Estradiol: what it is and how it's used

Mainly to treat menopause symptoms: hot flashes, night sweats and vaginal dryness. It's also used to replace estrogen after early or surgical menopause, to prevent osteoporosis in women at high risk, and occasionally to treat advanced breast or prostate cancer.

It's usually said ess-truh-DYE-ol, with the stress on the third syllable. It's the chemical name of the main estrogen in the body, also written as 17-beta estradiol or E2 on lab reports. On prescriptions and packs you may also see it written as estradiol USP or 17β-estradiol.

Both. Estradiol is the hormone your ovaries make, and prescription estradiol is the same molecule made in a lab. That's why it's called bioidentical. As a medication it needs a prescription in the US and comes as tablets, patches, gels, a spray and vaginal forms.

It doesn't matter for effectiveness; take it at the same time each day, with or without food. If you miss a dose, take it when you remember unless your next dose is nearly due. Don't double up.

Just the dose. Guidelines count 1 to 2 mg of oral estradiol as a medium dose and 0.5 mg as low. Most women start low and increase only if symptoms persist after 3 months. The 2 mg tablet contains tartrazine, a dye some people react to.

US estradiol tablets are approved to be swallowed. Taking them under the tongue isn't an approved use, and the dose absorbed would differ. If tablets don't suit you, patches, gels and sprays are approved ways to take estradiol without it passing through the liver first.

Estradiol ground into very fine particles so it's absorbed better when swallowed. US estradiol tablets contain micronized estradiol, in 0.5, 1 and 2 mg strengths. It's the same hormone, not a different type, and it isn't the same as micronized progesterone, which is a separate medicine.

Studies don't show that it does. A Cochrane review found no difference in weight gain between women taking estrogen and women not taking it. Some women notice bloating in the first weeks, which usually settles.

Estradiol tablets are approved for palliation of advanced androgen-dependent prostate cancer and, in selected men and women, some metastatic breast cancers. Outside those uses, they're prescribed mainly to women for menopause and for low estrogen caused by hypogonadism, removal of the ovaries or primary ovarian failure.

In its original container, tightly closed, at room temperature and away from heat and moisture, so not in the bathroom. Don't flush unused tablets; use a medicine take-back program. Check the expiration date on the pack.