Estriol should be used with caution in: women who have or have had unusual growth of the lining of the womb (endometrial hyperplasia), asthma, circulatory diseases, kidney disease, fitting (epilepsy), gallstones, high blood pressure, migraine headache, diabetes, deafness caused by thickened ear tissue, the rare disease systemic lupus erythematosus (SLE), fibroids (growths) in the womb (uterus), endometriosis (tissue that lines the womb grows in other areas outside the womb), patients with high levels of cholesterol in their blood (hypercholesterolaemia), women with relatives who have had blood clots, women with blood clotting problems requiring treatment with warfarin, women using a barrier method of contraception including condoms or a diaphragm, women whose close relatives have had breast cancer or cancer of the lining of the womb, patients who are overweight, women who have had one or more miscarriage, women who are not very active because of major surgery, injury or illness.
It should not be used in: women who have an allergy to estriol, soya or peanuts or to any other ingredients in the medicine, angina (a heart condition), women who have had a heart attack or blood clot (thrombosis), heart disease, women who have had breast cancer, liver problems, women who have had cancer of other sex organs, unexplained vaginal bleeding, untreated unusual growth of the lining of the womb (endometrial hyperplasia), the rare condition porphyria, pregnancy, breast-feeding.
Also see list of precautions and interactions
Store between 15 to 30ºC depending on preparation.
Estriol is used to mimic the activity of the naturally occurring female sex hormone oestrogen, and it helps to restore the natural balance of this hormone in the body.
It is a hormone known as oestrogen, sometimes known as hormone replacement therapy (HRT).
It is used to treat problems associated with the vagina that are caused by a lack of oestrogen in the body. It is used to relieve symptoms that start to occur when the female body no longer produces certain hormones such as oestrogen. This may occur after the change of life, also known as the menopause, or after surgery to remove the ovaries.
In general this drug is used to treat symptoms associated with a lack of oestrogen in women who have gone through the menopause (change of life) or after surgical removal of the ovaries.
Benefits of being on this drug can include relief from symptoms associated with a lack of oestrogen including dryness and itching of the vagina, uncomfortable or painful sexual intercourse.
Listed below are the typical uses of estriol.
- Treatment of symptoms associated with a lack of oestrogen
- To help wound healing after vaginal surgery
On occasion your doctor may prescribe this medicine to treat a condition not on the above list.
HOW TO USE/TAKE
How often do I take it?
- Estriol is available as tablets for oral use and as a cream or pessaries for vaginal use.
- Tablets: Take this medication orally usually once daily, with or without food. Swallow the tablets whole, do not chew.
- Pessaries and cream: Use vaginally usually once a day, preferably in the evening. If your symptoms improve your doctor may then tell you to use estriol pessaries or cream less often.
- Make sure that you carefully read the patient information leaflet provided with your medicine as it is important that you understand exactly how often and how to use your medicine. If you are unsure then consult your doctor or pharmacist.
- It is important that you see your doctor for regular check-ups (at least once a year) whilst you are taking estriol. You should also go for regular breast screening and cervical smear tests and check yourself regularly for any breast changes such as dimpling of the skin, changes in the nipples and lumps.
- Use this medication regularly in order to get the most benefit from it.
- Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
- It may take up to several weeks before the full benefit of this drug takes effect.
- Certain medical conditions may require different dosage instructions as directed by your doctor.
- Dosage is based on your age and medical condition, response to therapy, and use of certain interacting medicines.
Do I need to avoid anything?
- There is no information on whether estriol affects a patient's ability to drive or operate machinery. See how estriol affects you before you drive or use any tools or machines. Consult your doctor or pharmacist for more details.
When can I stop?
- It is important to continue taking this medication even if you feel well, unless your doctor tells you to stop.
ESTRIOL SIDE EFFECTS
- Irritation or itching of the skin in or around the vagina
- Increased discharge from the vagina
- Feeling bloated
- Cystitis-like symptoms (pain on passing water or urine)
- Passing water (urine) more often
- Gall bladder problems
- Dark patches or small red marks on the skin
- Red painful swellings or bruising on the legs
- Loss of memory
- Abdominal pain
- Leg cramps
- Premenstrual tension (PMT) symptoms
- Fast or irregular heart beat (palpitations)
- Feeling depressed
- Breakthrough bleeding or spotting from your vagina
- Skin rash or allergy to the sun
- Swollen, tender or painful breasts
- Feeling sick
- Being sick
If any of these persist or you consider them severe then inform your doctor or pharmacist.
Tell your doctor immediately if you develop any of the following symptoms:
- Pain in your chest that spreads to the arm or neck
- Sudden swelling of the face or throat which may cause difficulty in swallowing or breathing and nettle rash or itchy skin, severe irritation, reddening of blistering of the skin
- Unexplained migraine-like headache, with or without eyesight problems
- Painful swelling in your legs, sudden chest pain and difficulty breathing
- Yellowing of your skin or the whites of the eyes (jaundice)
- Increased blood pressure
- Dimpling of the skin on the breasts, changes in the nipples or lumps that you can see or feel.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.
Before taking estriol, tell your doctor or pharmacist if you are allergic to it; or to other hormone replacement therapies; or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: an allergy to estriol, soya or peanuts or to any other ingredients in the medicine, angina (a heart condition), have had a heart attack or blood clot (thrombosis), heart disease, have had breast cancer, liver problems, have had cancer of other sex organs, unexplained vaginal bleeding, untreated unusual growth of the lining of the womb (endometrial hyperplasia), the rare condition porphyria, are pregnant or breastfeeding.
Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following unusual growth of the lining of the womb (endometrial hyperplasia), asthma, circulatory diseases, kidney disease, fitting (epilepsy), gallstones, high blood pressure, migraine headache, diabetes, deafness caused by thickened ear tissue, the rare disease systemic lupus erythematosus (SLE), fibroids (growths) in the womb (uterus), endometriosis (tissue that lines the womb grows in other areas outside the womb), high levels of cholesterol in the blood (hypercholesterolaemia), relatives who have had blood clots, blood clotting problems requiring treatment with warfarin, close relatives who have had breast cancer or cancer of the lining of the womb, miscarriage, low activity because of major surgery, injury or illness, you are using a barrier method of contraception including condoms or a diaphragm, you are overweight.
Before having surgery, tell your doctor or dentist that you are taking this medication.
Does alcohol intake affect this drug?
- Alcohol intake is not know to affect estriol.
The elderly: estriol can be used in the elderly.
Pregnancy and breastfeeding - please ensure you read the detailed information below
Estriol is not safe to take if you are, or are planning to become, pregnant.
It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Estriol is not safe to take if you are breastfeeding.
It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:
- There are no drugs listed with absolute contraindications to estriol.
Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:
- St John's wort
This information does not contain all possible interactions. Therefore, before using estriol, tell your doctor or pharmacist of all the products you use.
Symptoms of overdose include feeling sick and bleeding from the vagina. If you have taken too much estriol or you have accidentally swallowed estriol cream or pessaries then consult your doctor or go to the nearest hospital casualty department straight away.
If you think you, or someone you care for, might have accidentally taken more than the recommended dose of estriol or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. Check the patient information leaflet for specific instructions.