the use of diuretics is not justified. Nevertheless, the aldosterone antagonist spironolactone may be helpful in women with appreciable weight gain and abdominal bloating in the luteal phase. Another symptom of PMS, cyclical mastalgia, is discussed.
Pyridoxine has been tried because it is a cofactor in neurotransmitter (specifically serotonin) synthesis and has been found to relieve depression induced by oral contraceptives in selected patients. However, its efficacy in PMS is equivocal, and high daily doses have been associated with neurotoxicity. Calcium supplementation may relieve symptoms of PMS.
Treatments that modify the menstrual cycle have often been used in women with PMS. In general, drugs with proven efficacy, such as danazol, estrogen implants, and gonadorelin analogs are reserved for women with severe PMS unresponsive to other treatments because of their adverse effects. Progestogen therapy was once popular, but beneficial responses have not been universally achieved, and the theory that progesterone was necessary to correct a hormone imbalance is now losing ground. In addition, a systematic review of clinical trials found no evidence to support the use of progesterone or progestogens for PMS. Combined oral contraceptives have met with limited success.
They may be helpful in some women for the control of somatic symptoms, but in others, PMS is caused or exacerbated by them. Some suggest that combined contraceptives containing drospirenone may be more effective in managing PMS than those containing progestogens such as levonorgestrel or norethisterone. Consideration should be given to continuous rather than cyclical use. Perimenopausal women may benefit from estrogen delivered from transdermal patches. In women with a uterus, a cyclical progestogen is required to avoid endometrial hyperplasia; unfortunately, the progestogen may be associated with the return of symptoms.
Possible strategies to minimize this include using a less androgenic progestogen, reducing the frequency with which it is given, or using an intra-uterine device to deliver it locally. Danazol can be helpful, but there is concern over its adverse effects on lipids during long-term use and the risk of masculinization of a female fetus if pregnancy occurs. For patients with severe symptoms not amenable to other treatments, gonadorelin analogs such as goserelin can be used to eliminate ovarian function, ‘add-back’ treatment with estrogen plus progestogen being given to protect against the adverse effects of estrogen deficiency, including osteoporosis. This treatment is very effective for both physical and psychological symptoms. Short-term use (3 months) of a gonadorelin analog alone has been used to confirm the diagnosis of PMS or to predict the response to bilateral oophorectomy.
Adverse Effects
The adverse effects of estradiol and other estrogens are related, depending on the dose and duration of therapy, and to the gender and age of the recipient. In addition, adverse effects may be modified by a progestogen in combined oral contraceptives or menopausal HRT. Whether the adverse effects of natural and synthetic estrogens differ and whether the dosage route has an effect is not clear.
The adverse effects of estrogens used in hormonal contraceptives are considered in detail starting. Those estrogens used in HRT are considered in detail starting. Using estrogens in children may cause premature closure of the epiphyses, resulting in decreased final adult height.
Large doses of estrogens used in palliation of cancers have also been associated with nausea, fluid retention, venous and arterial thrombosis, and cholestatic jaundice. In men, they cause impotence and feminizing effects such as gynecomastia. In women, they may cause withdrawal bleeding; when used for breast cancer, they cause hypercalcemia and bone pain.
Effects on the Skin
Transdermal patches in which estradiol is dissolved in the adhesive matrix may cause fewer skin reactions than those releasing estradiol from an alcoholic reservoir.
Precautions
The precautions for using estradiol and other estrogens used as menopausal HRT and in hormonal starting contraceptive therapy are considered in detail.
High doses of estrogen used in treating malignant disease should be used cautiously in patients with cerebrovascular disorders, coronary artery disease, or venous thromboembolism. They may exacerbate hypercalcemia of malignancy. Estrogens should be used with caution in children because premature closure of the epiphyses may occur, resulting in inhibited linear growth and small stature. Estrogens have been reported to interfere with diagnostic tests, such as thyroid function and glucose tolerance.
Breastfeeding
Estradiol has been detected in breast milk after using pessaries containing 50 or 100 mg of estradiol. The American Academy of Pediatrics considers estradiol usually compatible with breastfeeding.
Make-Up Use
Using products containing estrogens has led to adverse effects such as precocious puberty in children and gynecomastia or postmenopausal bleeding in adults. Such products have been used by a greater proportion of African Americans than any other ethnic group in the USA, and it has been hypothesized that this may have contributed to the observations of earlier onset of puberty in girls and increased risk of breast cancer in young women.
Porphyria
Estrogens are considered to be unsafe in patients with porphyria, although there is conflicting experimental evidence of porphyrogenicity.
Pregnancy
Although gross abnormalities of the genito-urinary tract have been reported in the male offspring of women who took diethylstilbestrol during pregnancy, there is conflicting evidence on whether the estrogen produced an increased risk of abnormalities, infertility, or testicular cancer in such offspring. The male fetus is normally protected from the feminizing effects of the natural estrogens in the uterine environment by the early development of the testes and the secretion of male hormones.
