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Is Estrace the Same as Estradiol? Comprehensive Comparison and Overview

What is the difference between Estrace and estradiol? How are they used, compared, and what are the side effects. Discover the key similarities and differences in this in-depth analysis.

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Understanding Estrace and Estradiol

Estrace and estradiol are both forms of the female hormone estrogen, but they are not exactly the same. Estrace is a brand name for the drug estradiol, which is a synthetic version of the naturally occurring estrogen estradiol. While they share similarities, there are also important distinctions between the two.

Active Ingredients and Formulations

The active ingredient in Estrace is estradiol, which is a synthetic version of the naturally occurring estrogen hormone. Estradiol can be administered in various formulations, including oral tablets, transdermal patches, vaginal creams, and injections. In contrast, Estrace specifically refers to the oral tablet formulation of estradiol.

Indications and Uses

Both Estrace and estradiol are primarily prescribed for the treatment of menopausal symptoms, such as hot flashes, vaginal dryness, and atrophic vaginitis. They may also be used to treat other conditions related to low estrogen levels, such as hypoestrogenism, oophorectomy, and primary ovarian failure. Additionally, estradiol may be used for gender-affirming hormone therapy and to help prevent osteoporosis.

Dosage and Administration

Estrace and estradiol are typically taken orally, with the dosage and frequency depending on the specific condition being treated. The dosage may need to be adjusted based on an individual’s response and the desired therapeutic effect. It’s important to follow the healthcare provider’s instructions carefully when taking either Estrace or estradiol.

Side Effects and Risks

Both Estrace and estradiol can have similar side effects, including breast tenderness, headaches, nausea, and changes in mood. However, long-term use of estrogen-containing drugs like Estrace or estradiol has been associated with an increased risk of certain serious conditions, such as endometrial cancer, breast cancer, and cardiovascular disease. Patients should discuss the potential risks and benefits with their healthcare provider.

Cost and Availability

Estrace and estradiol are both prescription medications, so the cost will depend on various factors, such as the patient’s insurance coverage, the specific formulation, and the dosage. Generic versions of estradiol are generally less expensive than the brand-name Estrace.

Key Similarities and Differences

In summary, the main similarities between Estrace and estradiol are that they are both forms of the hormone estrogen and are used for similar medical indications. The key difference is that Estrace is a brand-name drug, while estradiol is the generic, active ingredient. The two may be used interchangeably, but the specific formulation, dosage, and costs may vary.

It’s important for patients to discuss the options with their healthcare provider to determine the most appropriate treatment based on their individual needs and medical history.

Are Estrace and Estradiol the Same?

No, Estrace and estradiol are not exactly the same. Estrace is a brand-name drug that contains the active ingredient estradiol, which is a synthetic version of the naturally occurring estrogen hormone. While they are closely related, they are not identical.

Can Estrace and Estradiol be Used Interchangeably?

Yes, in many cases Estrace and estradiol can be used interchangeably. Since Estrace contains the active ingredient estradiol, the two can often be substituted for one another under the guidance of a healthcare provider. However, the specific formulation, dosage, and cost may vary between the brand-name Estrace and the generic estradiol.

What are the Key Differences Between Estrace and Estradiol?

The main differences between Estrace and estradiol are:
– Estrace is a brand-name drug, while estradiol is the generic, active ingredient
– Estrace is available only as an oral tablet, while estradiol can be administered in various formulations (oral, transdermal, vaginal)
– The cost of Estrace is generally higher than generic estradiol
– The specific dosage and administration may vary slightly between the two
– Estrace and estradiol may have slightly different inactive ingredients or excipients

Overall, Estrace and estradiol are very closely related and can often be used interchangeably, but there may be some minor differences in terms of formulation, cost, and specific usage instructions.

Estrace vs Estradiol Comparison – Drugs.com

Estrace vs Estradiol Comparison – Drugs.com
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</p> <p> Estrace may also be used for purposes not listed in this comparison guide. </p> ”>
Prescription only

Prescribed for Atrophic Vaginitis, Atrophic Urethritis, Postmenopausal Symptoms, Breast Cancer – Palliative, Hypoestrogenism, Oophorectomy, Primary Ovarian Failure, Prostate Cancer. Estrace may also…
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Its use is associated with an increased risk of endometrial and breast cancer and cardiovascular disease. The ACP no longer recommends estrogens for the treatment of postmenopausal osteoporosis.</p> <p> Prescribed for Atrophic Vaginitis, Gender Affirming Hormone Therapy , Atrophic Urethritis, Postmenopausal Symptoms, Breast Cancer – Palliative, Hypoestrogenism, Oophorectomy, Primary Ovarian Failure, Prevention of Osteoporosis, Prostate Cancer. </p> <p> May also be prescribed off label for Gender Dysphoria. </p> ”>
Prescription only

