Estradiol Topical

Estradiol increases the risk that you will develop endometrial cancer (cancer of the lining of the uterus [womb]). The longer you use estradiol, the greater the risk that you will develop endometrial cancer. If you have not had a hysterectomy (surgery to remove the uterus), you should be given another medication called a progestin to take with topical estradiol. This may decrease your risk of developing endometrial cancer but may increase your risk of developing certain other health problems, including breast cancer. Before you begin using topical estradiol, tell your doctor if you have or have ever had cancer and if you have abnormal or unusual vaginal bleeding. Call your doctor immediately if you have abnormal or unusual vaginal bleeding during your treatment with topical estradiol. Your doctor will watch you closely to help ensure you do not develop endometrial cancer during or after your treatment.

In a large study, women who took estrogens (a group of medications that includes estradiol) by mouth with progestins had a higher risk of heart attacks, strokes, blood clots in the lungs or legs, breast cancer, and dementia (loss of ability to think, learn, and understand). Women who use topical estradiol alone or with progestins may also have a higher risk of developing these conditions. Tell your doctor if you smoke or use tobacco, if you have had a heart attack or a stroke and if you or anyone in your family has or has ever had blood clots or breast cancer. Also tell your doctor if you have or have ever had high blood pressure, high blood levels of cholesterol or fats, diabetes, heart disease, lupus (a condition in which the body attacks its own tissues causing damage and swelling), breast lumps, or an abnormal mammogram (x-ray of the breast used to find breast cancer).

The following symptoms can be signs of the serious health conditions listed above. Call your doctor immediately if you experience any of the following symptoms while you are using topical estradiol: sudden, severe headache; sudden, severe vomiting; speech problems; dizziness or faintness; sudden complete or partial loss of vision;double vision; weakness or numbness of an arm or a leg; crushing chest pain or chest heaviness; coughing up blood; sudden shortness of breath; breast lumps or other breast changes; discharge from nipples; difficulty thinking clearly, remembering, or learning new things; or pain, tenderness, or redness in one leg.

You can take steps to decrease the risk that you will develop a serious health problem while you are using topical estradiol. Do not use topical estradiol alone or with a progestin to prevent heart disease, heart attacks, or strokes. Use the lowest dose of topical estradiol that controls your symptoms and only use topical estradiol as long as needed. Talk to your doctor every 3-6 months to decide if you should use a lower dose of topical estradiol or should stop using the medication.

You should examine your breasts every month and have a mammogram and a breast exam performed by a doctor every year to help detect breast cancer as early as possible. Your doctor will tell you how to properly examine your breasts and whether you should have these exams more often than once a year because of your personal or family medical history.

Tell your doctor if you are having surgery or will be on bedrest. Your doctor may tell you to stop using topical estradiol 4-6 weeks before the surgery or bedrest to decrease the risk that you will develop blood clots.

Americans see their primary care doctors less often than they did a decade ago. Adults under 65 made nearly 25% fewer visits to primary care providers in 2016 than they did in 2018, according to National Public Radio. In the same time period, the number of adults who went at least a year without visiting a primary care provider increased from 38% to 46%.

Talk to your doctor regularly about the risks and benefits of using topical estradiol.

🔔 Why is this medication prescribed?

Estradiol topical gel and spray are used to treat and prevent hot flushes (hot flashes; sudden strong feelings of heat and sweating) in women who are experiencing menopause (change of life; the end of monthly menstrual periods). Estradiol topical gel is also used to treat vaginal dryness, itching, and burning in women who are experiencing menopause. However, women whose only bothersome symptoms are vaginal burning, itching, and dryness may benefit more from a medication that is applied topically to the vagina. Estradiol is in a class of medications called estrogen hormones. It works by replacing estrogen that is normally produced by the body.

🔔 How should this medicine be used?

Topical estradiol comes as a gel in single dose packets and in a pump that dispenses measured amounts of the medication to apply to the skin once a day. Topical estradiol also comes as a spray to apply to the skin as 1 to 3 sprays once a day in the morning. Estradiol gel may be applied at any time of day, but should be applied at around the same time of day every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use topical estradiol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Topical estradiol products are manufactured differently and are used in slightly different ways. Be sure that you know which topical brand you are using and how and where you should apply it. Read the manufacturer’s instructions for use that came with your topical estradiol product carefully. These instructions describe how to apply topical estradiol gel or spray. Be sure that you understand these directions. Ask your healthcare provider if you have any questions about how to apply this medication.

If you are using estradiol gel in a pump, you should apply it in a thin layer to one arm, from the wrist to the shoulder. If you are using estradiol gel in single dose packets, you should apply it in a thin layer to one thigh, on the front of the thigh. If you are using estradiol, you should apply it to the inner arm. Do not apply estradiol gel or spray to your breasts or your genital area. Be sure that the skin where you will apply topical estradiol is clean and completely dry, and is not red, irritated, or broken.

If you take a bath or a shower, apply topical estradiol after you have dried your skin completely. Read the manufacturer’s patient information about your topical estradiol product for information about when you can wash, shower, bathe, or swim after you apply the medication.

Estradiol gel and spray may catch fire. When you apply topical estradiol, do not smoke or go near a fire or open flame until the medication dries.

Topical estradiol is only for use on the skin. Be careful not to get topical estradiol in your eyes. If you do get topical estradiol in your eyes, wash them with plenty of warm water right away. Call a doctor if your eyes become irritated.

You should apply topical estradiol yourself. If someone else applies the medication to your skin, they should wear disposable gloves and wash their hands well with soap and water after removing the gloves.

Talk to you doctor about applying other skin preparations, including sunscreen, to skin where topical estradiol gel or spray is applied.

Estradiol topical may control your symptoms but will not cure your condition. Continue to use estradiol topical even if you feel well. Do not stop using estradiol topical without talking to your doctor. If you stop using estradiol topical, your symptoms may return.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.