However, there has been considerable concern about a rising incidence of disorders of the male reproductive tract and a reduction in sperm counts, which has been noted in the last 20 to 30 years. It has been hypothesized that overexposure of male fetuses to environmental estrogens derived from pollutants such as pesticides and plastics may be responsible for this decline, although some dispute this. A systematic review of epidemiological data found no strong evidence to link fetal exposure to estrogens (as pharmaceuticals or pollutants) with reduced sperm count, cryptorchidism, or hypospadias. However, some evidence supported a possible link with testicular cancer.
For discussion of the lack of effects of hormonal contraceptives on the fetus, including evidence that they are unlikely to increase the risk of hypospadias in the male fetus, see pregnancy, under Precautions of Hormonal Contraceptives.
Veterinary Use
An FAO/WHO expert committee examining the risks from residues of veterinary drugs in foodstuffs established an acceptable daily intake for estradiol but concluded that there would be no need to specify a numerical maximum residue limit for estradiol in the edible tissues of cattle when products are used as growth promotors according to good practice.l However, it should be noted that in the EU, the use of steroidal hormones such as estrogens in veterinary practice is restricted, and their use as growth promotors is banned.
There is concern about the effect of environmental estrogens on male fertility and development, see Pregnancy section.
Interactions
Like any medication, estradiol can interact with other substances, including medications, supplements, and certain lifestyle factors. It’s crucial to inform your healthcare provider about all your medications and supplements to avoid potential interactions.
Drug Interactions
-
- Blood Thinners (Anticoagulants): Estradiol may interact with blood-thinning medications, potentially increasing the risk of bleeding.
- Anticonvulsants: Certain anticonvulsant medications may decrease the effectiveness of estradiol.
Herbal Supplements
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- St. John’s Wort: This herbal supplement can induce estradiol metabolism, reducing effectiveness. It’s advisable to discuss the use of St. John’s Wort with your healthcare provider.
Lifestyle Factors
-
- Tobacco Smoke: Smoking may increase the metabolism of estradiol, potentially reducing its effectiveness. If you smoke, it’s essential to inform your healthcare provider.
Medical Conditions
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- Liver Disease: Estradiol is metabolized in the liver, so individuals with liver disease may require special monitoring and dosage adjustments.
- Certain Cancers: Estradiol is contraindicated in individuals with certain hormone-sensitive cancers, such as breast or uterine cancer.
Other Medications
-
- Corticosteroids: Certain corticosteroids may interact with estradiol, potentially affecting hormone levels.
Always communicate openly with your healthcare provider about your medical history and the substances you are taking. Your healthcare provider can guide potential interactions and adjust your treatment plan. It’s crucial not to self-adjust your medication dosage or stop taking prescribed medications without consulting your healthcare provider.
Drug Approvals
(British Approved Name, rINN)
Synonyms: Ösztradiol; Beta-oestradiol; Dihydrofolliculin; Dihydrotheelin; Dihydroxyoestrin; Estradiol; Estradioli; Estradiolis; Estradiolum; NSC-20293 (alpha-estradiol); NSC-9895; Oestradiol
BAN: Estradiol
INN: Estradiol [rINN (en)]
INN: Estradiol [rINN (es)]
INN: Estradiol [rINN (fr)]
INN: Estradiolum [rINN (la)]
INN: Естрадиол [rINN (ru)]
Chemical name: Estra-1,3,5(10)-triene-3,17β-diol
Molecular formula: C18H24O2 =272.4
CAS: 50-28-2 (anhydrous estradiol)
ATC code: G03CA03
Read code: y07sI [Gynae]
Pharmacopoeias. In China and the US. Europe includes the hemihydrate.
European Pharmacopoeia, 6th ed. (Estradiol Hemihydrate). A white or almost white crystalline powder or colorless crystals. It is practically insoluble in water, sparingly soluble in alcohol, soluble in acetone, and slightly soluble in dichloromethane.
The United States Pharmacopeia 31, 2008 (Estradiol). White or creamy-white, odorless, hygroscopic tiny crystals or crystalline powder. Practically insoluble in water, soluble 1 in 28 of alcohol, 1 in 435 of chloroform, and 1 in 150 of ether soluble in acetone, in dioxane, and solutions of fixed alkali hydroxides sparingly soluble in vegetable oils. Store in airtight containers at a temperature of 25°, excursions permitted between 15° and 30°. Protect from light.