Estradiol is a synthetic form of estrogen that may be given for several different indications, including the relief of menopausal symptoms or low estrogen levels caused by other conditions. Its use…
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Postmenopausal Symptoms

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Atrophic Vaginitis

  • Estrace Vaginal Cream
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Prostate Cancer

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Oophorectomy

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More about
Estrace
(estradiol)

More about
Estradiol

Generic Status

Lower-cost generic is available

Lower-cost generic is available

Ratings & Reviews

Estrace has an average rating of
7. 4 out of 10 from a total of
12 ratings on Drugs.com.
64% of reviewers reported a positive effect, while 18% reported a negative effect.

Estradiol has an average rating of
5.6 out of 10 from a total of
553 ratings on Drugs.com.
45% of reviewers reported a positive effect, while 41% reported a negative effect.

View all 12 reviews

View all 553 reviews

Drug Class
  • Estrogens
  • Estrogens
Side Effects

See also: Estrace side effects in more detail.

Commonly reported side effects include:

  • cerebrovascular accident
  • infection
  • malignant neoplasm of breast
  • endometrium disease
  • headache
  • mastalgia

See also: estradiol side effects in more detail.

Pricing and Coupons
* Prices are without insurance
Quantity100 tablet
Dosage1 mg
Per Unit*$5.83
Cost*$583.49

View all
Estrace prices and generic prices

Quantity30 tablet
Dosage1 mg
Per Unit*$0. 52
Cost*$15.73

View all
estradiol prices

Get free Discount Card

Get free Discount Card

Dosage Form(s) Available
  • Oral tablet
  • Intramuscular solution
  • Oral tablet
  • Transdermal gel
Half Life
The half-life of a drug is the time taken for the plasma concentration of a drug to reduce to half its original value.

16 hours

16 hours

CSA Schedule **
View glossary of terms

Is not subject to the Controlled Substances Act.

Is not subject to the Controlled Substances Act.

Pregnancy Category

See the full pregnancy warnings document.

See the full pregnancy warnings document.

Drug Interactions

A total of 325 drugs are known to interact with Estrace:

  • 13 major drug interactions (30 brand and generic names)
  • 293 moderate drug interactions (1065 brand and generic names)
  • 19 minor drug interactions (83 brand and generic names)

A total of 325 drugs are known to interact with estradiol:

  • 13 major drug interactions (30 brand and generic names)
  • 293 moderate drug interactions (1065 brand and generic names)
  • 19 minor drug interactions (83 brand and generic names)
Alcohol/Food/Lifestyle Interactions

No known alcohol/food interactions. This does not necessarily mean no interactions exist. Always consult your healthcare provider.

No known alcohol/food interactions. This does not necessarily mean no interactions exist. Always consult your healthcare provider.

Disease Interactions
  • Abnormal vaginal bleeding
  • Carcinomas (estrogenic)
  • Hypercalcemia in breast cancer
  • Hypertension
  • Thromboembolism/cardiovascular
  • Hepatic neoplasms
  • Angioedema
  • Gallbladder disease
  • Hypercalcemia
  • Hyperlipidemia
  • Liver disease
  • Melasma
  • Depression
  • Fluid retention
  • Glucose intolerance
  • Retinal thrombosis
  • Thyroid function tests
  • Abnormal vaginal bleeding
  • Carcinomas (estrogenic)
  • Hypercalcemia in breast cancer
  • Hypertension
  • Thromboembolism/cardiovascular
  • Hepatic neoplasms
  • Angioedema
  • Gallbladder disease
  • Hypercalcemia
  • Hyperlipidemia
  • Liver disease
  • Melasma
  • Depression
  • Fluid retention
  • Glucose intolerance
  • Retinal thrombosis
  • Thyroid function tests
First Approval Date

July 23, 1975

July 23, 1975

WADA Class
View World Anti-Doping Agency classifications.

N/A

N/A

More Information
  • Side effects
  • Pregnancy warnings
  • Breastfeeding warnings
  • Dosage information
  • Drug images
  • Drug interactions
  • Support group
  • Pricing and coupons
  • En Español
  • Side effects
  • Pregnancy warnings
  • Breastfeeding warnings
  • Dosage information
  • Drug images
  • Drug interactions
  • Support group
  • Pricing and coupons
Patient resources
  • Overview
  • Overview
  • Advanced reading
Professional Resources
  • Prescribing information
  • Monograph (AHFS)
  • Prescribing information

** The Controlled Substances Act (CSA) schedule information displayed applies to substances regulated under federal law. There may be variations in CSA schedules between individual states.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

If you experience menopausal symptoms, such as hot flashes, night sweats, sleep problems, and vaginal dryness, your healthcare provider might have mentioned hormone replacement therapy or estrogen therapy. Menopause symptoms occur when the body makes less estrogen, so medications that replace estrogen can help improve these symptoms, and also help prevent osteoporosis.

