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Oestrogen Replacement Therapy

Estradiol (HRT — Hormone Replacement Therapy)

Brand names: Elleste Solo (oral), Evorel (patch), Oestrogel (gel), Lenzetto (spray), Vagifem (vaginal tablet), Estring (vaginal ring)

Estradiol is an oestrogen used in hormone replacement therapy (HRT) to relieve menopausal symptoms such as hot flushes, night sweats and vaginal dryness. It is available orally and transdermally as patches or gel.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Take one tablet daily by mouth at the same time every day for 91 days. (2.1) Take tablets in the order directed on the Extended-Cycle Wallet. (2.2) 2.1 How to Start and Take Iclevia Iclevia is dispensed in an Extended-Cycle Wallet [see How Supplied/Storage and Handling (16) ]. Iclevia should be started on a Sunday (see Table 1). For the first cycle of a Sunday Start regimen, an additional method of contraception should be used until after the first 7 consecutive days of administration. Table 1: Instructions for Administration of Iclevia Starting Iclevia in females with no current use of hormonal contraception (Sunday Start) Important: Consider the possibility of ovulation and conception …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-07-02. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It replaces declining endogenous oestrogen, relieving vasomotor and urogenital symptoms of the menopause by acting on oestrogen receptors throughout the body.

Prescribing in practice

  • Women with a uterus also need a progestogen, because unopposed oestrogen causes endometrial hyperplasia and endometrial cancer.
  • The transdermal route avoids the increased venous-thromboembolism risk seen with oral oestrogen and is preferred where thrombotic risk is a concern.
  • There is a small increase in breast cancer risk with combined HRT, and oral therapy carries small increases in stroke and venous thromboembolism, so individualise treatment and review regularly.

Monitoring

Review symptom control, bleeding pattern and risks regularly, including blood pressure; investigate unscheduled or persistent bleeding and reassess the benefit-risk balance at each review.

Counselling the patient

  • If you still have a womb, take the progestogen part exactly as prescribed to protect the lining of the womb.
  • Report any unexpected or persistent vaginal bleeding, or a new breast lump.
  • Continue to attend breast and cervical screening, and seek urgent help for symptoms of a clot such as leg swelling or breathlessness.

Evidence & guidelines

Recommended for menopausal symptoms by NICE (NG23).

Reference: NICE NG23 (Menopause); BMS HRT Guidelines 2020; WHI Trial; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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