Estradiol Acetate
(British Approved Name Modified, US Adopted Name, rINNM)
Drug Nomenclature
Synonyms: E-3A; Estradiol-3-acetate; Oestradiol Acetate
BAN: Estradiol Acetate [BANM]
USAN: Estradiol Acetate
INN: Estradiol Acetate [rINNM (en)]
INN: Acetato de estradiol [rINNM (es)]
INN: Estradiol, Acétate d’ [rINNM (fr)]
INN: Estradioli Acetas [rINNM (la)]
INN: Естрадиола Ацетат [rINNM (ru)]
Chemical name: Estra-1,3,5(10)-triene-3,17β-diol 3-acetate
Molecular formula: C20H26O3 =314.4
CAS: 4245-41-4
Estradiol Benzoate
(British Approved Name Modified, rINNM)
Drug Nomenclature
Synonyms: Ösztradiol-benzoát; Benzoato de estradiol; Beta-oestradiol Benzoate; Dihydroxyoestrin Monobenzoate; Estradiol, benzoato de; Estradiol-benzoát; Estradiolbensoat; Estradioli Benzoas; Estradiolibentsoaatti; Estradiolio benzoatas; NSC-9566; Oestradiol Benzoate
BAN: Estradiol Benzoate [BANM]
INN: Estradiol Benzoate [rINN (en)]
INN: Benzoato de estradiol [rINN (es)]
INN: Estradiol, Benzoate d’ [rINN (fr)]
INN: Estradioli Benzoas [rINN (la)]
INN: Естрадиола Бензоат [rINN (ru)]
Chemical name: Estra-1,3,5(10)-triene-3,17β-diol 3-benzoate
Molecular formula: C25H28O3 =376.5
CAS: 50-50-0
ATC code: G03CA03
Pharmacopoeias. In China, Europe, Japan, and the US.
European Pharmacopoeia, 6th ed. (Estradiol Benzoate). An almost white crystalline powder or colorless crystals. It exhibits polymorphism. It is practically insoluble in water, sparingly soluble in acetone, freely soluble in dichloromethane, and slightly soluble in methyl alcohol.
The United States Pharmacopeia 31, 2008 (Estradiol Benzoate). A white to off-white, crystalline powder. Insoluble in water, soluble in alcohol and acetone, slightly soluble in ether. Store in airtight containers. Protect from light.
Estradiol Cypionate
Drug Approvals
(British Approved Name Modified, rINNM)
Synonyms: Estradiol Cypionate; Estradiol, cipionato de; Oestradiol Cyclopentylpropionate; Oestradiol Cypionate
BAN: Estradiol Cipionate [BANM]
INN: Estradiol Cipionate [rINNM (en)]
INN: Cipionato de estradiol [rINNM (es)]
INN: Estradiol, Cipionate d’ [rINNM (fr)]
INN: Estradioli Cipionas [rINNM (la)]
INN: Естрадиола Ципионат [rINNM (ru)]
Chemical name: Estra-1,3,5(10)-triene-3,17β-diol 17-(3-cyclopentylpropionate)
Molecular formula: C26H36O3 =396.6
CAS: 313-06-4
ATC code: G03CA03
Pharmacopoeias. In US.
The United States Pharmacopeia 31, 2008 (Estradiol Cypionate). A white to practically white crystalline powder, odorless or has a slight odor. Insoluble in water, soluble 1 in 40 of alcohol, 1 in 7 of chloroform, and 1 in 2800 of ether, soluble in acetone and dioxan, sparingly soluble in vegetable oils. Store in airtight containers. Protect from light.
Estradiol Dipropionate
Drug Approvals
(British Approved Name Modified, rINNM)
Synonyms: Dihydroxyoestrin Dipropionate; Estradiol, dipropionato de; Oestradiol Dipropionate
BAN: Estradiol Dipropionate [BANM]
INN: Estradiol Dipropionate [rINNM (en)]
INN: Dipropionato de estradiol [rINNM (es)]
INN: Estradiol, Dipropionate d’ [rINNM (fr)]
INN: Estradioli Dipropionas [rINNM (la)]
INN: Естрадиола Дипропионат [rINNM (ru)]
Chemical name: Estra-1,3,5(10)-triene-3,17β-diol dipropionate
Molecular formula: C24H32O4 =384.5
CAS: 113-38-2
ATC code: G03CA03
Estradiol Enanthate
(British Approved Name Modified, rINNM)
Drug Nomenclature
Synonyms: Estradiol, enantato de; Oestradiol 17-Heptanoate; Oestradiol Enanthate; SQ-16150
BAN: Estradiol Enantate [BANM]
USAN: Estradiol Enanthate
INN: Estradiol Enantate [rINNM (en)]
INN: Enantato de estradiol [rINNM (es)]
