EstroGel (estradiol) is a topical estrogen supplement, most commonly used in post-menopausal women to treat hot flashes and vaginal atrophy. Though rare, it may sometimes be used in other circumstances.

Note that while EstroGel treats vaginal atrophy symptoms, it should not be applied directly on or near the vagina; it should be applied to the arms. As with all estrogen medications, EstroGel should never be applied directly to the breasts.

What to Expect from EstroGel

EstroGel is a simple but effective medication for menopausal women. Applied just once per day in most cases, it supplies the body with the estrogen that is largely no longer produced during and following menopause. It is effective at alleviating:

• Hot flashes
• Sweating
• Night sweats
• Vaginal dryness
• Vaginal itching
• Painful intercourse

EstroGel has not been approved for treating all menopause symptoms, however. It's unclear how beneficial, if at all, it is towards treating osteoporosis, hair loss, memory or concentration difficulties, anxiety, and other disturbances.

Patients should generally not use EstroGel to treat only vaginal symptoms; hot flashes or related sweating symptoms should also be present. Women wanting to treat vaginal atrophy alone should consider a more direct application method, such as found with Ovestine Cream, applied directly in the vagina. EstroGel should not be applied directly to the vagina.

Women who are experiencing hot flashes as well as vaginal symptoms should be happy with EstroGel.

Patients who order this product will receive a metered-dose pump. The pump should be primed prior to first use---simply depress the pump three times and dispose of any product which came out. It is now ready to use, and will deliver exactly the same dose of medication each time.

Most women are advised to administer one pump of gel each day, though some may be advised to use two pumps. More than two pumps is unusual but not unheard of. Application is simple:

• Press the pump down fully one time, using the other hand to catch the gel that comes out.
• Apply the gel to the skin of the arm, usually from the wrist to the shoulder.
• Spread the gel thin but do not massage it into the skin.
• Allow the gel to dry for five minutes before covering it with clothing.
• Wash hands with soap and water to prevent others from being exposed to the hormone.

Some other tips to keep in mind for hassle-free treatment:

• The gel will be flammable until dry; avoid smoking or open flames.
• Do not allow other individuals to handle the gel or contact the arm the gel was applied to for at least one hour; estrogen can be harmful to others.
• Avoid showering, bathing, swimming, or otherwise getting the application site wet for as long as possible after application.
• Do not apply this or any estrogen-containing product directly to the breasts.
• Do not apply EstroGel directly in or near the vagina.

Improvements should start to be noticeable within two to six weeks, sometimes sooner. If no significant improvements are noticed by the six-week mark, speak with a doctor; dosage may need to be increased.

Contraindications

Some patients are poor candidates for EstroGel. This medication may be inadvisable in patients who:

• Have unexplained vaginal bleeding
• Have had a heart attack or stroke
• Have a history of blood clots
• Have a history of estrogen-positive cancer
• Have a bleeding disorder
• Have a history of liver impairment

Patients who have the above but are interested in EstroGel anyway should definitely speak with a doctor prior to starting treatment; a doctor can better assess the situation and fully explain all risks associated with EstroGel use.

Potential Side Effects

Like any medication, EstroGel is associated with certain side effects. Fortunately most are mild, transient, and will stop occurring when treatment ends if not sooner. Most commonly reported are:

• Bloating
• Stomach cramps
• Headache
• Tender or painful breasts
• Fluid retention
• Mild hair loss

The above are not cause for concern unless severe enough to be disruptive.

Rarely more serious side effects develop that warrant consulting a doctor:

• Unusual vaginal bleeding
• Severe headaches
• Symptoms of blood clots
• Confusion
• Changes in vision
• Breast lumps

Very rare side effects warrant emergency medical attention:

• Heart attack
• Stroke
• Cancer of the breasts, ovaries, or uterus
• Blood clots
• Liver problems
• Gallbladder problems
• High blood pressure or blood sugar
• Dementia

The above may or may not be related to EstroGel use, but patients who take EstroGel do have a slightly higher incidence of them. It is often very difficult for a patient to tell when many of the above are present; it's important to attend regular doctor checkups so they can be screened for. Caught early many of the above are much easier dealt with. Again, the above are very rare.