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An estrogen preparation very similar to CEEs but differing in source and composition is esterified estrogens. [1] In 2020, it was the 283rd most commonly prescribed medication in the United States, with more than 1 million prescriptions. [17] [18]
Conjugated estrogens (Premarin) – 25 mg/vial; Estradiol cypionate (Depo-Estradiol, Estradiol Cypionate) – 5 mg/mL (1 mg/mL and 3 mg/mL discontinued) Estradiol valerate (Delestrogen, Estradiol Valerate) – 10 mg/mL, 20 mg/mL, 40 mg/mL; Polyestradiol phosphate (Estradurin) was previously available in the U.S. but was discontinued.
Estrogen helps maintain the endometrial lining of the uterus and help prepare for pregnancy. Research shows higher pregnancy rate if the mother takes estrogen in addition to progesterone. [67] Estradiol is the predominant form of estrogen during reproductive years and is most commonly prescribed. [67]
Therapy can take the form of an estrogen pill, skin patch, ring, gel, cream, or spray, and it usually includes a second hormone, progestogen, which can be either progesterone or a synthetic progestin.
The hormone estriol, produced during pregnancy, is frequently compounded into bioidentical preparations in the United States. While some think it to be a weaker estrogen, with a more limited period of effectiveness than estradiol, it has been demonstrated to be a stronger estrogen in certain ways. [22]
[3] [40] Oral micronized estradiol consists of more than 80% of estradiol particles micronized to a size smaller than 20 μm in diameter, or to about 1 to 3 μm on average. [41] [42] [40] [43] All oral formulations of estradiol available today are micronized, [36] and oral estradiol valerate tablets also seem to be micronized. [44]
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