In women with a uterus, hormone therapy includes both estrogen and progesterone. In women with a uterus, estrogen alone increases the risk for endometrial cancer.

Women without a uterus (who have had a hysterectomy) do not need to take progesterone with estrogen. These women can use estrogen-only products such as Estrace or Premarin.

Estrace and Premarin are two brand-name medications indicated for the treatment of menopause symptoms. Both drugs are approved by the United States Food and Drug Administration (FDA). They are in a class of medications called estrogens and are also known as hormone replacement therapy. They are available in a variety of formulations, including creams and tablets. Although both Estrace and Premarin contain estrogen, they are not exactly the same. Continue reading to learn more about Estrace and Premarin.

What are the main differences between Estrace and Premarin?

Estrace is available in brand and generic form and contains the ingredient estradiol. Estrace is available as a vaginal estrogen cream, and also as an oral tablet.

Premarin is available as a brand-name drug only. It contains conjugated estrogens, purified from pregnant mares’ urine (hence the name Premarin- PREgnant MARes urINe). Premarin is available as a vaginal estrogen cream, oral tablet, or injection.

Conditions treated by Estrace and Premarin

Estrace cream and Premarin cream treat moderate to severe symptoms of vaginal and vulvar atrophy (thinning, drying, and inflammation) due to menopause.

In the tablet form, Estrace and Premarin treat various other conditions listed in the chart below.

Is Estrace or Premarin more effective?

Studies show that when comparing estrogen products, estradiol (the ingredient in Estrace) and conjugated estrogens (the ingredient in Premarin) are equally effective in treating menopause symptoms. Vaginal creams are effective and well-tolerated.

Your healthcare provider can determine which medication is appropriate for you, considering your symptoms, medical conditions, and medical history.

Coverage and cost comparison of Estrace vs. Premarin

Insurance and Medicare prescription plans typically cover Estrace and Premarin.

A typical generic Estrace prescription is for a tube of cream and costs about $36 if you pay out of pocket, but using a free SingleCare coupon can bring the price down to as little as $6.

A typical prescription for a tube Premarin costs about $250 out-of-pocket. A SingleCare card can bring the price down to as low as $198.

As plans vary, contact your insurance provider for coverage details.

Common side effects of Estrace vs. Premarin

The most common side effects of Estrace and Premarin cream include application site reactions like itching, discharge, uterine bleeding, and inflammation. Additionally, headache and pelvic pain may occur. The percentage of side effects is not included in the prescribing information for Estrace.

Common side effects of Estrace and Premarin in the tablet form are more systemic. Some of these side effects include abdominal or back pain, weakness, swelling, headache, constipation, gas, nausea, weight gain, depression, nervousness, dizziness, breast tenderness/pain/changes, and vaginal discharge, bleeding, or yeast infection.

This is not a full list of side effects.  Other adverse effects may occur. Consult your healthcare provider to discuss what side effects to expect, and how to address them.

*depends on dosage frequency
Source: DailyMed (Estrace cream), DailyMed (Premarin cream)

Drug interactions of Estrace vs. Premarin

Estrace or Premarin may be affected by certain drugs that are metabolized by an enzyme called cytochrome-p 450 3A4. Drugs that inhibit the enzyme may slow down the body’s processing of Estrace or Premarin, meaning Estrace or Premarin might stay in the body longer, causing more side effects. Also, drugs that induce the enzyme may cause the body to process Estrace or Premarin more quickly, making it less effective. Consult your healthcare provider regarding possible drug interactions.

Warnings of Estrace and Premarin

Estrace and Premarin have a boxed warning, which is the strongest warning required by the FDA. Because systemic absorption can occur with Estrace or Premarin cream, the warnings apply to all formulations.

Estrogen alone:

  • Using estrogen alone (without a progestin) in a woman with a uterus increases the risk of endometrial cancer. Adding progestin to estrogen treatment can lower the risk of endometrial cancer (but can increase the risk of breast cancer). Postmenopausal women with abnormal bleeding should be tested to rule out malignancy.
  • Do not use estrogen alone to prevent heart disease or dementia. The Women’s Health Initiative (WHI) study found an increased risk of stroke and DVT (deep vein thrombosis, or a blood clot in the leg) in postmenopausal women who took estrogen alone (without progestin).
  • The study also showed an increased risk of dementia in postmenopausal women who took estrogen alone.

