Estradiol is a form of estrogen, which is the female hormone produced by the ovaries. It is a prescription drug used for treatment of moderate to severe symptoms of menopause, including hot flashes, vaginal dryness and vaginal burning or irritation. It is also used in vulvar and vaginal atrophy, which is inflammation and thinning of the vulva and vagina. Estradiol may also be given as part of cancer treatment and in the prevention of osteoporosis. Like any medication, estradiol can produce many side effects.
Side Effects
Estradiol may produce side effects on the reproductive organs. Drugs.com reports that patients may experience breast tenderness and enlargement. Nipple pain and breast milk secretion may occur, as well. Women may experience changes in their menstrual cycles, vaginal inflammation, vaginal discharge and itchiness. Mild nausea, vomiting, stomach cramps and bloating are other common side effects. The estradiol patch and topical formulations may cause local irritation and burning, tingling and redness. Patients may notice the appearance of freckles or darkened facial skin and loss of scalp hair. If a patient is concerned about side effects, he should speak with a health care professional.
Monitoring
Patients on estradiol should keep all doctor appointments so they may be monitored appropriately. Blood pressure and vision should be checked yearly. Women should receive a Pap smear, breast exam, and mammogram regularly. Female patients should be monitored for endometrial cancer. Other monitoring parameters are specific to other diseases the patient may have, such as diabetes and high cholesterol.
Warnings
Estradiol should be used with caution in patients with cardiovascular disease or dysfunction. The medication may increase the risk of developing a stroke, heart attack, blood clot and high blood pressure. The "Drug Information Handbook" states that estradiol may increase the risk of dementia in postmenopausal women. The drug may also increase the risk of endometrial cancer in postmenopausal women and exacerbate endometriosis. Women with endometriosis should be placed on a progestin in addition to estradiol to lower the risk. Breast cancer and abnormal mammograms have also been reported with this drug. Estradiol may also lead to a severe increase in calcium in patients with breast and bone cancers; if high calcium levels are present, the patient should discontinue the medication.
Pregnancy
Estradiol should not be used during pregnancy. The medication may increase the risk of reproductive tract disorders and other birth defects. The drug should not be used if the mother will be breastfeeding.
Contraindications
Patients who are allergic to estradiol or any other component should not be administered the drug. The liver breaks down estradiol in the body; therefore, patients with liver disease or liver impairment should not use the medication. Women with unexplained vaginal bleeding must receive a diagnosis before using estradiol. Estradiol is also contraindicated in patients with a history of blood clots or those who have had a heart attack or stroke within the past year, explains the "Drug Information Handbook." Patients with breast cancer, except those with metastatic disease, should avoid the use of estradiol.
References
- Drugs.com: Estradiol
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2009
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