Estriol / Hyaluronic Acid – Gel

Available Dosage Strengths

0.3% / 0.5%

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Product Overview

Estriol Description 1-5

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 can be combined with other compounds into a gel.

Hyaluronic Acid Description6,7 

Hyaluronic Acid, a glycosaminoglycan, has an important role for the skin. It helps maintain hydration, elasticity, and skin integrity. It also has a role in wound healing. As people age, the production of hyaluronic acid decreases, leading to drier and less elastic skin.

Estriol1-5

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:

  • 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

Hyaluronic Acid6,7

Hyaluronic acid may have the following two mechanisms for its activity on the skin: 1) as a passive structural molecule and 2) as a signaling molecule (based on its molecular size). Hyaluronic acid has hydgroscopicity and viscoelasticity properties. It is highly anionic that can attract water. This attraction of water provides the ability of the skin to create volume and provide structural support. The signaling mechanism may be facilitated by its anti-inflammatory properties through its effects on cell migration and cell division.

Estrogen1-5

Common

  • Transient burning, itching, or discharge
  • Spotting or light bleeding (usually resolves quickly)
  • Increased vaginal secretions

Systemic (estriol) (rare at low doses):

  • Breast tenderness
  • Headache
  • Nausea
  • Edema

 

Hyaluronic Acid

Common8 

  • Irritation, redness, and itchiness.

Contraindications: 1-5,8

  • Hypersensitivity or intolerance to estriol, hyaluronic acid or its excipients
  • 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

Precautions: 1-5,8 

Use caution in:

  • Women with a history of estrogen-sensitive malignancy
  • Liver disease
  • Migraines with aura
  • Uncontrolled hypertension

Store at 20°C to 25°C (68°F to 77°F) in a dry place, away from heat and light. Keep out of reach of children.

  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
  6. Fallacara A, Baldini E, Manfredini S, Vertuani S. Hyaluronic Acid in the Third Millennium. Polymers (Basel). 2018 Jun 25;10(7):701.
  7. Bravo B, Correia P, Gonçalves Junior JE, Sant’Anna B, Kerob D. Benefits of topical hyaluronic acid for skin quality and signs of skin aging: From literature review to clinical evidence. Dermatol Ther. 2022 Dec;35(12):e15903.
  8. Modglin L, Cho J. Hyaluronic Acid: Benefits, Uses And More – Forbes Health. January 4, 2024. https://www.forbes.com/health/supplements/hyaluronic-acid/ Accessed August 25, 2025.

This information is for educational purposes only. This compounded product has not been reviewed, approved, or evaluated by the Food and Drug Administration for safety and effectiveness. This product is not intended to diagnose, treat, cure, or prevent any disease. No claims are made regarding treatment, cure, or prevention of any disease or condition.

This information 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.

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