INN: Estradiol, Enantate d’ [rINNM (fr)]
INN: Estradioli Enantas [rINNM (la)]
INN: Естрадиола Енантат [rINNM (ru)]
Chemical name: Estra-1,3,5(10)-triene-3,17β-diol 17-heptanoate
Molecular formula: C25H36O3 =384.6
CAS: 4956-37-0
ATC code: G03CA03
Estradiol Hexahydrobenzoate
Drug Approvals
(British Approved Name Modified, rINNM)
Synonyms: Estradiol, hexahidrobenzoato de; Oestradiol Hexahydrobenzoate
BAN: Estradiol Hexahydrobenzoate [BANM]
INN: Estradiol Hexahydrobenzoate [rINNM (en)]
INN: Hexahidrobenzoato de estradiol [rINNM (es)]
INN: Estradiol, Hexahydrobenzoate d’ [rINNM (fr)]
INN: Estradioli Hexahydrobenzoas [rINNM (la)]
INN: Естрадиола Гексагидробензоат [rINNM (ru)]
Chemical name: Estra-1,3,5(10)-triene-3,17β-diol 17-cyclohexane carboxylate
Molecular formula: C25H34O3 =382.5
CAS: 15140-27-9
ATC code: G03CA03
Estradiol Phenylpropionate
Drug Approvals
(British Approved Name Modified, rINNM)
Synonyms: Estradiol, fenilpropionato de; Oestradiol Phenylpropionate
BAN: Estradiol Phenylpropionate [BANM]
INN: Estradiol Phenylpropionate [rINNM (en)]
INN: Fenilpropionato de estradiol [rINNM (es)]
INN: Estradiol, Phénylpropionate de [rINNM (fr)]
INN: Estradioli Phenylpropionas [rINNM (la)]
INN: Естрадиола Фенилпропионат [rINNM (ru)]
Chemical name: Estra-1,3,5(10)-triene-3,17β-diol 17-(3-phenylpropionate)
Molecular formula: C27H32O3 =404.5
ATC code: G03CA03
Estradiol Valerate
(British Approved Name Modified, rINNM)
Drug Nomenclature
Synonyms: Ösztradiol-valerát; Estradiol, valerato de; Estradiol-valerát; Estradioli Valeras; Estradiolio valeratas; Estradiolivaleraatti; Estradiolvalerat; NSC-17590; Oestradiol Valerate; Valerato de estradiol
BAN: Estradiol Valerate [BANM]
INN: Estradiol Valerate [rINN (en)]
INN: Valerato de estradiol [rINN (es)]
INN: Estradiol, Valérate d’ [rINN (fr)]
INN: Estradioli Valeras [rINN (la)]
INN: Естрадиола Валерат [rINN (ru)]
Chemical name: Estra-1,3,5(10)-triene-3,17β-diol 17-valerate
Molecular formula: C23H32O3 =356.5
CAS: 979-32-8
ATC code: G03CA03
Pharmacopoeias. In China, Europe, and the US.
European Pharmacopoeia, 6th ed. (Estradiol Valerate). A white or almost white, crystalline powder or colorless crystals. Practically insoluble in water, soluble in alcohol. Protect from light.
The United States Pharmacopeia 31, 2008 (Estradiol Valerate). A white crystalline powder that is usually odorless or may have a faint fatty odor. It is practically insoluble in water, soluble in benzyl benzoate, dioxane, methyl alcohol, and castor oil, sparingly soluble in arachis oil and sesame oil. Store in airtight containers. Protect from light.
Preparations
British Pharmacopoeia 2008: Estradiol and Norethisterone Acetate Tablets; Estradiol and Norethisterone Tablets; Estradiol Injection; Estradiol Transdermal Patches
The United States Pharmacopeia 31, 2008: Estradiol and Norethindrone Acetate Tablets; Estradiol Cypionate Injection; Estradiol Injectable Suspension; Estradiol Pellets; Estradiol Tablets; Estradiol Transdermal System; Estradiol Vaginal Cream; Estradiol Valerate Injection.
Proprietary Preparations
The symbol ¤ denotes a preparation which is discontinued or no longer actively marketed.
Argentina: Aerodiol; Climaderm¤; Disequens; Estraderm; Estradot; Estreva; Estring¤; Estrofem; Etrosteron; Eutocol; Evorel; Fem 7; Ginatex; Hormodiol; Lindisc; Oestro Gel; Progynon; Progynova; Replasyn; Ronfase; Rontagel; Transdiol¤; Trial Gel; Trial Sat; Australia: Aerodiol; Climara; Dermestril; Estraderm; Estradot; Estring¤; Estrofem; Femtran; Menorest; Primogyn Depot; Progynova; Sandrena; Vagifem; Zumenon;
