Estrogel (Estradiol Gel)

Estrogel is a hormone replacement therapy that contains 0.06% estradiol in a clear, colorless gel. The medication works by applying estradiol, a form of estrogen hormone, to the skin, where it is absorbed. By replacing some of the estrogen the body no longer makes, it can help manage hot flashes, night sweats, and vaginal dryness or irritation. It comes in a non-aerosol pump that gives the same dose each time you use it.

Directions

Estrogel is applied once daily to clean, dry skin on one arm at the same time each day. The pump needs to be primed before first use by pressing it 3 times and throwing away the gel that comes out. After priming, press the pump only once per application to get the correct dose of 1.25 grams of gel, which contains 0.75 mg of estradiol.

The gel should be spread in a thin layer from the wrist to the shoulder on the outer surface of one arm. Apply it to either arm, but use the entire arm for each application. The gel needs to dry for about 5 minutes before getting dressed, and avoid washing the application site for at least 1 hour after applying.

Ingredients

The active ingredient in this drug is estradiol.

Cautions

• Before using this medication, you may want to consult a healthcare provider about the following:
  • Any existing health conditions
  • Any allergies
  • A list of all medications currently being taken
• Estrogel, like other estrogen therapies, can increase the risk of blood clots, stroke, and heart problems. Stop using it and get medical help right away if you notice symptoms like chest pain, trouble breathing, sudden leg swelling, or sudden weakness or vision changes. Your doctor may check and manage risk factors such as high blood pressure, high cholesterol, smoking, or a personal or family history of blood clots.
• Using estrogen alone can increase the risk of cancer of the uterine lining if you still have a uterus. Unusual vaginal bleeding should always be checked by a doctor. Adding a progestogen may lower this risk but may slightly increase the risk of breast cancer. Therefore, regular breast exams and mammograms are important.
• Estrogen therapy may also slightly increase the risk of ovarian cancer and dementia in older women. If you have new memory changes, pelvic pain, or symptoms that concern you, let your healthcare provider know.
• Estrogel can worsen gallbladder problems and may cause problems like high calcium levels, vision changes, or high triglycerides that can lead to pancreatitis. Stop using it and call your doctor if you notice severe abdominal pain, yellowing of the skin or eyes, or sudden vision problems.
• Women who need thyroid hormone replacement may require dose changes because estrogen affects how the body manages thyroid hormones. Estrogel may also cause water retention, worsen certain conditions (like asthma, migraines, diabetes, or epilepsy), and trigger angioedema in women who already have this condition.
• Because Estrogel is alcohol-based, keep it away from flames or smoking until it dries.
• Avoid applying moisturizing lotions for at least one hour after using Estrogel, since this can increase absorption.

Contraindications

Avoid taking or using this medication if any of the following apply:

• Undiagnosed abnormal genital bleeding
• Known, suspected, or history of breast cancer
• Known or suspected estrogen-dependent neoplasia
• Active deep vein thrombosis (DVT), pulmonary embolism (PE), or history of these conditions
• Active arterial thromboembolic disease, such as stroke or myocardial infarction, or a history of these conditions
• Known anaphylactic reaction or angioedema to estradiol or any gel ingredients
• Known liver impairment or disease
• Known protein C, protein S, or antithrombin deficiency, or other known thrombophilic disorders

Side Effects

Common side effects of Estrogel include:

• Hair loss
• Fluid retention
• Breast tenderness or pain
• Vaginal yeast infections
• Headaches
• Stomach or abdominal cramps, bloating
• Nausea or vomiting

These effects are usually mild and may improve as your body adjusts to treatment. Some women may also notice changes in mood, mild swelling, or digestive upset. If any symptom becomes persistent or disruptive, it's a good idea to discuss it with your healthcare provider.

More serious but less common reactions can occur, including blood clots, stroke, heart attack, breast or uterine cancer, and vision changes. Estrogel may also affect thyroid levels, triglycerides, blood pressure, calcium levels, liver health, and gallbladder function. Seek medical care if you develop new breast lumps, unusual vaginal bleeding, sudden severe headaches, chest pain, leg pain or swelling, trouble speaking or seeing, or signs of angioedema such as swelling of the face, lips, or tongue.