Estradiol / Estriol Cream

Estradiol / Estriol Cream
Usage
Estradiol / estriol cream is a compounded topical hormone replacement therapy (HRT) used to manage symptoms associated with estrogen deficiency, particularly in peri- and postmenopausal women. It may be applied topically (transdermal) or intravaginally, depending on the indication.
It may be prescribed for:
• Menopausal symptoms (e.g., hot flushes, night sweats)
• Vaginal atrophy (dryness, irritation, discomfort)
• Urogenital symptoms (e.g., dyspareunia, urinary symptoms)
• Hormonal imbalance or deficiency states
• Other practitioner-directed uses in individualised HRT programmes

Dosage
Dosage should be individualised and prescribed by a qualified healthcare professional based on symptoms and clinical response.
Typical dosing considerations include:
• Apply a measured amount once daily, or as directed
• For transdermal use: apply to clean, dry skin (e.g., inner arms, thighs)
• For vaginal use: apply using an applicator, if provided
• Rotate application sites for transdermal use
• Use the lowest effective dose
Regular clinical review and dose adjustment are recommended.

Mechanisms of Action
Estradiol & Estriol (Estrogens) act by binding to estrogen receptors in various tissues:
Restoration of estrogen levels
They replace deficient estrogen, helping restore hormonal balance.
Regulation of gene expression
Binding to estrogen receptors influences cellular activity in reproductive, vascular, and skeletal systems.
Relief of menopausal symptoms
They reduce vasomotor symptoms (e.g., hot flushes) and improve mood and sleep.
Improvement of urogenital health
Enhances vaginal tissue integrity, lubrication, and elasticity, reducing discomfort.

Contraindications
This formulation should not be used in patients with:
• Hypersensitivity to estrogens or any component of the formulation
• Known or suspected estrogen-dependent cancers (e.g., breast or endometrial cancer)
• Undiagnosed abnormal vaginal bleeding
• Active or history of thromboembolic disorders (e.g., DVT, pulmonary embolism)
• Severe liver disease
• Pregnancy

Precautions
Use with caution in patients with:
• Cardiovascular disease or risk factors
• History of thromboembolism
• Hormone-sensitive conditions
• Liver impairment
• Migraine disorders
Additional considerations include:
• Use the lowest effective dose for the shortest duration consistent with treatment goals
• May require combination with progesterone in women with an intact uterus to reduce endometrial risk
• Possible side effects include:
• Breast tenderness
• Fluid retention
• Headache
• Skin irritation at application site
• Regular clinical review and screening (e.g., breast exams) are recommended
Patients should seek medical advice if they experience unusual bleeding, chest pain, severe headaches, or signs of thrombosis.

Storage
• Store below 25°C unless otherwise directed
• Keep the container tightly closed when not in use
• Protect from heat, moisture, and direct light
• Do not freeze unless specifically instructed
• Keep out of reach of children and pets
Patients should follow the storage instructions provided on the dispensing label supplied by the pharmacy.