Austria: Aerodiol; Climara; Cycloderm; Dermestril; Duokliman; Estracutan; Estraderm; Estradot; Estramon; Estring¤; Estrofem; Estrogel; FemSeven; FemSieben; Klimapur; Klimareduct; Linoladiol; Menorest; Merimono; Oesclim¤; Progynon; Progynova; Sandrena¤; Sterigin; Substitol¤; Systen; Vagifem; Zerella; Zumenon;
Belgium: Aerodiol; Climara; Dermestril; Estraderm; Estreva; Estrofem; Feminova; Meno-Implant; Oestrogel; Progynova; Systen; Vagifem; Vivelle; Zumenon;
Brazil: Aerodiol; Avicis; Benzo-Ginoestril; Climaderm; Estradelle; Estraderm; Estradot; Estreva; Estrofem; Fem 7; Ginedisc¤; Hormodose; Lindisc; Menorest¤; Merimono; Natifa; Oesclim¤; Oestrogel¤; Primogyna; Reglovar¤; Riselle; Sandrena; Systen;
Canada: Climara; Delestrogen; Estrace; Estraderm; Estradot; Estring; Estrogel; Femogex¤; Oesclim; Vagifem; Vivelle¤; Chile: Climaderm; Cyclobiol; Dermatrans; Enadiol; Epiestrol; Estranova E; Estreva; Farlutes; Fem 7; Femalon; Femiderm; Femidott; Ginoderm; Mirion; Oesclim¤; Primaquin; Primofol Depot¤; Primogyna¤; Progynova; Sandrena; Transvital; Vagifem;
Czech Republic: Agofollin; Climara; Dermestril; Divigel; Elleste; Estrace; Estraderm; Estrahexal; Estreva; Estrimax; Estring; Estrofem; Fem 7; Linoladiol N; Menorest; Neofollin; Octodiol; Oesclim; Oestrogel; Riselle; Systen; Vagifem;
Denmark: Aerodiol; Climara; Divigel; Estraderm; Estring; Estrofem; Estrogel; Evorel; Femanest; FemSeven¤; Menorest¤; Progynon; Sandrena; Vagifem; Vivelle Dot;
Finland: Climara; Dermestril; Divigel; Estraderm; Estradot; Estrena; Estring; Estrofem; Estrogel; Evorel; FemSeven; Menorest¤; Merimono; Progynova; Vagifem; Zumenon;
France: Aerodiol; Benzo-Gynoestryl¤; Climara; Delidose; Dermestril; Estraderm; Estrapatch; Estrofem; Evafilm¤; Femsept; Menorest; Oesclim; Oestrodose; Oestrogel; Oromone; Progynova; Provames; Systen; Thais; Vivelledot;
Germany: Aerodiol; Cerella¤; Cutanum; Dermestril; Ephelia; Estrabeta; Estraderm; Estradot; Estramon; Estreva; Estrifam; Estring; Estronorm; Evorel; Fem 7; Femoston mono; Gynokadin; GynPolar; Linoladiol N; Menorest; Merimono; Pantostin; Progynon B¤; Progynon Depot 100¤; Progynon Depot 10; Progynon Depot 40¤; Progynova; Sandrena; Sisare mono; Tradelia; Vagifem;
Greece: Aerodiol; Dermestril; Estraderm TTS¤; Estradot; Estramon; Estring¤; Estrofem; Estrogel; Menorest; Oesclim¤; Oestrogel; Vagifem;
Hong Kong: Aerodiol¤; Bisteron¤; Dermestril; Estraderm; Estreva; Estrofem; Fem 7¤; Oestrogel; Progynova;
Hungary: Calidiol; Dermestril; Divigel; Estraderm; Estradot; Estramon; Estrimax; Estrofem; Linoladiol N; Oesclim; Oestrogel; Systen; Triaklim; Vagifem;
India: Estraderm;
Ireland: Aerodiol; Climara; Dermestril; Divigel; Epiestrol¤; Estraderm; Estradot; Estramon¤; Estrofem; Evorel; Fematab; Fematrix¤; Menorest¤; Oestrogel; Progynova¤; Vagifem;
Israel: Climara¤; Dermestril; Estraderm; Estrofem; Evorel; Meno-Patch¤; Oestrodose; Oestrogel; Progynova; Vagifem;
Italy: Aerodiol; Armonil; Benztrone¤; Climara; Dermestril; Ephelia; Epiestrol; Esclima; Estraderm; Estroclim; Estrodose; Estrofem; FemSeven; Gelestra; Ginaikos; Menorest; Progynon B¤; Progynon Depot¤; Progynova; Sandrena; Sprediol; Systen; Vagifem; Zerella;
Malaysia: Divigel; Estrofem; Oestrogel; Progynova; Trisequens; Mexico: Armistor; Benzo-Ginestryl; Climaderm; Essventia; Estraderm; Estramon; Estreva; Evorel; Fem 7; Ginedisc; Oestrogel; Primogyn; Sandrena; Systen;
Monaco: Estreva; Netherlands: Aerodiol; Climara; Dermestril; Dimenformon¤; Estraderm; Estradot; Estring¤; Estrofem; Fem 7; Femring; Meno-Implant; Menorest; Progynon Depot 100¤; Progynon Depot 10¤; Progynova; Sandrena; Systen; Vagifem; Zumenon;
