Estradiol (E2)

What is Estradiol (E2)?

Estrogen is the main female sex hormone, and estradiol, also called 17 beta-estradiol, is a form of estrogen. It is one of the two major biologically active estrogens in non-pregnant women, along with estrone (E1). A third bioactive estrogen, estriol (E3) is the main pregnancy estrogen.

Both women and men have estrogen in their bodies. Estrogen affects the development of female sex organs and body characteristics, the production of eggs and sperm, and pregnancy. In both sexes, they are involved in growth, nerve growth, bone remodeling, and endothelial responsiveness.

Estradiol is produced primarily by the ovaries in women and by the testicles in men. Smaller amounts are produced in the breasts, adrenal glands of men and women, and some peripheral tissues, mostly fat cells. E2 and E1 can be converted into each other, but E2, estradiol, is stronger. It has up to five times the biological potency of E1.

Belmar compounds estradiol as a bioidentical hormone. Bioidentical hormones have the exact chemical and molecular structure and functions as hormones made in the human body, while other types of lab-made hormones, such as conjugated equine estrogen, do not. Bioidentical estradiol is derived from plant sources and, like the body’s naturally-produced E2, has the chemical formula C18H24O2.

Who May Benefit From Estradiol Replacement?

Estradiol supplementation may be a beneficial treatment for:
Menstruating women with low estrogen levels

Low levels may cause abnormal periods or infertility. Normal levels for estradiol in premenopausal women are about 15 to 350 picograms per milliliter (pg/mL), although these amounts vary widely through the menstrual cycle. The causes of low E2 levels can be genetic, autoimmune, toxic (due to chemotherapy or radiation therapy), or related to diseases of the ovaries, pituitary gland, or hypothalamus. There can also be lifestyle causes, including malnutrition, over-exercise, severe physical or emotional stress, and heavy drug or alcohol use.

Girls who are late starting puberty

Low estradiol levels can delay the development of female body characteristics and menstruation. In these cases, causes are generally genetic, autoimmune, or possibly toxic. Estradiol may stimulate puberty in girls who are not developing naturally.

Women who have reached menopause

Postmenopausal women generally have less than 10pg/ml of estradiol. Although these low levels are the typical result of ovaries ceasing to function with age, treatment with estradiol may help alleviate some of the uncomfortable symptoms of perimenopause and menopause.

Men with low hormone levels

Although testosterone is the primary male sex hormone, estradiol is also essential for healthy sex drive, erectile function, and sperm production. Since the estrogen men have is converted from testosterone through an enzymatic process, men with low testosterone levels also tend to have low estrogen levels. The normal range of estradiol in adult males is 10-40 pg/mL. If a patient’s levels continue to be low even with testosterone therapy, estradiol may need to be added to a treatment plan to reverse symptoms such as exhaustion, reduced sex drive, shrinking muscle mass, and osteoporosis. Persistent low estradiol levels in men may have the same causes as in women — genetic, autoimmune disorders, toxicity, malnutrition, rapid weight loss, or conditions that affect the sexual organs, pituitary gland, or hypothalamus.

Dosage and Form

Estradiol is often combined with other hormones to support a healthy balance of hormones in the body. The following dosage forms and strengths of estradiol and estradiol combinations currently fall within our formulary:

Medication Form Strength
Estradiol Tablet 0.5mg – 2mg
Estradiol (paraben-free) Sindi Cream Base 0.1mg/gm – 5mg/gm
Estradiol Vaginal Tablet 25mcg
Estradiol Liquigel for vaginal use 0.01%/gm – 4mg/1mg
Biest (Estriol/Estradiol – 80/20) Tablet 1mg/0.25mg
Biest Sindi Cream Base 1.25mg/gm – 2.5mg/gm
Triest (Estriol/ Estradiol/ Estrone – 80/10/10) Tablet 2mg/ 0.25mg/ 0.25mg
Estradiol/ Progesterone Tablet 0.5mg/50mg – 1mg/2mg
Estradiol/ Testosterone Sindi Cream Base 1mg/ 2mg/gm – 2.5mg/ 2.5mg/gm
Biest/ Testosterone Sindi Cream Base 5mg/1mg/gm
Biest/ DHEA Sindi Cream Base 2.5mg/20mg/gm
Biest/ Progesterone Tablet 1.25mg/50mg – 5mg/100mg
Biest/ Progesterone Sindi Cream Base 2.5mg/ 100mg/gm – 2.5mg/ 200mg/gm
Estradiol/ Progesterone/ Testosterone Tablet 0.5mg/ 100mg/2mg – 1mg/ 100mg/2mg
Biest/ Progesterone/ Testosterone Tablet 1.25mg/ 100mg/1mg – 5mg/ 200mg/2.5mg
Biest/ Progesterone/ Testosterone Sindi Cream Base 2.5mg/ 100mg/ 0.5mg/gm – 2.5mg/ 200mg/ 1mg/gm
Triest/ Progesterone Tablet 2.5mg/ 100mg
Estradiol/ Finasteride/ Melatonin/ Spironolactone Topical Foam (to treat hair loss) 0.06%/ 0.5%/ 0.05%/ 0.1%/gm

How Belmar Can Help

If you’re a clinician interested in prescribing compound medications to your patients, contact us for information on how to get started and to access all of our clinical resources. If you are new to compounding, you may find our page on How to Write a Compounding Prescription helpful. You can also visit our Treatment Options page to find a formulary and learn more about all the medication solutions available from Belmar.

Contact Belmar Pharma Solutions

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If you’re a patient, we’re here to help you fill prescriptions or provide you the information you need to work with your doctor to help decide if a compounded prescription might be a good treatment for you.

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