| Route/form | Estrogen | Low | Standard | High | |||
|---|---|---|---|---|---|---|---|
| Oral | Estradiol | 0.5–1 mg/day | 1–2 mg/day | 2–4 mg/day | |||
| Estradiol valerate | 0.5–1 mg/day | 1–2 mg/day | 2–4 mg/day | ||||
| Estradiol acetate | 0.45–0.9 mg/day | 0.9–1.8 mg/day | 1.8–3.6 mg/day | ||||
| Conjugated estrogens | 0.3–0.45 mg/day | 0.625 mg/day | 0.9–1.25 mg/day | ||||
| Esterified estrogens | 0.3–0.45 mg/day | 0.625 mg/day | 0.9–1.25 mg/day | ||||
| Estropipate | 0.75 mg/day | 1.5 mg/day | 3 mg/day | ||||
| Estriol | 1–2 mg/day | 2–4 mg/day | 4–8 mg/day | ||||
| Ethinylestradiola | 2.5–10 μg/day | 5–20 μg/day | – | ||||
| Nasal spray | Estradiol | 150 μg/day | 300 μg/day | 600 μg/day | |||
| Transdermal patch | Estradiol | 25 μg/dayb | 50 μg/dayb | 100 μg/dayb | |||
| Transdermal gel | Estradiol | 0.5 mg/day | 1–1.5 mg/day | 2–3 mg/day | |||
| Vaginal | Estradiol | 25 μg/day | – | – | |||
| Estriol | 30 μg/day | 0.5 mg 2x/week | 0.5 mg/day | ||||
| IM or SC injection | Estradiol valerate | – | – | 4 mg 1x/4 weeks | |||
| Estradiol cypionate | 1 mg 1x/3–4 weeks | 3 mg 1x/3–4 weeks | 5 mg 1x/3–4 weeks | ||||
| Estradiol benzoate | 0.5 mg 1x/week | 1 mg 1x/week | 1.5 mg 1x/week | ||||
| SC implant | Estradiol | 25 mg 1x/6 months | 50 mg 1x/6 months | 100 mg 1x/6 months | |||
| Footnotes: a = No longer used or recommended, due to health concerns. b = As a single patch applied once or twice per week (worn for 3–4 days or 7 days), depending on the formulation. Note: Dosages are not necessarily equivalent. Sources: [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] | |||||||
Template documentationSee also
- Template:Estrogen dosages for breast and prostate cancer
- Template:Medications and dosages used in hormone therapy for transgender women
References
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- ^ Kuhl H, Wiegratz I (1 January 2008). Klimakterium, Postmenopause und Hormonsubstitution [Climacteric, Postmenopause and Hormone Replacement] (in German) (4 ed.). UNI-MED-Verlag. p. 188. ISBN 978-3-83742-043-2.
- ^ Wiegratz I, Kuhl H (2007). "Praxis der Hormontherapie in der Peri- und Postmenopause" [Practice of hormone therapy in the peri- and postmenopause]. Gynäkologische Endokrinologie. 5 (3): 141–149. doi:10.1007/s10304-007-0194-9. ISSN 1610-2894. S2CID 27130717.
- ^ Birkhäuser MH, Panay N, Archer DF, Barlow D, Burger H, Gambacciani M, et al. (April 2008). "Updated practical recommendations for hormone replacement therapy in the peri- and postmenopause". Climacteric. 11 (2): 108–123. doi:10.1080/13697130801983921. PMID 18365854. S2CID 31169836.
- ^ Borgelt LM (2010). Women's Health Across the Lifespan: A Pharmacotherapeutic Approach. ASHP. pp. 257–. ISBN 978-1-58528-194-7.
- ^ DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM (23 January 2017). Pharmacotherapy: A Pathophysiologic Approach, Tenth Edition. McGraw-Hill Education. p. 1295. ISBN 978-1-259-58749-8.
- ^ Warren MP (February 2007). "Historical perspectives in postmenopausal hormone therapy: defining the right dose and duration". Mayo Clinic Proceedings. 82 (2): 219–226. doi:10.4065/82.2.219. PMID 17290731.
