Estradiol: Uses, Dosage, Side Effects, Interacts and Tests - Dr. Axe

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Estradiol: What You Need to Know About the Strongest Estrogen Hormone


Estradiol - Dr. Axe

You hear about estrogen a lot, but did you know that there are actually three estrogen hormones that are naturally produced by the body. The strongest of the three is estradiol, which plays a major role in reproductive health.

This estrogen hormone plays a vital role in reproductive health and is the key player in the menstrual cycle and menopause. The key to optimal health is maintaining healthy estradiol levels.

This can be difficult for people who consume high-estrogen foods, take certain medications (like birth control pills) or have a health condition that impacts their reproductive hormones.

In a nutshell, if you want to stay in tune with your reproductive health or think that your hormone levels aren’t properly balanced, read up on estradiol and the important role it plays in both male and female health.

What Is Estradiol?

Estradiol, also called oestradiol or 17 beta-estradiol, is one of three estrogens, and it’s an important factor in the female reproductive system. It’s naturally produced in the body, and although both men and women have this estrogen hormone, it’s present in much higher levels in women.


For women, it’s made primarily in the ovaries but also produced in the breasts and adrenal glands. The placenta makes the estrogen hormone during pregnancy, too.

Males make the hormone in their adrenal glands and testes.


Estradiol is mainly responsible for the maturation and maintenance of the reproductive system. It supports the growth and development of female sex organs, including the breasts, vagina, uterus and fallopian tubes.

It’s very much involved in the menstrual cycle, and estradiol levels vary with a woman’s menstrual cycle. During menstruation, increased levels cause the maturation and release of the egg and the thickening of the uterus lining.

This allows the fertilized egg to be implanted. The hormone also plays an essential role in bone and joint health for women.

As females age, their ovaries produce less estradiol, which causes their menstrual cycles to stop and begins menopause. Research shows that women undergo the menopausal transition at about 51 years of age, and this period of change may occur over a period of a few years.

As estrogen levels decline, women can experience symptoms such as vaginal dryness, urinary symptoms, hot flashes, sleep disturbances and mood changes. Research also indicates that, over time, the risk of osteoporosis also increases as estradiol levels decrease.

In men, estradiol helps maintain bone health, cognitive function and nitric oxide production. It may also prevent sperm destruction.

Although men need lower levels of the reproductive hormone, it’s still required for male health.

Just like low levels of estradiol can lead to health issues, too much of the hormone can cause low sex drive, depression, menstrual problems, weight gain, constipation and acne.

Estradiol Test

An estradiol test is used to measure the hormone’s levels in your blood. This blood test may be performed by a doctor to detect causes of female infertility, abnormal periods, abnormal vaginal bleeding and menopause symptoms.

Women get estradiol tests to detect if they have entered menopause or to see how well their ovaries are working. The test is also used if a woman is experiencing symptoms of an ovarian tumor, such as abdomen bloating and pain, weight loss, and increased urination.

If the test shows abnormal estradiol levels, a doctor will then order further testing to make a diagnosis.

This blood test can cause lightheadedness and risk of fainting. Overall, the risks of having the test done are low.

Supplements and Dosage

Estradiol cream, patches and supplements are used by women to relieve symptoms of menopause, such as vaginal dryness and hot flashes. Creams are applied topically in and around the vagina to improve dryness.


It’s recommended that you try topical use before using medications.

Estradiol pills or medications are sometimes taken to reduce the risk of osteoporosis, and they may be useful for women who are not able to produce enough estrogen naturally, which can be caused by conditions like hypogonadism and primary ovarian failure.

The proper estradiol dosage depends on your health condition and is decided by your health care professional. For one medication, called Estrace, each estradiol tablet contains one-half, one or two milligrams of micronized estradiol.

Daily doses typically range from one to two milligrams. The lowest effective dose is used to treat patient symptoms, and the patient is usually reevaluated every three to six months to determine if continued treatment is necessary.

Studies suggest that for women taking these types of medications for menopause symptoms, a progestin is usually prescribed to reduce the risk of endometrial cancer.

Risks and Side Effects

There are numerous reported estradiol side effects, including the following:

  • upset stomach
  • nausea
  • vomiting
  • headache
  • increased irritability
  • jaundice
  • bloating
  • rash
  • breast tenderness and enlargement
  • nipple discharge
  • weight changes
  • mood changes
  • vaginal bleeding, spotting or discharge
  • changes in cervical secretions
  • increased thirst and urination

In rare but serious cases, these medications may cause heart issues from blood clots, such as heart attack and stroke.

Research indicates that hormone replacement therapy in the form of estradiol supplements may increase the risk of:

  • breast cancer
  • blood clots
  • heart disease
  • stroke

Drug Interactions

Estradiol medications may interact with other drugs, including:

  • aromatase inhibitors
  • fulvestrant ospemifene
  • tamoxifen
  • toremifene
  • tranexamic acid
  • raloxifene

It’s also important to know that some medications can affect your levels, including birth control pills, estrogen therapy and glucocorticoids.


  • Estradiol is the strongest of the three estrogen hormones. It plays an important role in the menstrual cycle.
  • Levels naturally reduce with age, leading to menopause. To improve menopause symptoms, women use an estradiol patch and estradiol vaginal cream for issues like vaginal dryness. Other health conditions that may call for these medications include female infertility and abnormal periods.
  • An estradiol test measures your levels and detects whether they are too high or too low. This may explain the cause of symptoms like bloating, urinary issues, hot flashes, moodiness and more.

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