Estrogen plus progestin:

  • Do not use estrogen plus progestin to prevent heart disease or dementia. The WHI study found higher risks of DVT, PE (pulmonary embolism), stroke, and MI in postmenopausal women who took estrogen plus progestin. The study also showed a higher risk of developing dementia in postmenopausal women who took estrogen plus progestins.
  • The WHI study also showed an increased risk of invasive breast cancer with estrogen plus progestin.

Therefore, estrogens, regardless of whether they are prescribed with or without progestins, should be prescribed at the lowest dose and for the shortest period of time. Talk with your healthcare provider about the risks vs benefits of various types of hormone replacement therapy.

Your doctor will give you medical advice on screening. All women should have a yearly breast exam by a healthcare professional and do a monthly self-exam. All women should also have mammography based on age, risk factors, and history.

Other warnings of Estrace and Premarin follow.

Do not use Estrace or Premarin if you have:

  • Undiagnosed abnormal bleeding
  • Breast cancer (known, suspected, or history)
  • Estrogen-dependent neoplasia (known or suspected)
  • DVT or pulmonary embolism (active or history)
  • Active or history of thromboembolic disease (stroke, MI)
  • Previous anaphylactic reaction to estrogen
  • Liver disease
  • Thrombophilic disorders
  • Pregnancy (known or suspected)

Combination hormone therapy (estrogen plus progestin) may increase the risk of ovarian cancer.

Postmenopausal women who take estrogen have an increase in the risk of gallbladder disease requiring surgery.

In people who take estrogens, visual problems have occurred. Seek immediate medical treatment if you have loss of vision (partial or complete), double vision, eye bulging, or migraine.

In rare cases, allergic reactions have occurred. If you have hives, itching, difficulty breathing, vomiting, or swelling of the face, lips, tongue, hands, or feet, seek emergency medical care right away. Estrogen medication may worsen angioedema symptoms in women with hereditary angioedema.

Talk to your healthcare provider about these risks before taking Estrace or Premarin, to see if the medicine is safe for you.

Frequently asked questions about Estrace vs. Premarin

What is Estrace?

Estrace is a hormone replacement medication that contains estradiol. It is used for a variety of indications, most often for symptoms of menopause. Estrace is available as an intravaginal cream as well as an oral tablet.

What is Premarin?

Premarin is also a hormone replacement drug. Premarin contains conjugated estrogens. It is used for several indications, most often for menopause symptoms. Premarin is available as an oral tablet, intravaginal cream, and injection.

Are Estrace and Premarin the same?

Estrace and Premarin are similar, but not exactly the same. The information above outlines the differences between the two medications.

Is Estrace or Premarin better?

Both medications are effective in treating menopause symptoms, however, these drugs do come with side effects and risks. Talk with your healthcare provider to determine if Estrace or Premarin is appropriate for you.

Can I use Estrace or Premarin while pregnant?

No. Neither medication should be used in pregnancy.

Can I use Estrace or Premarin with alcohol?

Drinking alcohol in combination with Estrace or Premarin can increase your risk for breast cancer. Consult your healthcare professional for guidance on alcohol use with any medical conditions you have.

What is the best alternative to Premarin?

Estrace is a similar alternative to Premarin. Other medications containing estrogen include the Vivelle Dot Patch, Climara Patch, or vaginal estrogen in the form of Vagifem vaginal tablets (vaginal tablets applied with a vaginal applicator) or Estring Vaginal Ring. Talk to your healthcare provider to see if one of these medications is appropriate for you.

Are estrogen and estradiol the same thing?

Estradiol is a form of estrogen, a female hormone. All estradiol products are estrogen. However, there are other forms of estrogen than just estradiol. For example, conjugated estrogens (Premarin) is another form of estrogen.

Does Premarin cause dementia?

Premarin (and Estrace) has a boxed warning about dementia. The WHI Memory Study mentioned above found an increased risk of developing dementia in postmenopausal women who took estrogen alone or estrogen with a progestin. Therefore, the prescribing information recommends that estrogen, whether taken alone or with progestin, should be prescribed at the lowest dose and for the shortest time.

Does Estrace increase estrogen levels?

Estrace (and Premarin) increase estrogen levels. Even in the vaginal form, there is systemic absorption, and estrogen levels increase. Your healthcare provider can determine which product is most appropriate for you.

Estradiol

Estradiol is an estrogenic steroid hormone produced in the ovaries, placenta, adrenal cortex, peripheral tissues and testes in men. It plays an important role in the proper formation and functioning of the reproductive system.

Synonyms Russian

E2.

