Estriol (E3)

What is Estriol (E3)?

Estrogen is the main female sex hormone, and estriol (E3) is a form of estrogen. In contrast to estrone (E1) and estradiol (E2), estriol (E3) is secreted mainly by the placenta rather than the ovaries and is the dominant estrogen during pregnancy. Levels of estriol in women who are not pregnant are almost undetectable.

Both women and men have estrogen, including estriol, in their bodies. However, men produce only very small amounts of estriol.

Of the three major estrogens, estriol forms the weakest bonds with estrogen receptors. It also is a short-acting estrogen. These characteristics are useful because some of the potential negative effects of estrogen depend on long-term interaction. Estriol has been found to provide some of the protection without the risks associated with stronger estrogens.

E3, like the other two estrogens, is an 18 carbon steroid — C18H24O3. It is available only as a compounded bioidentical hormone medication. Bioidentical hormones have the exact chemical and molecular structure and function as hormones made in the human body. Bioidentical estriol is derived from plant sources.

Who May Benefit From Estriol Replacement?

Estriol supplementation may be a beneficial treatment for:
Menopausal women

Some of the symptoms that may respond to estriol treatment include hot flashes, night sweats, insomnia, skin issues, vaginal atrophy, and frequent urinary tract infections. Estriol has been identified to be safe even over periods of several years, with no increased risk of such effects as breast or endometrial cancer, even without adding progesterone.

Elderly men and women with osteoporosis

Estriol has been shown to improve bone mineral density by inhibiting bone absorption. It may also improve endothelial function. Because it doesn’t impact other parts of the body in the same way as the stronger estrogens, it may be an option for use in bioidentical hormone replacement therapy (BHRT) in elderly patients.

Men and women with autoimmune disorders

Estriol can be used to help in the treatment of patients with Th1-mediated autoimmune diseases, including multiple sclerosis and rheumatoid arthritis. At levels similar to those found in pregnant women, E3 has been seen to regulate the immune response and improve symptoms.

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 Strengths
Estriol Sindi Cream Base 0.5 – 3mg/gm
Estriol Vaginal Cream 1mg – 3mg/gm
Biest (Estriol/Estradiol – 80/20) Tablet 1mg/ 0.25mg – 4mg/ 1mg
Biest Sindi Cream Base 1.25mg – 2.5mg/gm
Triest (E3/E2/E1 – 80/10/10) Tablet 2mg/ 0.25mg/ 0.25mg
Biest/ Progesterone Tablet 1.25mg/ 50mg – 5mg/ 100mg
Biest/ Progesterone Sindi Cream Base 2.5mg/ 100mg/gm – 2.5mg/ 200mg/gm
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
Biest/ Testosterone Sindi Cream Base 5mg/ 1m/gm – 2.5mg/ 2.5mg/gm
Biest/ DHEA Sindi Cream Base 2.5mg/ 20mg/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.

Prescribers, for a complete formulary or access to our clinical resources fill out the form below and one of our Solutions Engineers will be in touch shortly. If you are new to compounding, you may also find our page on How to Write a Compounding Prescription helpful.


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Thank you for reaching out. A member of our team is reviewing your message and will reach out as soon as possible. In the meantime, below are a few links, including our formulary, that we think you might find helpful:

Formulary
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