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Average number of moderate-to-severe hot flashes per week with placebo and different doses of oral estradiol in menopausal women [40] [41]. Estradiol is used in menopausal hormone therapy to prevent and treat moderate to severe menopausal symptoms such as hot flashes, vaginal dryness and atrophy, and osteoporosis (bone loss). [11]
Vaginal estrogen is a form of estrogen that is delivered by intravaginal administration. Vaginally administered estrogens are thereby exerting their effects mainly in the nearby tissue, with more limited systemic effects compared to orally administered estrogens. [ 1 ]
[186] [10] Vaginal estradiol can be used both as a systemic form of estradiol therapy, and at very low doses to selectively achieve a local vaginal effect without systemic effects, for instance in the treatment of menopausal symptoms such as vaginal atrophy and dryness. [10] [254] Vaginal estradiol is rapidly and almost completely absorbed. [72]
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. Combined with progestins
Estradiol valerate by intramuscular injection is usually used at a dosage of 10 to 20 mg every 4 weeks in the treatment of menopausal symptoms and hypoestrogenism due to hypogonadism, castration, or primary ovarian failure in women. [13] In the past, it was used at even higher doses of 10 to 40 every 1 to 4 weeks for estrogen replacement. [36]
Vaginal cornification grade is percentage cornification of vaginal epithelial cells and is 1 (+) = 10–25%, 2 (++) = 25–50%, and 3 (+++) = 50–75%. Mean change in vaginal smear test grade with different doses of estradiol pivalate (Estrotate) and estrone (Theelin-In-Oil) in oil solution by intramuscular injection in 10 to 20 women each.