Available Dosage Strengths
1 mg/gm | 2 mg/gm
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Micronized estriol is a bioidentical form of estriol (E3)—one of the three naturally occurring estrogens in women (alongside estradiol and estrone). Estriol is the weakest estrogen, with a much lower receptor binding affinity and duration of action than estradiol (E2). Though the weakest estrogen, estriol shows potential for skin-rejuvenating properties such as restoring dermal thickness and elasticity. Estriol is most commonly used along with estradiol in postmenopausal women with estrogen-deficiency. Estriol is most commonly prepared in a transdermal cream, allowing for incremental dosing adjustments. 1-5
Estriol acts by binding to estrogen receptors alpha (ERα) and beta (ERβ) in estrogen-responsive tissues, particularly the vaginal epithelium, bladder, urethra, and pelvic floor musculature.
Mechanisms and Effects: 1-5
– Can help restore vaginal epithelial thickness and improves cell maturation index
– Can improve blood flow, elasticity, and lubrication of vaginal tissues
– Locally can improve thickening of dermal-epidermal junction, potentially improving skin firmness
– May exert cytoprotective and anti-inflammatory effects on urogenital tissues
Common: 1-5
Systemic (rare at low doses): 1-5
Contraindications: 1-5
– Active or history of estrogen-dependent cancers (e.g., breast, endometrial) — unless use is explicitly approved by an oncology or menopause specialist
– Active or recent thromboembolic disease
– Undiagnosed abnormal genital bleeding
– Severe liver dysfunction
– Hypersensitivity to estriol or excipients
Precautions: 1-5
Use caution in:
– Women with a history of estrogen-sensitive malignancy
– Liver disease
– Migraines with aura
– Uncontrolled hypertension
Store in a cool, dry place, away from direct light and heat; Room temperature (20°C–25°C / 68°F–77°F) is ideal. Keep out of reach of children and pets.
1. Cynthia A. Stuenkel, Susan R. Davis, Anne Gompel, Mary Ann Lumsden, M. Hassan Murad, JoAnn V. Pinkerton, Richard J. Santen, Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 100, Issue 11, 1 November 2015, Pages 3975–4011, accessed July 2025 through: https://doi.org/10.1210/jc.2015-2236
2. North American Menopause Society (NAMS) Position Statement on Hormone Therapy (2022) Supports vaginal estrogen (including estriol) for GSM with minimal systemic risks; accessed July 2025 through: https://www.menopause.org/docs/default-source/professional/2022-nams-ht-position-statement.pdf
3. NIH DailyMed, Estriol; accessed July 2025 though: https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=estriol
4. Estriol: A Comprehensive Guide for Patients; accessed July 2025 through: https://clinicaltrials.eu/inn/estriol/
5. Rzepecki AK, Murase JE, Juran R, Fabi SG, McLellan BN. Estrogen-deficient skin: The role of topical therapy. Int J Womens Dermatol. 2019 Mar 15;5(2):85-90. Accessed July 2025; doi: 10.1016/j.ijwd.2019.01.001. PMID: 30997378; PMCID: PMC6451761
This sheet is a summary. It may not cover all possible drug information about this product. Call your doctor for medical advice and/or about side effects. You may report side effects to the FDA at 1-800-FDA-1088. A Wells Pharmacy Network pharmacist will be happy to answer any questions. For consultation, please call 1-800-622-4510.