- ^ Simon JA, Snabes MC (December 2007). "Menopausal hormone therapy for vasomotor symptoms: balancing the risks and benefits with ultra-low doses of estrogen". Expert Opinion on Investigational Drugs. 16 (12): 2005–2020. doi:10.1517/13543784.16.12.2005. PMID 18042008. S2CID 34040632.
- ^ Fritz MA, Speroff L (28 March 2012). Clinical Gynecologic Endocrinology and Infertility. Lippincott Williams & Wilkins. pp. 751–753. ISBN 978-1-4511-4847-3.
- ^ Thomas JA, Keenan EJ (6 December 1986). "Estrogens and Antiestrogenic Drugs". Principles of Endocrine Pharmacology. Springer Science & Business Media. pp. 135–165. doi:10.1007/978-1-4684-5036-1_7. ISBN 978-1-4684-5036-1.
- ^ Ruggiero R (2002). "Estrogen: physiology, pharmacology, and formulations for replacement therapy". Journal of Midwifery & Women's Health. 47 (3): 130–138. doi:10.1016/S1526-9523(02)00233-7. ISSN 1526-9523. PMID 12071379.
- ^ "Depo-Estradiol Estradiol cypionate injection, USP" (PDF). Pharmacia & Upjohn Co. U.S. Food and Drug Administration. December 2004.
- ^ Brunton L, Lazo J, Parker K (13 September 2005). Goodman & Gilman's The Pharmacological Basis of Therapeutics (Eleventh ed.). McGraw Hill Professional. p. 1553. ISBN 978-0-07-160891-6.
These preparations differ widely in their oral potencies; e.g., a dose of 0.625 mg of conjugated estrogens generally is considered equivalent to 5 to 10 μg of ethinyl estradiol.
- ^ Kutlesic RM, Popovic J, Stefanovic M, Vukomanovic P, Andric A, Milosevic J (July 2016). "Menopausal hormone therapy: Benefits and different forms". Medicinski Pregled. 69 (7–8): 247–254. doi:10.2298/MPNS1608247K. PMID 29693907.
- ^ Kuhl H (1998). "Adverse effects of estrogen treatment: natural vs. synthetic estrogens". In Lippert TM, Mueck AO, Ginsburg J (eds.). Sex Steroids and the Cardiovascular System: The Proceedings of the 1st Interdisciplinary Workshop, Tuebingen, Germany, October 1996. London/New York: Parthenon. pp. 201–210. ISBN 9781850709565.
- ^ Martin KA, Barbieri RL, Crowley Jr WF (September 24, 2021). "Preparations for menopausal hormone therapy". UpToDate. UpToDate. Retrieved February 2, 2022.
The potency, and therefore the doses, of these estrogen preparations differ, but they differ little in efficacy [9]. In general, 0.625 mg of conjugated estrogens or esterified estrogen is considered equivalent to 1 mg of micronized 17-beta estradiol, 0.05 mg of transdermal estradiol, or 5 mcg of ethinyl estradiol (table 1). (See 'Dose equivalents' below.) [...] A transdermal dose of 50 mcg/day [5] is approximately equivalent to 1 mg of oral 17-beta estradiol and a 0.625 mg daily oral dose of conjugated estrogens [1]. [...] "Ultra-low doses" of estrogen (transdermal estradiol 0.014 mg/day and oral micronized 17-beta estradiol 0.25 mg/day) also appear to prevent bone loss [10,20] and are effective for hot flashes in some women. [...] Dose equivalents — Many studies of the safety and efficacy of postmenopausal estrogen have used conjugated estrogen 0.625 mg. This is considered to be standard-dose estrogen; low-dose preparations, in general, contain one-half the standard dose. The doses of other estrogens that are similarly effective for the treatment of hot flashes as 0.625 mg of CEE include (table 1): ● 1 mg micronized 17-beta estradiol. ● 50 mcg/day transdermal 17-beta estradiol. ● 1.25 mg piperazine estrone sulfate. ● Estradiol gels and sprays are available in different strengths and delivery systems (pump, foil packets). Dosing equivalents depend upon the individual preparation. Measurement of estradiol levels may be warranted when trying to adjust dosing.