Norway: Climara; Estraderm; Estradot; Estring; Evorel; Menorest¤; Progynova; Vagifem;
New Zealand: Aerodiol; Climara; Estraderm; Estring¤; Estrofem; Femtran; Progynova; Sandrena¤; Vagifem¤;
Portugal: Climara; Dermestril; Estraderm; Estradot; Estrofem; Estronar¤; Menorest; Vagifem; Zumenon;
Russia: Climara (Климара); Divigel (Дивигель); Estrimax (Естримакс); Estrofem (Естрофем); Oestrogel (Естрожель);
South Africa: Climara; Estraderm; Estring; Estro-Pause; Estrofem; Evorel; Femigel; Menorest¤; Primogyn Depot; Progynova; Vagifem; Singapore: Divigel; Estraderm; Estreva; Estrofem; Fem 7¤; Oestrogel; Progynova; Vagifem;
Spain: Absorlent; Alcis; Cliogan; Dermestril; Endomina; Esotran¤; Esprasone; Estraderm; Estradot; Estroffik; Evopad; Menorest¤; Meriestra; Oestraclin; Oestrodose¤; Progynon Depot¤; Progynova; Vagifem;
Sweden: Climara; Divigel; Estraderm; Estradot; Evorel; Femanest; FemSeven; Menorest¤; Oesclim; Oestring; Progynon; Vagifem;
Switzerland: Aerodiol; Cerina; Climara; Dermestril; Divigel; Epiestrol¤; Estraderm; Estradot; Estramon; Estreva; Estring; Estrofem N; Fem 7; FemSeven¤; Menorest; Oestrogel; Progynon Depot 100¤; Progynon Depot 10¤; Progynova; Sandrena; Systen; Vagifem; Zumenon; Thailand: Climara; Divigel; Estrofem; Oestrogel; Progynon; Progynova; Vagifem;
United Kingdom: Adgyn Estro¤; Aerodiol; Bedol; Benztrone¤; Climaval; Dermestril¤; Elleste-Solo; Estraderm; Estradot; Estring; Evorel; Fematrix; FemSeven; FemTab; Menorest¤; Menoring¤; Oestrogel; Progynova; Sandrena; Vagifem; Zumenon;
United States: Alora; Climara; Deladiol¤; Delestrogen; depGynogen; Depogen; Dioval¤; Dura-Estrin¤; Duragen¤; E-Cypionate¤; Esclim; Estra-D¤; Estra-L¤; Estrace; Estraderm; Estrasorb; Estring; Estro-Cyp¤; Estrogel; Estroject¤; FemPatch; Femring; Femtrace; Gynodiol; Gynogen¤; Menaval¤; Menostar; Vagifem; Valergen; Vivelle;
Venezuela: Aerodiol; Climaderm; Estraderm; FemSeven
Multi-ingredient Preparations
Argentina: Activelle; Angeliq; Atrimon; Ciclocur; Climene; Cristerona; Dilena; Dos Dias N; Estalis Sequi; Estalis; Estracomb; Estragest; Evorel Conti; Evorel Sequi; Farludiol Ciclo; Farludiol; Fem 7 Combi; Fempack; Gynodian Depot; Hosterona; Kliogest; Lubriderm; Menstrogen; Mesigyna; Perlutal; Plenifem¤; Prefest; Primosiston; Supligol NF; Supligol¤; Totelle Ciclico; Totelle Continuo; Trial Combi; Trial Gest; Trial Pack¤; Trisequens;
Australia: Angeliq; Climen; Divina¤; Estalis Continuous; Estalis Sequi; Estracombi; Estrapak¤; Femoston; Kliogest; Kliovance; Primodian Depot¤; Trisequens;
Austria: Activelle; Climabelle; Climen; Climodien; Cyclacur; Estalis Sequens; Estalis; Estandron¤; Estracomb; Estragest¤; Femipak; Femoston Conti; Femoston; Femphascyl conti; Femphascyl; FemSeven Combi; Filena; Gravibinon¤; Gynodian Depot; Ichth-Oestren¤; Kliogest; Lafamme; Liseta; Mericomb; Merigest; Minique; Novofem; Ostrolut¤; Perikliman; Primodian Depot¤; Totelle cyclo¤; Tri-Filena¤; Trisequens;
Belgium: Activelle; Climen; Climodien; Cyclocur; Dimenformon; Diviplus¤; Diviva¤; Estracombi; Feminova Plus; Femoston Conti; Femoston; Kliogest; Novofem; Totelle Cycle; Trisequens; Trivina¤;
Brazil: Activelle; Cicloprimogyna; Ciclovular¤; Cliane; Climene; Cyclofemina; Dilena; Elamax; Estalis SQ; Estalis; Estandron P; Estracomb; Estragest; Evitas¤; Femineo; Femoston Conti; Femoston; Gestadinona; Ginecoside¤; Ginedisc 50 Plus¤; Hormoginase¤; Kliogest; Lindisc Duo¤; Mericomb; Merigest; Mesigyna; Natifa Pro; Normomensil¤; Perlutan; Postoval; Prefest; Preg-Less; Progest¤; Suprema; Systen Conti; Systen Sequi; Trinestril; Trisequens; Unalmes; Uno-Ciclo;