Synonyms English

Estradiol, 17-beta-estradiol, E2.

Test method

Electrochemiluminescent immunoassay (ECLIA).

Detection range: 5 – 30000 pg/ml.

Units

Pg/mL (picograms per milliliter).

What biomaterial can be used for research ?

Venous blood.

How to properly prepare for an examination?

  1. Do not eat for 2-3 hours before the examination, you can drink pure non-carbonated water.
  2. Stop taking steroid and thyroid hormones 48 hours before the study (as agreed with the doctor).
  3. Exclude physical and emotional overexertion within 24 hours prior to the study.
  4. Do not smoke 3 hours before the study.

General information about the study

Estradiol belongs to the group of estrogenic steroid hormones and is one of the most common and active of them. It plays an important role in the regulation of the menstrual cycle and the functioning of the female reproductive system.

Estradiol is responsible for the development of female genital organs and secondary sexual characteristics and affects the menstrual cycle and pregnancy. It is considered the main sex hormone in women and is present in small amounts in men. It is one of the main estrogens in non-pregnant women.

It is produced mainly in the ovaries, but also additionally in the adrenal glands in women and in the testicles and adrenal glands in men.

In women during the menstrual cycle, the level of estradiol changes during the month, rising and falling in concert with the stimulation of ovarian follicles by follicle-stimulating hormone, luteinizing hormone and progesterone, during the release of the egg and the readiness of the uterus for potential pregnancy. Estradiol levels are lowest at the beginning of the menstrual cycle, and rise to their highest levels just as the release of an egg from the ovary (ovulation). A normal level of estradiol allows for proper ovulation, egg fertilization and pregnancy, as well as healthy bone structure and normal cholesterol levels.

What is research used for?

  • Estradiol levels are used to evaluate ovarian function.
  • For the diagnosis of early (premature) puberty in girls and gynecomastia in men.
  • To identify causes of amenorrhea (for example, to determine if it is due to pregnancy or disease).
  • To control the development of the follicle in the ovary in the days preceding in vitro fertilization (in assisted reproductive technologies).

When is the test ordered?

  • Women with pelvic pain, abnormal vaginal bleeding, menstrual irregularities, infertility, or when genital development occurs earlier or later than expected.
  • For menopausal symptoms: hot flashes, night sweats, insomnia and/or amenorrhea.
  • If a woman has problems conceiving (to control the degree of growth of a particular follicle and subsequent in vitro fertilization).
  • For symptoms of feminization in men, such as gynecomastia, which may be caused by an estrogen-secreting tumor.

What do the results mean?

Reference values ​​

Cycle phase, pregnancy

Estradiol, pg /m L

Women

Folliculin

12. 4 – 233

Ovulatory

41 – 398

Luteal

22.3 – 341

Postmenopausal

1st trimester

154 – 3243

2nd trimester

1561 – 21280

3rd trimester

8525 – 30000

Men

11.26 – 43.25

Care must be taken when interpreting the results because the concentration of estradiol changes every day during the menstrual cycle. A doctor who monitors a woman’s hormone levels should take into account trends in its changes, increase or decrease in connection with the menstrual cycle or pregnancy, and not evaluate individual values. The results of the analysis are not specific, but give the doctor additional information about the possible cause of the development of certain symptoms in the patient.

Causes of a decrease in the level of estradiol

  • Shereshevsky-Turner syndrome is a chromosomal disease accompanied by anomalies in physical development, short stature and sexual infantilism.
  • Hypopituitarism (Simmonds’ disease, Shien’s syndrome) – a decrease in the concentration of circulating pituitary hormones with the subsequent development of hypofunction and atrophy of the adrenal glands, thyroid and gonads.
  • Hypogonadism is a decrease in the function of the ovaries due to their congenital underdevelopment or damage in infancy.
  • Anorexia nervosa, manifested in women by amenorrhea.
  • Polycystic ovary syndrome (Stein-Leventhal syndrome) is a polyendocrine syndrome accompanied by dysfunction of the ovaries (absence or irregularity of ovulation, increased secretion of androgens and estrogens), pancreas, adrenal cortex, hypothalamus and pituitary gland.
  • Extreme endurance exercise.
  • Postmenopausal.

Causes of increased estradiol levels

  • Early puberty.
  • Gynecomastia is a benign breast enlargement in men with hypertrophy of adipose tissue.
  • Tumors of the ovaries, testicles or adrenal glands.
  • Hyperthyroidism is an increase in the conversion of androgens to estrogens in tissues and an increase in the level of circulating sex hormone-binding globulin, which causes an increase in the ratio of estrogens to androgens.
  • Cirrhosis of the liver.

