Estrace vs Estradiol Comparison – Drugs.com

Estrace vs Estradiol Comparison – Drugs.com
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View side-by-side comparisons of medication uses, ratings, cost, side effects and interactions.

</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… View more	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… View more	Related suggestions Postmenopausal Symptoms Premarin Activella Prempro Climara Estradiol Patch Vivelle-Dot Atrophic Vaginitis Estrace Vaginal Cream Vagifem Premarin Vaginal Estradiol topical Estring Yuvafem Prostate Cancer Bicalutamide Casodex Zytiga Lupron Depot Xtandi Erleada Oophorectomy Premarin Vivelle-Dot Estradiol Patch Climara Alora Delestrogen
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
Quantity 100 tablet Dosage 1 mg Per Unit* $5.83 Cost* $583.49 View all Estrace prices and generic prices	Quantity 30 tablet Dosage 1 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 ​​

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.

Estradiol

E2 is a steroid hormone, the most active of estrogens, predominantly determines all stages of the formation and normal functioning of the female body: it ensures the formation of the female reproductive system, the development of female secondary sexual characteristics, the regulation of menstrual function, growth and development of the uterus during pregnancy. E2 has a significant impact on many processes of the body’s functioning: it enhances bone tissue metabolism and accelerates the maturation of skeletal bones, promotes sodium and water retention in the body, lowers total cholesterol and increases the concentration of triglycerides.

In women, E2 is synthesized mainly in the ovaries, to a lesser extent in the reticular zone of the adrenal cortex and during the peripheral conversion of testosterone. In men, E2 is formed in the testes, in the adrenal cortex, but most of it is in peripheral tissues due to the conversion of testosterone, as a result of which the level of E2 rises during puberty.

In women of childbearing age, the level of E2 in serum and plasma depends on the phase of the menstrual cycle, the highest level of the hormone is observed in the follicular phase. During pregnancy, E2 is synthesized by the placenta, the concentration of the hormone in the blood increases by the time of delivery, returns to normal on the 4th day after them. With age, women experience a decrease in the concentration of E2. The concentration of E2 in the blood is subject to a daily rhythm with a maximum from 15 to 18 hours.

Determination of the E2 level is one of the main tests for assessing the reproductive function of women, including examinations for infertility, oligo-, amenorrhea and in the menopausal period, during preparation for IVF. A decrease in E2 levels in the blood of young women is often a manifestation of primary or secondary hypogonadism. A high level of E2 in violation of menstrual function is noted in patients with polycystic ovary syndrome, as well as in the presence of androgen or estrogen-producing tumors.

Indications for examination

• Premenstrual syndrome;
• amenorrhea, oligomenorrhea, anovulation;
• acyclic uterine bleeding;
• puberty disorder, hypogonadism;
• infertility;
• assessment of the functioning of the fetoplacental complex in early pregnancy;
• in IVF: assessment of ovarian status, including follicle development;
• monitoring hormone replacement therapy, antiestrogen therapy;
• osteoporosis in women;
• hirsutism;
• bacterial vaginosis;
• clinical signs of feminization in men.

Increased values ​​

• Follicle persistence;
• ovarian endometrioid cysts, estrogen-secreting tumors;

Reduced values ​​

• Hypergonadotropic hypogonadism (primary), hypogonadotropic (secondary, tertiary)
• pituitary dwarfism;
• hyperprolactinemia;
• virile syndrome;
• threat of termination of pregnancy of endocrine origin;
• taking glucocorticoids, androgens, chemotherapy.