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Estrace (estradiol) is a female hormone used in a variety of conditions when the body is not producing enough estrogen, usually in menopausal women. The medication is also sometimes used to treat breast and prostate cancer in both genders.

The medication is administered by tablet, available in 1 mg or 2 mg doses. Food is optional but often utilized as it minimizes stomach-related side effects. Treatment typically involves taking a dose one to three times per day for several weeks or months.

Estrace is predominantly used to treat:

• Menopause symptoms;
• Vaginal atrophy when creams or other direct applications are unsuitable;
• Low estrogen levels from injury, removal, or other ovarian failure;
• Preventing osteoporosis when other non-estrogen medications are not suitable;
• Palliative treatment of breast cancer;
• Palliative treatment of prostate cancer.

Note that all women who have an intact uterus, regardless of menopause, should not take estrogen supplements without also taking a progestin, another hormone that will help reduce risk of uterine cancer. Women who have had their uterus removed and men do not need to worry about taking a progestin.

Treating Menopause and Vaginal Atrophy

Most women are familiar with symptoms of menopause, such as hot flashes, irritability, and painful intercourse due to vaginal atrophy. Estrace can alleviate, or even completely eliminate, these symptoms. Treatment will be customized to some extent according to patient response, but in general consists of:

• Take 1 to 2 mg once per day for 3 weeks.
• Take 1 week off.
• Resume treatment for the next 3 weeks.

The need for HRT should be reassessed every three to six months; it is not meant to be indefinite. Most women will gradually adjust and no longer have symptoms of menopause even without HRT.

Treating Low Estrogen Levels from Other Causes

Low estrogen levels in pre-menopausal women are usually caused by removal of the ovaries, injury to the ovaries, genetic abnormalities, and other causes. Low estrogen causes many similar effects as menopause. Men who wish to develop female characteristics may also benefit from using Estrace.

Treatment here is usually the longest term, and can be quite variable. Most patients are started on:

• Take 1 to 2 mg once per day.

Duration of treatment may last months or even years; it may stop at times only to be restarted later. Speak with a doctor who can take into account personal variables about the best course of treatment.

Preventing Osteoporosis

Estrogen supplements like Estrace are not the ideal treatment for osteoporosis, as they can cause problems just as severe. Non-estrogen medications, such as raloxifene, are preferred. However, when these other medications are not suitable, Estrace may be used instead in women who are at high risk of osteoporosis.

There are no official guidelines regarding dosage and duration of treatment in using Estrace for this purpose. Speak with a doctor.

Palliative Cancer Care

Estrace may be used as a palliative treatment in certain cancer scenarios. Keep in mind that many cancers feed off of estrogen and Estrace should not be used without explicit doctor approval.

Use of estrogen to treat even estrogen-positive cancer was fairly normal until the 1970s, at which time it was discovered that other medications---such as tamoxifen---did so much more effectively. However, some patients develop resistance to these medications, with the cancer responding poorly. It has since been discovered that among those no longer responding to non-estrogen medications, administering estrogen can help significantly. By the time the cancer is no longer responding well to estrogen, other medications may once again be beneficial.

Cancer is a complex subject and treatment will be individualized. Starting guidelines are:

• For breast cancer: Take 10 mg three times per day for at least three months.
• For prostate cancer: Take 1 to 2 mg three times per day until a doctor instructs otherwise.

Doctor instructions may deviate from the above and should always be followed closely when using Estrace to combat cancer.