Estrogens: Uses, most common brand names, and safety information
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At the beginning of the 20th century, ovarian secretions were shown to produce a substance called estrus, which is where the term “estrogen” came from. It took until 1929 for the hormone estrogen to be isolated. Ten years later similar substances were found in pregnant mare urine which led to the production of Premarin (conjugated estrogens), which contains at least 10 different estrogens. For the next 70 years, medications such as these were used to treat symptoms of menopause among other conditions. After results from the Women’s Health Initiative (WHI) in 2002 showed there was an increased risk of breast cancer, stroke, and DVT (blood clot in the leg) among women taking hormone replacement therapy (HRT), research began to try and find a safer delivery system. Today, most all estrogens are derived from plants or synthesized in a lab and are the same in structure and function as the estrogens your body makes.
The list below includes estrogens approved by the U.S. Food and Drug Administration (FDA) and their pricing:
List of Estrogens
Estrace is indicated to treat estrogen deficiency, symptoms of menopause, prostate cancer, and metastatic breast cancer.
Menostar transdermal (estradiol)
Menostar is indicated to treat bone loss following menopause.
Vivelle-Dot transdermal (estradiol)
Vivelle-Dot is indicated to treat estrogen deficiency, symptoms of menopause, and osteoporosis.
Alora transdermal (estradiol) is indicated to treat estrogen deficiency, symptoms of menopause, and osteoporosis.
Climara transdermal (estradiol)
Climara is indicated to treat symptoms of menopause and bone loss after menopause.
Estring vaginal ring (estradiol)
Estring is indicated to treat estrogen deficiency, symptoms of menopause, prostate cancer, and metastatic breast cancer.
Femring vaginal ring (estradiol)
Femring is indicated to treat symptoms of menopause.
Estrogel topical (estradiol)
Estrogel is indicated to treat symptoms of menopause.
Vagifem vaginal inserts (estradiol)
Vagifem is indicated to treat symptoms of menopause.
Elestrin vaginal gel (estradiol)
Elestrin is indicated to treat symptoms of menopause.
Premarin (conjugated estrogens)
Premarin is indicated to treat symptoms of menopause, prostate cancer, abnormal uterine bleeding, and female castration.
Premarin vaginal cream (conjugated estrogens)
Premarin vaginal cream is indicated to treat symptoms of menopause.
Menest (esterified estrogens)
Menest is indicated to treat symptoms of menopause, breast cancer, and prostate cancer.
Ogen is indicated to treat symptoms of menopause and to prevent bone loss.
Some other products that contain estrogens include:
- Evamist topical spray (estradiol)
- Divigel topical (estradiol)
- Estraderm transdermal (estradiol)
- Minivelle transdermal (estradiol)
- Activella (estradiol/norethindrone)
- Prempro (conjugated estrogens/medroxyprogesterone acetate)
What are estrogens?
Estrogens are a group of sex hormones that play a significant role in the sexual and reproductive development of women. They also help regulate many processes in the skeletal, cardiovascular, and central nervous systems that impact your overall health. Estrogens are primarily produced by the ovaries, but adrenal glands and fat cells also make a small amount of these hormones. There are 3 types of estrogen the body makes, which include estrone (E1), estradiol (E2), and estriol (E3). Estradiol acetate is the most common form of estrogen therapy used to manage the symptoms of menopause. Estrogens also play an important role in male sexual function. It is produced in men by the adrenal cortex, fat tissue, and testicles.
How do estrogens work?
When women approach menopause, they begin to have a reduction in their estrogen levels. These low hormone levels are the cause of symptoms such as hot flashes, vaginal dryness, night sweats, mood swings, loss of sex drive, and trouble sleeping. Estrogen replacement is used to increase the concentration of estrogens which helps resolve symptoms in postmenopausal women.
What conditions are estrogens used to treat?
Estrogens are a class of medications used in:
- Low estrogen due to ovarian insufficiency, hypogonadism, or castration.
- Menopausal symptoms which include vaginal atrophy, painful intercourse, hot flashes, and night sweats. Low-dose topical estrogen is an effective treatment for vaginal symptoms due to menopause.
- Prevention of osteoporosis.
- Oral contraceptives that contain estrogen and progesterone, or progesterone alone to prevent pregnancy.
- Treatment of acne.
- Androgen-dependent prostate cancer with metastasis.
Are estrogens safe?
The use of estrogens is relatively safe and effective when taken as prescribed. However, estrogen alone can increase endometrial cancer in women who haven’t had a hysterectomy. Estrogen alone or with progestin should not be used to prevent dementia or cardiovascular disease. It may cause higher risks of blood clots, heart attack, and stroke, in those with heart disease.
There are certain conditions you should use estrogen with extreme caution, including:
- History of breast cancer or are at an increased risk of breast cancer
- History of uterine cancer
- History of blood clots
- Bleeding disorders
- Unusual vaginal bleeding or menstrual cycle
- Gallbladder disease
- Liver disease
Menopausal hormone therapy should be used at the lowest dose for the shortest duration to minimize these risks.
What are the common side effects of estrogens?
The adverse effects you experience from estrogens will depend on several factors including the medication and dose. The most common adverse effects include:
- Breast tenderness
- Breakthrough bleeding
- Weight gain
- Fluid retention
- Hair loss
Serious side effects of estrogen products include:
- Blood clots (DVT, PE)
- Endometrial cancer
- Asthma exacerbations
- High cholesterol levels
- Gallbladder disease
- Liver impairment
- Low calcium levels
- Hypertension (high blood pressure)
- Serious hypersensitivity reactions
This is not a complete list of side effects and we encourage you to consult with your healthcare provider for medical advice about any possible side effects.
Can men take estrogens?
There are certain conditions that men take estrogen products to treat, including:
- Male hypogonadism (sex glands produce little or no hormones)
- Testicle removal (castration)
- Metastatic breast cancer or advanced androgen-dependent prostate cancer
- Transitioning from male to female
Do estrogen pills make you gain weight?
Long-term use of high-dose estrogen may cause weight gain due to increased appetite and fluid retention.
How much do estrogens cost?
Estrogens are very expensive with an average cost of around $5,000 per year.
You can purchase Estrogens for $49 per month from NiceRx if eligible for assistance. Prices at the pharmacy vary by location, strength, and quantity, as well as your insurance status.
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