What can influence the result?

  • Glucocorticosteroids, ampicillin, estrogen-containing drugs, phenothiazines, tetracyclines can increase the level of estradiol.
  • Ingestion of the herb cascara sagrada sometimes results in falsely high results in this test.
  • A diet high in carbohydrates and low in fat, like that of vegetarians, may lower estradiol levels.

Important notes

  • Estradiol analysis is an important part of the complex diagnosis of diseases and is not used as an independent study for diagnosis.

Also recommended

  • Follicle stimulating hormone (FSH)
  • Luteinizing hormone (LH)
  • Progesterone
  • Testosterone
  • Sex hormone-binding globulin (SHBG)

Who orders the examination?

Gynecologist, endocrinologist, reproductive specialist, internist, oncologist.

The effect of estradiol on the body: the main functions of the sex hormone

Estradiol is a hormone produced by the ovaries, adrenal glands, and placenta during pregnancy. Estradiol is the most important female hormone, essential for reproductive and sexual function, and also affects the health of other organs and tissues. In addition, it plays an essential role in the male body.

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What is estradiol

Estradiol is an estrogenic steroid sex hormone vital for maintaining fertility and is responsible for the development and function of the reproductive organs and the formation of secondary sexual characteristics in women. This is the main representative of estrogens, which has the highest biological activity.

Along with the hormone progesterone, they help regulate the menstrual cycle, are involved in breast and uterine growth, and help maintain a healthy pregnancy. Although estradiol is considered the primary sex hormone for women, it is also found in men and plays a role in metabolism and bone growth in both sexes.

In addition, the functions of estradiol are to regulate male libido, erectile function and spermatogenesis. Estrogen receptors, as well as aromatase, the enzyme that converts testosterone to estrogen, are abundant in the brain, penis, and testicles.

Estradiol levels vary with a woman’s age and reproductive status, being a good marker of ovarian function.

Effects on the female body

Estradiol plays a crucial role in regulating the menstrual and sexual cycles. It is involved in the formation of female sexual characteristics, in particular, in the expansion of the hips, the distribution of fat in a special female pattern, breast enlargement. It contributes to the protection of reproductive tissues (mammary glands, vagina, uterus).

Its amount is unstable and constantly changing: when the ovaries are stimulated by FSH, LH and progesterone, when the egg passes through the fallopian tubes and while the uterus is preparing for conception.

Fluctuations in the daily amount of estradiol are associated with the rhythm of LH excretion. The peak of activity falls on 15-18 hours, and the decrease is observed from midnight to 14 hours.

In childbearing age, the level of this hormone is different in each phase of the cycle. The concentration of estradiol rises and becomes maximum at ovulation. After the release of the egg, its quantity immediately decreases and grows again, but with less intensity. The final decline occurs at the end of the existence of the corpus luteum.

Low levels of estradiol are characteristic of the onset of the menstrual cycle, while elevated levels are typical of ovulation, when the egg leaves the ovary and travels to the sperm.

Adequate ovulation and successful conception are not possible without estradiol. During pregnancy, this hormone is just as important as progesterone, it is also responsible for maintaining childbearing.

Functions of estradiol in the female body:

  • proper functioning of the reproductive system;

  • proper formation of organs;

  • determination of the type of female figure;

  • the formation of the endometrium in the uterus;

  • help in muscle development;

  • regulation of blood flow in the uterus;

  • normalization of cholesterol levels;

  • replenishment of energy reserves;

  • strengthening of blood vessels inside the uterus;

  • strengthening of the bone structure;

  • maintaining tone;

  • accumulation of fat on the abdomen, thighs, etc.

In addition, a number of researchers believe that estradiol is able to protect against neurodegeneration.

Estradiol in the male body

Recent studies have shown that estradiol is important for spermatogenesis, libido and sexual function in general.

Estrogen receptors, as well as aromatase, the enzyme that converts testosterone to estrogen, are abundant in the brain, penis, and testicles, organs important for sexual function. In the brain, estradiol synthesis is increased in areas associated with sexual arousal. In addition, in the penis, estrogen receptors are found throughout the cavernous body with a high concentration around the neurovascular bundles.

Low testosterone and elevated estrogen increase the incidence of erectile dysfunction independently. In the testes, spermatogenesis is modulated at all levels by estrogen. The regulation of testicular cells by estradiol exhibits both inhibitory and stimulatory effects.

Scientists agree that the balance of hormones, namely testosterone, estradiol and progesterone in the male body, is a prerequisite for sexual health and proper reproductive function.

In addition, estrogens, together with testosterone, model the sexual appetite and behavior of men. As in women, estrogen in men provides hydration and maintenance of skin turgor, and also regulates the formation of collagen, which affects skin elasticity and hair growth.