Canada: Climacteron; Duogex LA¤; Estalis Sequi; Estalis; Estracomb; Estrand¤; Neo-Pause¤;
Chile: Activelle; Agurin; Avaden; Cliane; Climene; Cyclofem; Enadiol CC; Enadiol MP; Enadiol Neta; Estandron Prolongado; Estracomb; Estragest; Estranova 30 Simple; Estranova CC; Farlupost; Fem 7 Combi; Femoston Conti; Femoston; Ginefolin; Gravidinona¤; Gynodian Depot; Kilios; Kliogest; Mesigyna; Novafem; Postoval; Primaquin MP Continuo; Primaquin MP; Progyluton; Totelle Continuo; Totelle; Trisequens; Unalmes¤;
Czech Republic: Activelle; Aknefug; Alpicort F; Avaden; Climara Duo; Climen; Convaden; Cyclo-Menorette; CycloOstrogynal; Divina; Diviseq; Estalis Sequi; Estalis; Estrace Plus; Estrace-C; Estracomb; Estragest; Femoston; Folivirin; Gynodian Depot; Indivina; Kliane; Klimodien; Klimonorm; Kliogest; Linoladiol-H N; Pausogest; Systen Conti; Systen Sequi; Triaklim; Trisequens;
Denmark: Activelle; Climen; Climodien; Cyclo-Progynon; Divina Plus; Divina; Estracomb; Evo-Conti; Evo-Sequi; Femanor; Femasekvens; Indivina; Klimalet; Klimaxil¤; Kliogest; Novofem; Nuvelle; Ostranorm¤; Totelle; Trevina; Trinorm¤; Trisekvens;
Finland: Activelle; Climara Duo¤; Cyclabil; Divina; Divitren; Estalis Sekvens; Estalis; Estracomb¤; Evorel Conti; Evorel Sequi; Femilar; Femoston Conti; Femoston; FemSeven Combi; Indivina; Kliogest; Mericomb; Merigest; Novofem; Senikolp¤; Totelle Sekvens; Trisekvens;
France: Activelle; Avadene; Climaston; Climaston; Climene; Climodiene; Divina; Diviseq; Duova; FemseptCombi; Gravibinan¤; Gynodian Depot¤; Kliogest; Naemis; Novofemme; Successia¤; TOM¤; Trisequens;
Germany: Acetonal Vaginale¤; Activelle; Aknefug-Emulsion¤; Alpicort F; Androfemon¤; Climen; Climodien; Clionara; Crinohermal fem; Cyclo-Menorette; Cyclo-Progynova; CycloOstrogynal; CycloPolar¤; Ell-Cranell¤; Estalis Sequi; Estracomb; Estrafemol; Estragest; Fem 7 Combi; Femoston Conti; Femoston; Fissan-Brustwarzensalbe¤; Gianda; Gravibinon¤; Gynamon; Gynodian Depot; Ichth-Oestren¤; Indivina; Jephagynon¤; Klimonorm; Kliogest N; Lafamme; Linoladiol-H N; Lynandron¤; Malun¤; Mericomb; Merigest; NeoOstrogynal; NeyNormin N (Revitorgan-Dilutionen N Nr 65); Novofem; Osmil; Ostronara; Ovatest¤; Primodian Depot¤; Primosiston¤; Procyclo; Sebohermal¤; Sisare 28; Sisare; Syngynon¤; Trisequens; Vitrena;
Greece: Activelle; Angeliq; Climodien; Cyclacur; Divina; Estalis; Estopause; Estracomb TTS; Femaston; Kliogest; Nuvelle¤; Systen Conti; Systen Sequi; Trisequens; Hong Kong: Activelle; Climen 28; Dilena; Estracomb; Femoston; Hormonin; Klimonorm¤; Kliogest; Progestrol¤; Trisequens;
Hungary: Activelle; Alpicort F; Climen; Cyclo-Menorette; Divina; Divitren; Estracomb; Estragest; Femoston; Klimodien; Klimonorm; Kliogest; Linoladiol-H N; Pausogest; Trisequens;
India: Kemicetine Antiozena; Mixogen;
Ireland: Activelle; Cyclo-Progynova¤; Diviseq¤; Estalis Sequi; Estalis; Estracombi; Estrapak¤; Evorel Conti; Femoston Conti; Femoston; Femplan-MA¤; Indivina; Kliogest; Novofem; Nuvelle; Tridestra¤; Trisequens;
Israel: Activelle; Evorel Conti; Evorel Sequi; Kliogest; Meno-MPA¤; Meno-Net¤; Novofem; Progyluton; Trisequens;
Italy: Ablacton¤; Activelle; Biormon¤; Climen; Clym-Depositum¤; Combiseven; Cyclacur¤; Duo-Ormogyn¤; Estalis Sequi; Estandron¤; Estiamen B¤; Estiamen¤; Estracomb; Femoston Conti; Femoston; Filena; Gravibinan; Gynodian Depot; Kliogest; Menovis; Nuvelle TS¤; Nuvelle; Pausene; Primodian Depot¤; Tesor-C¤; Totelle; Trisequens; Malaysia: Activelle; Climen; Femoston; Klimonorm; Kliogest; Progyluton;
