Estradiol gel

Estradiol gel is a "bioidentical" hormone therapy, meaning the estrogen it contains is chemically identical to what your body produces naturally. It is absorbed through your skin directly into your bloodstream to help relieve symptoms of perimenopause and menopause.

Estradiol gel is highly effective at reducing hot flashes and night sweats, improving sleep quality by reducing nighttime disruptions, protecting bone health to prevent osteoporosis, and alleviating vaginal dryness and urinary symptoms.

Transdermal/topical estrogen does not increase the risk of blood clots to the same degree as oral estrogens, making it a preferred option for patients with controlled hypertension or higher BMI. It also offers an alternative for women with adhesive allergies or skin irritation from patches, and allows for flexible dosing not always available in commercial products.

Apply once daily, ideally at the same time each day.

Spread the gel in a thin, even layer. Do not rub or massage it in. Wash your hands immediately with soap and water. Allow the gel to dry completely (about 1–5 minutes) before dressing. Do not shower, swim, or apply lotion or sunscreen to the area for at least 1 hour after application.

To prevent accidental transfer, ensure the application site is completely dry before skin-to-skin contact with others. 

If a child or pet touches the area before it is dry, wash the exposed skin immediately with soap and water.

Store the gel at room temperature, away from excessive heat or moisture. Keep in a secure place out of reach of children and pets.

Yes but most side effects are mild and usually disappear within 2 to 4 weeks as your body adjusts.

You may experience breast tenderness, mild nausea, or slight bloating. While rare, you may experience occasional redness at the application site. You may experience light, intermittent vaginal spotting in the first few months. If bleeding is heavy or persists beyond four months, contact your provider.

• Thyroid: If you take thyroid medication, we may check your TSH levels after 6 weeks, as estrogen can sometimes change your thyroid needs.
• Potassium: If used with Slynd (Drospirenone) and other potassium-sparing drugs (e.g., spironolactone), we may monitor serum potassium in the first month.

Do not apply other products to the same patch of skin at the same time as your gel and always wait for the area to dry before applying moisturizers or sunscreen.

You should generally not use estradiol gel if you have:

• Active liver disease.
• A history of hormone-sensitive cancers (like certain breast cancers).
• Unexplained vaginal bleeding that hasn’t been evaluated.
• A history of blood clots or heart attack (though transdermal gel is safer than oral pills, your specific history must be reviewed).
• Pregnancy: MHT is not recommended if you are pregnant.

Talk to your Midi clinician before combining this cream with a patch or any other estradiol product.