Prescription onlyNo lower cost generic available


(Estradiol Gel)

  • Cream, gel, or ointment
  • Hot flashes and night sweats
  • Vaginal dryness and inflammation
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Relieves hot flashes and vaginal dryness due to menopause.

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Prescription onlyNo lower cost generic available

Our bottom line

Estrogel (Estradiol Gel) is the only topical gel that treats hot flashes and vaginal symptoms, but it needs to be applied over your entire arm instead of one small area like other types of estrogen products.


  • Estrogel (Estradiol Gel) is the only estrogen gel that treats menopausal both hot flashes and vaginal symptoms.
  • It’s a popular topical estrogen that's also used in Europe and Canada.
  • Replenishes estrogen to your whole body and relieves multiple symptoms due to low estrogen (hot flashes, vaginal dryness).
  • Good for people who don't want to take daily pills.
  • The pre-measured packets are easy to use and can be taken anywhere.
  • Fewer side effects than pills since there are lower amounts of estrogen in topical gels.
  • Can lower your risk of fractures by keeping your bones healthy. Make sure you also get enough calcium and Vitamin D.
  • Improves mood, energy, and mental alertness for some people.
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  • Increases your risk of endometrial and breast cancer.
  • If you have your uterus, you have to use Estrogel (Estradiol Gel) with another hormone called progestin to lower your risk of uterine cancer.
  • Increases your risk of developing blood clots and stroke.
  • Can't be used in people with liver problems.
  • It's possible to expose other people to the estrogen before it's absorbed by your skin.
  • Can be expensive since it's only available as a brand name product.

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What to expect when you take Estrogel (Estradiol Gel)

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Tips from our pharmacists
  • Spread the gel thinly over your right or left arm (from the wrist to the shoulder), alternating arms each day.
  • Don't put it on your face, breasts, vagina, or irritated skin.
  • Don't rub it in. Let the gel dry before dressing, and don't get the application site wet for at least 1 hour.
  • Wash your hands well after applying the gel.
  • Can cause nausea, dizziness, bloating, and breast tenderness.
  • Tell your doctor about any unusual vaginal bleeding.
  • Get emergency care if you notice unexplained swelling and pain in your limbs, shortness of breath, chest pain, severe headache, or changes in vision.
  • The gel is alcohol-based and flammable, so you shouldn't smoke while applying it.
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Side effects for Estrogel (Estradiol Gel)

From clinical trials of Estrogel / Postmenopausal estrogen replacement (1.25 g/day)  ( 241)

  • Breast painBreast pain11% for Estrogel vs.8% for placebo
  • HeadacheHeadache10% for Estrogel vs.3% for placebo
  • Passing gasPassing gas5% for Estrogel vs.4% for placebo
  • Application site reactionsApplication site reactions1% for Estrogel vs.0% for placebo

Risks and Warnings for Estrogel (Estradiol Gel)

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    • Higher risk if:
    • Using estrogen for more than one year

    Vaginal bleeding after menopause can be a warning sign of uterus (endometrial) cancer, so let your doctor know if you notice any unusual bleeding. When estrogen is prescribed to women after menopause who still have a uterus, progestin should be used with it to lower the risk of cancer. Low-dose vaginal estrogen products are often a better choice than oral pills for women 65 years or older who have vaginal symptoms.

    This is a black box warning. The FDA requires this warning when there is a significant risk of serious or life-threatening effects that anyone taking the drug should consider.

Means that some groups have a high risk of experiencing this side effect

Tips from pharmacists and people taking Estrogel (Estradiol Gel)

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The FDA category for this medication is X. It is advised that you: Unsafe
  • Tips from our pharmacists
  • The gel is alcohol-based and flammable, so you shouldn't smoke while applying it.
  • I sleep better since I apply the Estrogel in the morning.