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Effect of estrogens on the skin

Our skin is made up of three important layers. The most superficial of them, the epidermis, is responsible for the pigment of the skin, provides protection and retains moisture. The layer below the epidermis, the dermis, contains hair follicles, nerves, blood vessels, sweat glands, collagen, and elastin (which is needed to stretch tissues). Beneath the dermis, the subcutaneous layer is composed of loose connective tissue and fat.

Hormones have a significant effect on skin thickness, as evidenced by skin changes that occur during the menstrual cycle. So, at the beginning of the menstrual cycle, the thickness of the skin is minimal – at this time, the level of estrogen is the lowest. It thickens as hormone levels rise.

With age, the thickness of the epidermis and the concentration of melanocytes (pigment-producing cells) decrease. In the dermis, the activity of fibroblasts, the content of collagen and hyaluronic acid decrease with age. These changes, combined with an increase in metalloproteinases (proteins that break down collagen), contribute to thinning of the skin.

Lifestyle can also accelerate skin aging. Smoking and UV exposure release inflammatory proteins that damage the skin by altering blood vessels and destroying collagen.

During menopause, when estradiol levels decrease, skin thickness decreases by more than 1% each year for the first five years, while collagen decreases by 2% annually. Wrinkles occur due to loss of elasticity due to loss of connective tissue, which decreases by 1.5% annually.

The norm of estradiol in the blood

In the female body, estradiol is synthesized in the ovaries, in the cells of the membrane and in the granulosa of the follicles. In the luteal phase of the menstrual cycle, it is produced exclusively by the cells of the follicle membrane, while the granulosa cells are luteinized and proceed to the synthesis of progesterone.

At the beginning of pregnancy, massive production of estrogen is carried out by the placenta. In other periods of life, especially in postmenopause, the adrenal cortex and peripheral adipose tissue are involved for this.

Determining the concentration of estradiol is necessary mainly to assess ovarian function.

Reference values ​​(norm) of estradiol concentration in blood serum

Age Estradiol, pg/ml
Children under 11 <15
The norm of estradiol in women (follicular phase) 20–350
Ovulation phase 150-750
luteal phase 30–450
Menopause <20
Men 10-50

The level of estradiol remains low at the beginning and middle of the follicular phase of the menstrual cycle. 3-5 days before the LH surge, estradiol levels begin to rise and peak about 12 hours before the LH surge.

After a sharp drop to the lowest values ​​observed 48 hours after the LH surge, estradiol levels begin to rise again (biphasic progression). The maximum concentration is reached at 9day after ovulation, then at the end of the cycle, the concentration of the hormone decreases again with atrophy of the corpus luteum.

Signs and Causes of Low Hormone Levels

Estradiol is called the hormone of femininity, since any changes in voice, figure, development of sexual characteristics indicate a lack of this hormone. For low estradiol in women, the following symptoms are characteristic:

  • anxiety;

  • fatigue regardless of the length of rest;

  • swelling;

  • fragility of nails and hair;

  • menstrual irregularities;

  • periodic dull pain in the chest;

  • premenstrual syndrome;

  • dryness and burning in the vagina;

  • low sex drive;

  • apathy;

  • migraine;

  • fluctuations in blood pressure;

  • rapid change in body weight.

Symptoms of a decrease in estradiol in the blood of a man are osteoporosis, cardiovascular disease, irritability, irascibility, and problems with conceiving a child.

The reasons for men and women lie in bad habits, in particular, in alcoholism and smoking, insufficient consumption of protein foods. An improperly balanced diet, in which the amount of carbohydrates predominates and the amount of fat is reduced, can also cause a violation.

More serious problems are a sharp weight loss, malfunctions of the endocrine system, inflammation in the genital organs, malfunctions of the pituitary gland.

In men, the most common cause is high physical activity, which leads to rapid fatigue and a sharp burning of subcutaneous fat.

Danger of low estradiol

The follicular system of the ovaries and placenta is responsible for the secretion of estradiol in women. In men, it is emitted by the testicles. The adrenal cortex and adipose tissue, with the participation of the aromatase enzyme, produce this hormone in both sexes. The traditional view of the division of hormones into two groups, namely exclusively “male” (androgens) and “female” (estrogen and progesterone) is wrong. All sex hormones are steroidal in nature.

In women, a lack of estradiol is observed during menopause or after it, which is considered a completely natural process. However, if the level of this hormone is low in women of reproductive age, this may be the first sign of a problem that needs to be addressed in order to maintain reproductive health.

