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How Long Does Estradiol Take to Work? A Complete Guide
Wondering, “How long does estradiol take to work?” Estradiol can take up to six months to work, depending on the delivery method, dose, and other factors like diet, genetics, and the severity of your symptoms.
Estradiol is both a hormone produced by the human body and a medication you can take to replace it. People who are deficient in estradiol due to menopause or other reasons may receive an estradiol prescription from their doctor.
Even though estradiol is FDA-approved, it does come with some risks. Estradiol has common, mild side effects and some more severe but less frequent risks. You should also be careful to note estradiol interactions.
This guide will explain how quickly you can expect your medication to take effect. We will also describe the most important facts to know about estradiol. Read on to learn more.
What Is Estradiol?
Estradiol is a naturally occurring estrogen hormone. It is one of the four primary types of estrogen produced by the bodies of people assigned female at birth. These four types include:
- Estrone
- Estradiol
- Estriol
- Estetrol
It is the most common hormone produced by the bodies of people assigned female at birth. The ovaries produce this hormone to regulate menstruation and the cardiovascular, neurological, skeletal, and vascular system.
Estrone is predominately active after menopause. Estriol and estetrol are only released during pregnancy. Estradiol is the most potent and abundant form of estrogen and is predominantly active during the reproductive years.
People assigned male at birth also have small amounts of estradiol circulating in their bodies. In these individuals, estradiol regulates sexual functions, such as libido, erections, and sperm production.
How Does Estradiol Work?
Estradiol medication works by replacing natural estrogens in the body. This medication is a type of hormone replacement therapy (HRT). Brand-name products like Estrace, Climara, and Vivelle are bioidentical to natural estradiol.
When someone takes estradiol, levels of estrogen in the body increase. These hormones can then act on certain estrogen receptors located in target tissues designed to respond to estradiol.
The exact effects estradiol has on your body will depend on the type of product you use and the symptoms your doctor prescribes it for. It also depends on whether you were assigned male or female at birth.
Who Needs Estradiol?
People who are experiencing menopause can benefit from taking estradiol. Estradiol levels decrease most significantly during menopause. Restoring levels of this hormone can help fight common menopause symptoms.
Your doctor may prescribe estradiol to reduce the severity of hot flashes, a menopause symptom. If you experience vaginal irritation, dryness, and pain during sex due to menopause, take to your doctor about getting on estradiol.
Estradiol can also be beneficial for people with late-stage breast cancer and prostate cancer in people assigned male at birth, individuals who are transitioning from male to female, and those with hypoestrogenism.
Who Should Not Use Estradiol?
You should not use estradiol if you have certain pre-existing medical conditions. Talk to your doctor about your history with the following conditions before starting your estradiol prescription:
- Abnormal vaginal bleeding
- Blood vessel disease
- A history of blood clots
- Certain types of cancer (breast, cervical, endometrial, ovarian, liver, or uterine)
- Dementia
- Diabetes
- Gallbladder disease
- Heart disease
- A history of heart attacks
- High blood pressure
- High cholesterol
- Hysterectomy
- Kidney disease
- Liver disease
- Migraines
- Protein C or S deficiencies
- Stroke
- Systemic lupus erythematosus
- Tobacco use
- Allergic reactions to estrogens or other HRTs
People who are breastfeeding, pregnant, or trying to get pregnant are also not ideal candidates for estrogen therapy.
Does Estradiol Have Side Effects?
Yes, estradiol does have side effects. The most common ones include breast tenderness or pain, hair loss, and gastrointestinal symptoms like bloating, stomach pain, nausea, and vomiting.
Estradiol also has more severe side effects. Experiencing the following side effects means you should see a doctor as soon as possible:
- Allergic reactions
- Blood clots
- Changes in your breast tissue
- Gallbladder issues
- Liver injuries
- Pelvic pain
- Post-menopausal vaginal bleeding
- Stroke
- Unusual vaginal discharge
Severe side effects are relatively uncommon. Your doctor will not recommend it unless they believe the known benefits of using estradiol outweigh the potential for these risks.
What Should You Not Take With Estradiol?