Mexico: Anafertin; Binodian; Cliane; Climene; Cyclofemina; Damax; Despamen; Dilena; Estracomb; Estrapak¤; Evorel Conti; Ginoplan¤; Gravidinona; Lutalmin; Lutoginestryl F; Mesigyna; Metrigen Fuerte; Ominol¤; Patector; Perludil; Perlutal; Prefest; Primosiston; Primoson-F; Progediol; Proger-F; Progyluton; Totelle Continuo; Totelle Secuencial; Yectames;
Monaco: Trioestrine-Retard¤; Netherlands: Activelle; Angeliq; Avaden; Climene; Cyclocur; Dimenformon Prolongatum¤; Divina¤; Estandron Prolongatum; Estracomb; Fem 7 Sequi; Femoston; Kliogest; Naemis; Novofem; Trisequens; Zumeston¤;
Norway: Activelle; Climen; Climodien; Cyclabil; Diviseq¤; Estalis Sekvens; Estalis; Estracomb¤; Indivina; Kliogest; Novofem; Totelle Sekvens; Trisekvens;
New Zealand: Cliane; Estrapak¤; Kliogest; Kliovance; Nuvelle; Trisequens; Portugal: Activelle; Cicnor; Climara Duo; Climen; Climodien; Dilena; Emmenovis; Estalis Sequi; Estalis; Estracomb; Femoston 1/5; Femoston 2/10; Kliogest; Nuvelle; Progyluton; Trisequens;
Russia: Climen (Климен); Climodien (Климодиен); Cyclo-Progynova (Цикло-прогинова); Divina (Дивина); Diviseq (Дивисек); Divitren (Дивитрен); Femoston (Фемостон); Femoston 1/5 (Фемостон 1/5); Gynodian Depot (Гинодиан Депо); Indivina (Индивина); Klimonorm (Климонорм); Pausogest (Паузогест); Triaklim (Триаклим); Trisequens (Трисеквенс);
South Africa: Activelle; Angeliq; Climen; Divina; Estracombi; Estro-Pause N; Evorel Conti; Evorel Sequi; Femoston; Kliogest; Mixogen; Postoval; Prefesta; Primodian Depot; Trisequens; Trivina;
Singapore: Activelle; Climen; Estracomb; Femoston; Kliogest; Progyluton; Trisequens;
Spain: Ablacton¤; Absorlent Plus; Activelle; Auroclim; Climen; Climodien; Clisin; Dinatrofon¤; Duofemme; Emenovister¤; Endomina Plus; Estalis Sequi; Estalis; Estandron Prolongado¤; Estracomb; Gynodian Depot¤; Merigest Sequi; Merigest; Mevaren; Nuvelle; Perifem; Primodian Depot¤; Primosiston Fuerte¤; Progyluton; Topasel; Trisequens;
Sweden: Activelle; Climodien; Cyclabil; Divina Plus; Divina; Estalis Sekvens; Estalis; Estracomb¤; Evorel Micronor; Femanor; Femasekvens; Indivina; Kliogest; Novofem; Totelle Sekvens; Totelle; Trisekvens; Trivina;
Switzerland: Activelle; Alpicort F; Climen; Cyclacur; Diviseq; Estalis Sequi; Estalis; Estandron Prolongatum¤; Estracomb; Estragest; Fem 7 Combi; Femoston Conti; Femoston; Gravibinon¤; Gynodian Depot; Indivina; Kliogest N; Linoladiol¤; Mericomb; Merigest; Novofem; OestroTabs Plus Cyclic¤; Primodian Depot¤; Primosiston¤; Systen Conti; Systen Sequi; Triaval; Trisequens; Tyliculine¤;
Thailand: Activelle; Climen; Cyclo-Progynova; Duoton; Indivina; Klimonorm; Kliogest¤; Primodian Depot; Trisequens¤; United Kingdom: Adgyn Combi¤; Angeliq; Climagest; Climesse; Clinorette; Cyclo-Progynova 1 mg; Cyclo-Progynova 2 mg; Elleste Duet Conti; Elleste-Duet; Estracombi; Estrapak¤; Evorel Conti; Evorel Pak¤; Evorel Sequi; Femapak; Femoston Conti; Femoston; FemSeven Conti; FemSeven Sequi; FemTab Continuous¤; FemTab Sequi; Hormonin; Indivina; Kliofem; Kliovance; Novofem; Nuvelle Continuous; Nuvelle TS¤; Nuvelle; Tridestra; Trisequens;
United States: Activella; Andro/Fem¤; ClimaraPro; CombiPatch; Deladumone¤; depAndrogyn¤; Depo-Testadiol; Depotestogen; Duo-Cyp¤; Duratestrin¤; Estra-Testrin¤; Lunelle¤; Prefest; T-E Cypionate¤; Test-Estro¤; Testaval 90/4¤; Valertest¤;
Venezuela: Cliane; Climene; Estracomb; Estragest; Ginecosid; Gynodian Depot; Mesigyna; Primosiston; Progyluton