What is Estrogel: Uses, Warnings & Interactions

Updated May 14, 2025  •  Published Dec 30, 2020

EstroGel is a brand-name topical gel that contains the female hormone estradiol. Healthcare providers prescribe it to relieve the symptoms of menopause. The gel comes in a metered pump. Women apply one pump’s worth of gel to the skin on an arm once daily.

Estrogel overview

BRAND NAMES:

  • EstroGel

Generic Names:

  • Estradiol

Uses:

  • Treats vasomotor symptoms and vulvovaginal atrophy due to menopause.

Therapeutic Classes:

  • Estrogen

Forms:

  • Topical gel

How it’s taken:

  • On the skin

What is Estrogel used for?

EstroGel is FDA approved to treat menopausal symptoms. These include vasomotor symptoms such as night sweats and flushing, as well as genital changes due to low estrogen.

What form(s) does Estrogel come in

  • Gel

    • 0.06% (0.75 mg/pump actuation)

What are common Estrogel doses?

  • For vasomotor symptoms or vulvovaginal atrophy due to menopause: one (1) pump actuation spread thinly over the skin of an entire arm once daily

Common Estrogel prescriptions

  • Estrogel
    37.5gm of 0.75 mg/1.25 gm(0.06%) bottle

How to take Estrogel

  • Follow all the prescriber’s instructions.

  • Please read the Patient Information sheet before using this medicine.

  • Review the instructions on that sheet before using the medicine.

  • Use only one pump actuation daily.

  • Do not allow other people to apply the medicine to your skin.

  • Before using an EstroGel canister for the first time, the pump must be primed.

    • Remove the cap.

    • Holding the pump over a sink, slowly push down the pump five times. Do not use or touch the gel that comes out.

    • Flush the medicine down the sink.

    • The pump is ready for use.

  • EstroGel is applied to the skin of your arm:

    • Apply EstroGel after a shower or bath.

    • Apply it only to clean, dry, and unbroken skin.

    • Press the pump firmly and completely one time to release medicine into the palm of your hand.

    • Spread the gel on the other arm in a thin layer. Cover all the skin from the wrist to the shoulder both on the inside and outside of the arm.

    • Do not massage or rub it in.

    • Let it dry for five minutes.

    • Avoid flames and smoking while it dries. The gel is flammable.

    • Wash your hands immediately with soap and water.

    • Do not let other people touch the treated skin for at least one hour.

  • Store the canister at room temperature. Keep it out of the reach of children.

  • Throw away the canister after 30 doses have been applied.

What to do if you miss a dose of Estrogel

  • Ask the prescriber what to do if a dose of EstroGel is missed.

  • Do not take more than one dose in a single day to make up for a missed dose.

Estrogel contraindications

  • This medicine is not right for everyone. 

  • Do not use it if you have had a severe allergic reaction to EstroGel, are pregnant, or have:

    • Liver problems

    • Unusual vaginal bleeding not checked by a doctor

    • Breast cancer or a history of breast cancer 

    • Any other estrogen-dependent cancer such as uterine or ovarian cancer

    • A history of blood clotting problems, especially deep vein thrombosis (DVT) or pulmonary embolism (PE)

    • A history of heart attack or stroke

    • Protein C or protein S deficiency

Estrogel warnings

  • Tell any doctor or other healthcare provider who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery, need certain types of medical tests, or if you require prolonged bed rest.

  • The doctor will need to regularly check on your progress and monitor for side effects. Keep all appointments.

  • Make sure to tell the prescriber if you have:

    • A history of cancer

    • Asthma

    • Epilepsy

    • Diabetes

    • Migraine

    • Endometriosis

    • Lupus

    • A history of angioedema (swelling of the face and tongue)

    • Heart problems

    • Liver problems

    • Kidney problems

    • Thyroid problems

    • Gallbladder problems

    • High calcium

    • High blood pressure

    • High cholesterol or a family history of high cholesterol

    • Porphyria

  • Estrogen therapy can cause serious problems including:

    • Heart attack

    • Stroke

    • Blood clots

    • Breast cancer

    • Endometrial cancer

    • Ovarian cancer

    • Benign tumors of the uterus (fibroids)

    • Gallbladder disease

    • Liver problems

    • Thyroid problems

    • Dementia

    • High blood pressure

    • High fat levels in the blood

    • Fluid retention

    • Worsening of angioedema

  • To reduce the risk of serious side effects, have yearly:

    • Pelvic exams

    • Breast exams

    • Mammograms

  • If you smoke, cutting back or quitting will reduce the risk of serious side effects.

  • Pregnancy after menopause is not likely, but if you think you could be pregnant, tell your doctor. This medicine could harm an unborn baby.

  • Do not breastfeed when using EstroGel.

  • Immediately contact the prescriber if you have unusual vaginal bleeding.

  • Do not allow children or pets to touch the skin where you applied the medicine. If this happens, immediately wash the child or pet's skin with soap and water.

Estrogel interactions

  • To avoid possible drug interactions, tell the prescriber about all the prescription drugs, over-the-counter medications, and supplements being taken, particularly:

    • Other female hormones

    • Thyroid hormones

    • Carbamazepine, clarithromycin, erythromycin, itraconazole, ketoconazole, phenobarbital, rifampin, ritonavir

  • Avoid grapefruit juice when using EstroGel.

  • Tell other healthcare providers you are using this medicine before they prescribe new medications.

Estrogel side effects

Serious side effects

Immediately contact a doctor or get medical attention if you notice any signs or symptoms of a possible serious side effect including:

  • Unusual vaginal bleeding

  • Sudden or severe headache, numbness or weakness on one side of your body, problems with vision, speech, or walking

  • New breast lumps, breast discharge

  • Swelling in your face, hands, ankles, or feet

  • Seizures

  • Abdominal pain, nausea, fatigue, yellow skin or eyes

  • Vision changes

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing

Less serious side effects

  • Headache

  • Breast tenderness

  • Abdominal cramps

  • Bloating

  • Nausea

  • Vomiting

  • Hair loss

  • Fluid retention

  • Vaginal yeast infections

Sources:

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