You should not take estradiol with aromatase inhibitors. These drugs lower estrogen levels and may make your medication less effective. Other medications to avoid while using estradiol include but are not limited to:
- Carbamazepine
- Certain antibiotics
- Certain azole antifungals
- Certain barbiturates
- Certain benzodiazepines
- Grapefruit juice
- Raloxifene
- Rifabutin
- Rifampin
- Rifapentine
- Ritonavir
- St. John’s Wort
- Tamoxifen
- Warfarin
Medications also interact with substances, including alcohol and tobacco products and herbal supplements. Always mention everything you take on a daily basis when discussing a new prescription with your doctor.
How Long Does Estradiol Take to Work?
How long estradiol takes to work depends on the format, the dose, and other factors, including genetics, diet, and severity of your symptoms. In general, you can expect your prescription to take effect within a few days to up to six months.
If you are looking for the fastest-acting option for your symptoms, talk to your doctor. Together, you can find the right format and dose that will offer you the fastest relief possible.
Estradiol Formats
Estradiol is available in multiple formats, including tablets, injections, vaginal rings, transdermal patches, and topicals. Some formats work faster than others, but not all formats are available for your symptoms.
Tablets
There are two types of estradiol tablets. Oral tablets can be taken by mouth once daily. Vaginal estradiol tablets are inserted into the vaginal once daily for the first two weeks and then two times per week after that.
Oral and vaginal estrogen tablets are typically prescribed for hot flashes and other menopause symptoms. They can take anywhere from a few weeks to a few months to work.
Injections
Vaginal injections are administered monthly or every three weeks if your symptoms are severe. Injections are one of the most common formats of estradiol doctors prescribe for hot flashes and other menopause symptoms.
One of the main benefits of estradiol injections is that they are delivered straight into the bloodstream. They work extremely fast or in as little as one to five days after undergoing your first treatment.
Vaginal Rings
Vaginal estradiol rings are inserted into the vagina and replaced after 90 days. It is another medication prescribed to reduce menopause symptoms, especially pain during sex, vaginal irritation, and vaginal dryness.
One brand-name vaginal estradiol ring, ESTRING, has been shown to improve symptoms in around 80% of people after 12 weeks. Other estimates claim that this format can work in as little as two weeks.
Transdermal Patches
Transdermal estradiol patches are delivered to the bloodstream via a patch applied to the skin. Doctors typically prescribe this format of estrogen to people who have undergone a hysterectomy.
This format of estradiol delivery is faster than taking an oral medication. Some studies have found that transdermal estradiol patches can work within one to two weeks of starting the treatment.
Topicals
Topical estrogens like estradiol are applied to the skin, typically the vaginal area. These medications are primarily designed to treat menopause-related dryness, irritation, and pain during sex. They come in many formats, including:
- Sprays
- Gels
- Creams
Estradiol topicals can take up to six months to work. However, most women will experience an improvement in the above symptoms within weeks of starting their prescription.
Estradiol Doses
The dose of estradiol your doctor prescribes will impact how quickly it takes effect. However, the same dose may impact two people differently depending on other factors (more on these below).
Your dose will depend on your symptoms. For example, doctors typically prescribe the following doses for menopause symptoms:
- Oral tablets: 1 to 2 milligrams once daily
- Transdermal patches: 0.025 to 0.1 milligram patch
- Injections: 1 to 5 milligrams every three to four weeks (estradiol cypionate) or 10 to 20 milligrams every four weeks (estradiol valerate)
In general, the higher the dose you take, the faster you can expect your medication to take effect.
Other Factors
Many other factors can impact how quickly your estradiol medication takes effect. Three of the most important ones are diet, your unique genetic makeup, and the severity of your symptoms.
Diet
Studies show that a high-fiber diet can reduce estrogen levels. While there is no research showing how fiber interacts with estradiol medication, there is a possibility that it may make your medication less effective.
Genetics
Genetics impact the way your body produces hormones. But your genes also affect your estrogen hormone receptors. If you naturally produce fewer estradiol receptors, it may take longer for your medication to take effect.
Severity of Symptoms
The more severe your symptoms are, the longer it may take your medication to work. Often, this is because your doctor may start you on a lower dose before increasing it if your symptoms do not respond.
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So how long does estradiol take to work? Estradiol can work within a few days if you receive injections. It may also take up to six months to experience the full effects of estradiol, depending on the format, dose, and other factors.
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