In some cases, low estradiol levels can be a sign of a variety of medical conditions. For example, these:

  • Hypogonadism. These are malfunctions in the work of the genital organs and mammary glands in women, provoking their atrophy.

  • Pituitary dwarfism or human growth hormone deficiency. It is manifested by a delay in linear growth (dwarfism) and physical development caused by poor functioning of the pituitary gland and insufficient production of hormones.

  • Turner syndrome. This disease is genetic in nature and is caused by a structural disorder of the X chromosome. Accompanied by pathology in the development of internal organs and short stature.

  • Inflammation of the genitals. With insufficient production of estradiol, the reproductive system is not able to work correctly.

How to raise estradiol in women? There is no universal answer – to solve the problem, be sure to consult a doctor.

Signs and causes of elevated hormone levels

In women, its level rises, as a rule, against the background of a follicular ovarian cyst, endometriosis, cirrhosis of the liver and obesity.

Elevated estradiol in women and men is accompanied by such signs:

High estradiol in men is often associated with low libido, heart and vascular disease, benign or malignant tumors of the prostate.

In addition, representatives of both sexes observe edema, gastrointestinal disorders, mood swings, sweating, poor sleep and anxiety. These signs can indicate many diseases. To determine the true cause of health problems, a thorough medical examination is necessary.

The following factors can increase the level of estradiol in both sexes:

If you suspect that you have insufficient or, conversely, elevated levels of estradiol, do not self-medicate, as you can only harm your health. Consult your doctor for appropriate treatment.

Application of estradiol

The artificial hormone is used to combat the symptoms of menopause, such as hot flashes and vaginal dryness, burning, thinning hair, night sweats, and chills.

Also, synthetic estradiol is used to prevent osteoporosis in postmenopausal women and for estrogen replacement therapy in patients with ovarian dysfunction or other diseases that lead to endogenous estrogen deficiency.

This hormone may also be part of cancer therapy in men and women.

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Estradiol and longevity

Aging is associated with the loss of sex hormones in both men (andropause) and women (menopause). In men, a decrease in testosterone can cause a decrease in muscle mass, bone mass, and physical function. In women, the effect of loss of sex hormones such as estradiol on bone is well understood, but data on whether loss of estradiol adversely affects muscle mass and physical function is limited.

However, deficiencies in several anabolic hormones have been shown to predetermine the health and longevity of the elderly. Scientists suggest that hormone replacement therapy may be effective in treating, for example, age-related sarcopenia or acute or chronic diseases.

Correct and timely HRT in men and women can prevent and reverse muscle and bone loss and possibly promote healthy aging and longevity.

Summary

  • Estradiol is a steroid sex hormone vital for maintaining female fertility.

  • It also plays an important role in male sexual function.

  • Low or high levels of estradiol can be associated with various medical conditions.

  • The artificial hormone is used to combat menopausal symptoms, prevent osteoporosis, and treat cancer.

  • There may be a link between estradiol balance and quality longevity.

References

  • Alessandro Villa, ElisabettaVegeto, Angelo Poletti, and Adriana Maggi Estrogens, Neuroinflammation, and Neurodegeneration.Endocr Rev. 2016 Aug; 37(4).
  • Anne Mette Lund Würtz, Anne Tjønneland, Jane Christensen, Lars Ove Dragsted, Julie Aarestrup, CecilieKyrø, Kim Overvad, Anja OlsenSerum estrogen and SHBG levels and breast cancer incidence among users and never users of hormone replacement therapy Cancer Causes Control 2012 Oct;23( 10).
  • Franck Mauvais-Jarvis, Deborah J. Clegg, and Andrea L. HevenerThe Role of Estrogens in Control of Energy Balance and Glucose Homeostasis. Endocr Rev. Jun 2013; 34(3).
  • HadineJoffe, Anouk de Wit, Jamie Coborn, Sybil Crawford, Marlene Freeman, Aleta Wiley, GeenaAthappilly, Semmie Kim, Kathryn A Sullivan, Lee S Cohen, Janet E Hall Impact of Estradiol Variability and Progesterone on Mood in Perimenopausal Women With Depressive Symptoms.J ClinEndocrinolMetab 2020 Mar 1;105(3).
  • Raghava, N., et al. (2017). Neuroprotective effects of estrogen in CNS injuries: insights from animal models. Neuroscience and Neuroeconomics. doi:10.2147/NAN.S105134
  • Gilbreath, E. T., et al. (2014). Chronic exposures to low levels of estradiol and their effects on the ovaries and reproductive hormones: Comparison with aging. Endocrine Disruptors (Austin, Tex.). doi:10.4161/23273739.2014.967127
  • Satoh T, et al. (2004) Studies on the interactions between drugs and estrogen.