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Average number of moderate-to-severe hot flashes per week with placebo and different doses of oral estradiol in menopausal women [40] [41]. Estradiol is used in menopausal hormone therapy to prevent and treat moderate to severe menopausal symptoms such as hot flashes, vaginal dryness and atrophy, and osteoporosis (bone loss). [11]
It may have a decreased risk of breast and colorectal cancer, though conversely it can be associated with vaginal bleeding, endometrial cancer, and increase the risk of stroke in women over age 60 years. [118] [119] Vaginal estrogen can improve local atrophy and dryness, with fewer systemic effects than estrogens delivered by other routes. [120]
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In women, low levels of estrogen may cause symptoms such as hot flashes, sleeping disturbances, decreased bone health, [3] and changes in the genitourinary system. Hypoestrogenism is most commonly found in women who are postmenopausal , have primary ovarian insufficiency (POI), or are presenting with amenorrhea (absence of menstrual periods ).
Estradiol is a naturally occurring and bioidentical estrogen, or an agonist of the estrogen receptor, the biological target of estrogens like endogenous estradiol. [10] Due to its estrogenic activity, estradiol has antigonadotropic effects and can inhibit fertility and suppress sex hormone production in both women and men.
Other research has found that the rate of VTE is 1 to 5 in 10,000 woman-years in women who are not pregnant or taking a birth control pill, 3 to 9 in 10,000 woman-years in women who are on a birth control pill, 5 to 20 in 10,000 women-years in pregnant women, and 40 to 65 in 10,000 women-years in postpartum women. [104]
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The majority of women with an intact uterus will develop endometrial hyperplasia within a few years of estrogen treatment even with mere replacement dosages of estrogen if a progestogen is not taken concomitantly. [25] The addition of a progestogen to estrogen abolishes the increase in risk. [26]