ESTRADIOL

Drugs in Pregnancy and Lactation..


Name: ESTRADIOL
Class: Estrogenic Hormone
Risk Factor:    XM

Fetal Risk Summary

Estradiol and its salts (cypionate, valerate) are used for treatment of menopausal symptoms, female hypogonadism, and primary ovarian failure. The more potent synthetic derivative, ethinyl estradiol, has similar indications and is also used in oral contraceptives (see also Oral Contraceptives).

The Collaborative Perinatal Project monitored 614 mother-child pairs with 1st trimester exposure to estrogenic agents (including 48 with exposure to estradiol) (1, pp. 389, 391). An increase in the expected frequency of cardiovascular defects, eye and ear anomalies, and Down's syndrome was found for estrogens as a group but not for estradiol (1, pp. 389, 391, 395). Re-evaluation of these data in terms of timing of exposure, vaginal bleeding in early pregnancy, and previous maternal obstetric history, however, failed to support an association between estrogens and cardiac malformations (2). An earlier study also failed to find any relationship with nongenital malformations (3).

In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 29 newborns had been exposed to ethinyl estradiol during the 1st trimester (F. Rosa, personal communication, FDA, 1993). Four (13.8%) major birth defects were observed (one expected), including (observed/expected) 1/0.3 cardiovascular defects, and 1/0 hypospadias. No anomalies were observed in four other categories of defects (oral clefts, spina bifida, polydactyly, and limb reduction defects) for which specific data were available. The number of exposures is too small for any conclusion.

Developmental changes in the psychosexual performance of boys have been attributed to in utero exposure to estradiol and progesterone (4). The mothers received an estrogen/progestogen regimen for their diabetes. Hormone-exposed males demonstrated a trend to have less heterosexual experience and fewer masculine interests than controls. Estradiol has been administered to women in labor in an attempt to potentiate the cervical ripening effects of prostaglandins (5). No detectable effect was observed. Use of estrogenic hormones during pregnancy is contraindicated.

Breast Feeding Summary

Estradiol is used to suppress postpartum breast engorgement in patients who do not desire to breast-feed. Following the administration of vaginal suppositories containing 50 or 100 mg of estradiol to six lactating women who wished to stop breast feeding, less than 10% of the dose appeared in breast milk (6). The American Academy of Pediatrics considers estradiol to be compatible with breast feeding (7).

References

  1. Heinonen OP, Slone D, Shapiro S. Birth Defects and Drugs in Pregnancy. Littleton, MA:Publishing Sciences Group, 1977.
  2. Wiseman RA, Dodds-Smith IC. Cardiovascular birth defects and antenatal exposure to female sex hormones: a reevaluation of some base data. Teratology 1984;30:359–70.
  3. Wilson JG, Brent RL. Are female sex hormones teratogenic? Am J Obstet Gynecol 1981;141:567–80.
  4. Yalom ID, Green R, Fisk N. Prenatal exposure to female hormones. Effect of psychosexual development in boys. Arch Gen Psychiatry 1973;28:554–61.
  5. Luther ER, Roux J, Popat R, Gardner A, Gray J, Soubiran E, Korcaz Y. The effect of estrogen priming on induction of labor with prostaglandins. Am J Obstet Gynecol 1980;137:351–7.
  6. Nilsson S, Nygren KG, Johansson EDB. Transfer of estradiol to human milk. Am J Obstet Gynecol 1978;132:653–7.
  7. Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.

Index

Q&A about Estradiol

korlis01
Estradiol...?
What does it mean if you have a low Estradiol (72), but an ultrasound shows you have a mature follicle? I'm supposed to trigger tonight, but I'm worried about that low E2 number...anyone?
17 weeks preggo
Hi Low estradiol means you will have a problems in ovulating.

You will probably ovulate late in your cycle. Your follicles will mature late and will rupture late to release an egg as my doc said. My doc gave me clomid but I think it isn't working so next month she will either put me on higher dose or a shot.lets see I am waiting for my periods.

Its good you are getting a shot to get you egg ovulated.

Once you ovulate estradiol has no role in pregnancy or later half. So dont worry.

here is a link to my ques which I asked when I discovered that I have low estradiol levels.

http://answers.yahoo.com/question/index;...

check this link too

http://www.advancedfertility.com/day3fsh...

you can also google low estradiol levels and you will get lots of info

Relax and go for a shot.

have sex for next three day andwait for a good news/

Take care and good luck

lots of baby dust to you
Kristy
What is the difference between birth control levonorgestrel and estradiol?
Right now I am on Levora - it has levonorgestrel and estradiol in it.

