Estrogens

Synonym(s)

Estrogens

Definition
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Female sex hormones.

Pharmacodynamics (Effect)
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Antiseborrhoeic; increase in the size of the epidermal cells; increase in the rate of cell division. In atrophic skin: reappearance of the normal reteleistae pattern. Also: Hyperemic; proliferation-increasing; antipruriginous (in climacteric); increased hair growth and formation of follicular units in animal experiments.

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Dermatology

Hirsutism

Pathologically increased facial, sexual and body hair (= androgen-dependent regions = male hair pattern) in...

Indication
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Climacteric complaints, Kraurosis vulvae.

Limited indication
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Breastfeeding, diabetes mellitus with vascular damage, peripheral circulatory disorders, endometriosis, lipometabolic disorder, liver dysfunction, renal insufficiency, edema, uterus myomatosus.

Notice! Stop 6 weeks before a planned major operation!

Undesirable effects
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Menstrual disorders, weight gain, loss or increase of libido, gastrointestinal disorders, hepatitis, icterus, liver adenomas, alopecia, chloasma, allergic reactions, photosensitization, hirsutism, vulvovaginal candidiasis, increase in blood pressure, phlebitis, thrombocytopenia, depression, seizures, visual disturbances, contact lens intolerance, sudden hearing loss, leg cramps.

Notice!

The risk of endometrial carcinoma in postmenopausal women is 5-14 times higher, therefore do not use as monotherapy in hysterectomized women! Therapy only simultaneously with gestagens!

Interactions
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See Table 2.

Contraindication
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Pregnancy, unclear vaginal bleeding, intrahepatic cholestasis, estrogen-dependent corpus carcinoma, gallbladder diseases, difficult to control hypertension, hypertriglyceridemia that is difficult to influence therapeutically, hormone-dependent mammary tumor, migraine, otosclerosis, pancreatitis, sickle cell anemia, Z.n. thrombosis.

Tables
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Overview of the most common estrogen preparations

Active ingredient	Concentration [mg]	Selection of ready-to-use preparations
Estradiol	0,025	Estraderm TTS 25 patch
	0,0375	Menorest 37.5 Patch
	0,05	Estraderm TTS 50 plaster
	0,075	Menorest 75 Patch
	0,1	Linoladiol N Cream
	0,1	Estraderm TTS 100 Patch
	1	Estrifam tbl. 1 mg
Estradiol valerate	2	Progynova Drg.
	4	Progynova Trp.
	10	Progynon Depot Amp.
Estriol	0,1	Ortho-Gynest Vaginal Cream
	0,25	Vago-med vaginal gel
	0,3	Oekolp vaginal ointment, suppository
	0,5	Ovestin Ovula
	1	Cordes Estriol cream
	2	Ovestin tbl / Ovestin vaginal cream
Ethinylestradiol	0,025	Ethinylestradiol Jenapharm Drg.
conjugated estrogens	0,3	Presomen mite Drg.
	0,6	Presomen Drg.
	0,625	Transannon mite Drg.
	1,25	Presomen 1.25
Estradiol valerate + Estriol	1 + 2	Neoestrogynal Drg.

Major interactions of estrogens

Alfacalcidol	Alfacalcidol action ↑
Antidepressants, tricyclic.	Estrogen toxicity ↑, antidepressant effect ↓
Ascorbic acid, high dose.	Estrogen levels ↑
Barbiturates	Estrogen levels ↓
Carbamazepine	Effect of low-dose estrogens ↓
Chenodeoxycholic acid	Chenodeoxycholic acid effect ↓
Coumarins	Coumarin effect ↓
Fibrates	Fibrate effect ↓, triglyceride ↑, especially in familial hypertriglyceridemia
Glucocorticoids	Glucocorticoid levels ↑
Griseofulvin	Estrogen level ↓
Insulin	Glucose tolerance disorder
Metformin	Glucose tolerance disorder
Penicillins	transient oestrogen levels↓
Phenytoin	Effect of low-dose estrogens ↓
Rifampicin	Estrogen effect ↓
Sulfonylureas	Blood sugar lowering ↑ or ↓
Ursodeoxycholic acid	Ursodeoxycholic acid effect ↓