Estrace (Estradiol) is a female hormone. It is used by women to help reduce symptoms of menopause including having hot flashes and vaginal dryness/itching. These symptoms are caused by the body making less estrogen. If you are using this medication to treat symptoms only in and around the vagina i.e. physical symptoms, products applied directly inside the vagina should be considered before medications that are taken orally, absorbed through the skin, or injected. Certain estrogen products may also be used by women after menopause to prevent osteoporosis. However, there are other medications that are also effective in preventing bone loss and may be safer. These medications should be considered for use before estrogen treatment. Certain estrogen products may also be used by men and women to treat certain types of cancer. Estradiol (Generic) is available in addition to the brand name Estrace. 

What is the most effective way to take Estrace?

• Estrogen comes as a tablet to take by mouth.
• Usually taken with or without food once a day. Estrogen is sometimes taken every day and sometimes taken according to a rotating schedule that alternates a period of time when estrogen is taken every day with a period of time when estrogen is not taken.
• When estrogen is used to relieve the symptoms of cancer, it is usually taken three times a day.
• Take estrogen at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
• Take estrogen exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor may start you on a low dose of estrogen and gradually increase your dose if your symptoms are still bothersome, or decrease your dose if your symptoms are well-controlled.
• Talk to your doctor about how well estrogen works for you. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Before taking Estrace,

• tell your doctor if you are allergic to it; or if you have any other drug allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
• tell your doctor or pharmacist your medical history, especially of: 
  • vaginal bleeding of unknown cause
  • certain cancers such as breast cancer
  • blood clots
  • stoke, heart disease
  • liver or kidney disease
  • family medical history of breast lumps and 
  • family or personal history of angioedema (a certain swelling disorder)
  • blood clotting disorders (such as protein C or protein S deficiency)
  • diabetes
  • mineral imbalance
  • uterus problems such as fibroids
  • asthma
  • mental/mood disorders such as depression

Do not smoke or use tobacco. Estrogens combined with smoking further increases your risk of stroke, blood clots, high blood pressure, and heart attack, especially in women older than 35.

This medication may cause blotchy, dark areas on your face and skin (melasma). Sunlight may worsen this effect. Limit your time in the sun and take precautions when outdoors. Avoid tanning booths and sunlamps. 

Children may be more sensitive to the side effects of this drug. It may affect their growth/development. Discuss the possible effects of this medication with the doctor, and monitor your child's growth periodically.

Pregnancy Warning:

• This medication must not be used during pregnancy. If you become pregnant or think you may be pregnant, tell your doctor right away.
• This medication passes into breast milk. It may reduce the quality and amount of breast milk produced. Consult your doctor before breast-feeding.

Common Estrace side effects include but are not limited to:

• headache
• nausea, vomiting, stomach cramps
• mood changes
• insomnia
• flu-like symptoms such as stuffy nose
• breast pain
• thinning scalp hair
• vaginal itching or discharge
• changes in your menstrual periods

Get emergency medical help if you have signs of an allergic reaction to Estrace: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• heart attack symptoms - chest pain or pressure, pain spreading to your jaw or shoulder, sweating and nausea

• signs of a stroke - sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;

• signs of a blood clot - sudden vision loss, stabbing chest pain, feeling short of breath, coughing up blood, pain or warmth in one or both legs;

• jaundice (yellowing of the skin or eyes);

• memory problems, confusion, unusual behavior;

• unusual vaginal bleeding, pelvic pain;

• a lump in your breast; or

• signs of high levels of calcium in your blood - nausea, constipation, increased thirst or urination, muscle weakness, bone pain, lack of energy

Why is Estrace prescribed?

Estrace is used to treat menopause symptoms.

What if I miss a dose of Estrace?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Are there known drug interactions?

Many drugs can interact with estradiol. Talk to your doctor or pharmacist for a full detailed list. 

Are there any major risks with this medication?

Long-term use of Estrace may increase your risk of breast, ovarian, or uterine cancer. See the Cautions section for more. 

What are some things I should avoid while taking Estrace?

Avoid taking with grapefruit or grapefruit juice.