I see Walmart offers a type of birth control that is estradoil only for $4, so I was thinking of switching. What is the difference?
Beau C
Not sure. Sorry.

Consult your doctor...
How?
How many molecules of ethinyl estradiol are there in one pill?
A particular oral contraceptive contains 0.043 mg of ethinyl estradiol in each pill. The formula of this compound is C20H24O2. How many molecules of ethinyl estradiol are there in one pill? (give answer to 3 digits)

How many hydrogen atoms are there in one of these pills (due to the presence of ethinyl estradiol)? (give answer to 3 digits)
Jonathan
do u think people are really going to do your homework for you?
kgirl
How will clomid help me get pregnant when my estradiol is too high?
I don't understand how a drug like clomid which works with ovulation can help a woman whose estradiol is too high.
HIDY
Clomid is an estradiol suppressant.
Marimar
Hello, I would like to know if anyone that has taken clomid has had abnormal estradiol results?
I am trying to concieve so they put me on clomid. I took them as recommended. 7 days after the last pill, the Dr. sent me to get my estradiol levels checked. My estradiol levels are 594.00, it is considered abnormal. Can someone give me some feedback on this please?, I am worried.
Mary K
OK here it comes these are the normal estradiol levels

Early Follicular 30-100 pg/ml

Late follicular 100-400 pg/ml

Luteal Phase 60-150 pg/ml

Pregnant up to 35,000 pg/ml

Post menopausal Less than 18 pg/ml

i don't know what your doctor's answer was to this but i recommend testing in another lab or asking the same lab to retest your blood they keep it frozen for a couple od days cause i think it was a lab error i take clomid and never had that problem but i also own a clinic and work with laboratories and I know for a fact that they make errors, foe example they once had my aunt test positive for pregnancy and she was not pregnant at all. i don't know where you live but if its in Miami i recommend quest diagnostics. Good luck and hope i helped a little.

note: also remember that the numbers can slightly change form lab to lab.
Amanda C
I have a medical question. Why would a man be taking estradiol along with spironolactone?
I have a coworker who is seeing a therapist and has recently been put on those medications. Says most of his friends have gone due to not understanding his issues and that he has not told his parents due to they would not understand either. I do know that estradiol is a female hormone so I guess Im wandering if these are something taken for sex changes, men wanting to be women?
Diane
A MAN wouldn't be taking oestradiol and spironolactone ; but a transsexual woman would.

Both drugs are often prescribed to transsexual women; oestradiol for it's feminising effects, and spironolactone for it's androgen-blocking effects.

Oestradiol is sometimes prescribed for prostate cancer, and spironolactone is sometimes prescribed for hypertension, but they wouldn't be prescribed together; oestradiol RAISES blood pressure, so they would cancel one another out.
Butterfl...
What is the highest dosage in Estradiol?
I can't find it anywhere. Is there such a thing as 627 mg?
tova4me
Tablets: 0.5, 1 and 2 mg. . No such thing as 627mg.
Eponine
Is it true that ethinyl estradiol will make you shorter?
Michelle Hunt
Yes.
Robert
What if any effects of etonogestrel and ethinyl estradiol vaginal ring (Nuvaring) if chewed by a dog?
My gf and I have a 8lb Pomeranian. He somehow got a hold of my gf's Nuvaring this morning and chewed (and I pressume swallowed) about half of it. This is NOT funny, but we have called everyone we can think of...Vet, OB-GYN, the maker of Nuvaring, and we have not been able to get an answer from anyone on whether the hormones would be harmful to the dog. We don't know what to do. Any help will be greatly appreciated.
Mandy
What I would do is call the ASPCA poison control hotline. The crappy thing is they charge you $55, but I think everyone invloved would like to have piece of mind that your little guy is going to be ok. There phone# is (888) 426-4435. Good Luck!
Charley F
Where is information on levels of Progesterone, Estradiol, Estriol, Testosterone & DHEA in a 20 yo woman?
I am interested in free hormone levels as would be reported in saliva testing. I would also like to know levels of Pregnenolone throughout the cycle.
sokokl
Here's the link to a site that may help you find more information. It's at: http://www.labtestsonline.com (if that doesn't work try .org)

This site has information about levels for lab tests.

To find out even more information check out: http://forums.obgyn.net/womens-health (there are doctors on this site where women can ask questions)