Evalon Cream (Estriol)

What is Estriol?

Estriol sold under the name Ortho Dienestrol or Evalon is one of the three types of Estrogen which is also produced by the female human body. Its main function is to help develop and nurture female reproductive organs and the urinary system. When your body has a deficiency of the hormone Estriol, it can be fulfilled by an outside supply to ease the unpleasant conditions brought about by its short supply. These include changes in conditions in the vagina, vulva (genitals), and urethra (a component of the urinary system). Vaginal Estriol treats conditions like genital skin condition - vulvar atrophy, vaginal inflammation – atrophic vaginitis, urethral inflammation – atrophic urethritis.

The best Estriol cream refers to a topical product that contains Estriol, a naturally occurring hormone from the estrogen family. Estriol cream is commonly used in hormone replacement therapy (HRT) to alleviate symptoms of menopause and vaginal dryness. Estriol cream over the counter refers to Estriol creams that can be purchased without a prescription. These creams typically contain lower concentrations of Estriol compared to prescription-strength options. They are often used for milder symptoms and may provide relief for vaginal dryness and discomfort. Estriol cream can also be used for wrinkles. Estriol, as a hormone, has been suggested to have beneficial effects on the skin, including increased collagen production and improved skin elasticity. Estriol cream may help reduce the appearance of fine lines and wrinkles, although individual results may vary.

Estriol Uses

Estradiol is used as a hormone replacement therapy (HRT) in post-menopausal women or women with absent ovaries or ovaries unable to produce enough estrogen and to prevent the fragility of bones (osteoporosis). Estradiol is sometimes also used as part of breast cancer treatment in women and men, and prostate cancer in men. It is used at a very low dose in combination with a progestogen hormone as an oral contraceptive.

How it works

• Estradiol is a form of estrogen, a female sex hormone produced by the ovaries. It acts by replacing the natural hormone in the body when the latter is deficient.
• Important Information about Estriol
• Estriol works partly by elevating a normal and clear discharge from the vagina leading to a healthy vulva and urethra. Using or applying Estriol leads to relief and lessening of Vaginal dryness and soreness. Vulvar itching, redness, or soreness, frequent urge to urinate which is more than required or pain while urinating, or pain during sexual intercourse.
• Estriol is absorbed into the bloodstream when used vaginally or applied on the skin and can have the same effects but not all when taken by mouth. Estriol which is a type of the hormone estrogen when used vaginally at low doses will help in treating local problems of the genitals and urinary system but will be ineffective in treating osteoporosis or hot flushes due to menopause. Estriol for vaginal use is strictly available on prescription only.
  
  

Things to know before taking Estriol

Remember to tell your doctor about any allergies you have from similar medicines or other drugs. Also tell your doctor or physician about other allergies like foods, dyes, preservatives, or animals before starting Estriol intake or application. Similarly, tell your doctor about an impending or current pregnancy or if you are a nursing mother as Estriol is not recommended for both pregnant and nursing women. This hormone should also not be taken if you have certain pre-existing medical conditions about which you should talk to your doctor along with your medical history.

How to take Estriol?

Estriol is available as pills for oral use or as vaginal creams that are directly applied inside the vagina. Vaginal estriol medications normally come with proper directions on their labels. Don’t forget to properly read all the instructions and precautions before taking or applying the medicine. Maintain a high degree of hygiene by washing hands before and after using the medication as you will be dealing with some of the most sensitive areas of your body which are highly prone to infections. Use Estriol strictly as advised by your doctor; anything more or less may have serious effects or may prove to be ineffective. Estriol can take up to 4 months of usage before you see its full effect. Your doctor may adjust your Estriol dosage several times during the course of treatment or even reconsider continuing with the medication depending on your condition. This can happen within the first one or two months and every 3 to 6 months after that.
Vaginal estriol is usually applied using a plastic applicator which is inserted into the vagina, directions for which are provided on the label. Ask your doctor for more information about the directions and use.

What to do in case of missed dose?

Although a medicine dose should never be missed, if you do forget to take or apply a dose of Estriol due to reasons best known to you, do it as soon as you remember. However, don’t take or apply the missed dose if it is time already for the next dose. Don’t ever try to take double doses as it may prove to be dangerous and fatal as your body can accommodate only a certain amount of dosage.

Overdose. Now what?

If you had an overdose of Estriol, you may experience symptoms of sickness and vaginal bleeding. If the intake or application of Estriol is very high or if you have accidentally ingested Estriol cream, then seek emergency medical help from your doctor or rush to your nearest hospital or medical facility.

Estriol Side Effects

Estriol can show these side effects: Skin irritation and itching around the vagina as well as increased vaginal discharge; bloated feeling; frequent urination as well as pain while doing it; gall bladder issues; dark areas or small red spots on the skin; painful red swelling or bruising on legs; memory loss; pain in the abdominal area; cramps in legs; premenstrual tension symptoms; palpitations; feeling low or depressed; breakthrough bleeding or spotting from the vagina; tender, breast swelling, tenderness, and pain; headache, feeling unwell.
Some rare and serious side effects of Estriol are pain in the chest that advances to the arm and neck; sudden swelling in the face or throat which may hinder breathing or swallowing; extreme blistering of the skin; excruciating migraine-like headache; painful leg swelling; yellow skin and white areas of eyes (Jaundice); high blood pressure; changes in the condition of the breasts like skin dimple formation, changes in nipple texture or lump formation that can be seen or felt. Immediately seek emergency medical help in case of these symptoms.
The side effects listed above are non-exhaustive and there can be other effects as well. Consult your doctor for more advice related to side effects.

How much Estriol is to take?

Again, this depends on patient to patient. You should strictly follow the directions of your doctor and avoid altering the dosage as prescribed by him or her.

Evalon Cream (Estriol) Interaction with other drugs

You should not start, stop or alter any medication without strict medical advice from your doctor. Estriol should not be taken with the following medicines as it may cause fatal reactions in combination with them. They are Rifampicin, Rifabutin, Nevirapine, Efavirenz, Ritonavir, Nelfinavir, Bosentan, Lamotrigine and Again, this list is non-exhaustive and there can be other possible interactions so lets your doctor know about any existing medicines, OTC pills or any herbal products which you may be using prior to using Estriol.

Expert advice

• The drug can cause nausea, vomiting, or breast tenderness.
• Do not use estradiol patches over your breast stop taking estradiol and see a doctor immediately if you notice any of the following when taking estradiol:
• yellowing of your skin or the whites of your eyes (jaundice).
• rise in your blood pressure (symptoms may be a headache, tiredness, and dizziness).
• new onset migraine-like headaches.
• pregnancy.
• signs of a blood clot, such as painful swelling and redness of the legs, sudden chest pain, and difficulty in breathing.
• Do not consider estradiol alone as a contraceptive. It must be used with progestogen to provide contraceptive benefits.
• Consult your doctor if you have unusual vaginal bleeding while taking this drug, Immediately consult your doctor if you notice unexplained swelling and pain in your limbs, shortness of breath, chest pain, severe headache, or changes in vision. This medicine should not be taken for a very long period.
• Consult your doctor from time to time to check if you still need it.

Frequently asked questions

Evalon Cream (Estriol)

Q. Is Estriol and estrogen the same/ is estradiol the same as progesterone/ is estradiol a synthetic hormone/does estradiol valerate work/What is Avalon cream?

Estriol is the most potent natural estrogen (or “estrogen”) produced by ovaries in females. It is different from another female hormone that is progesterone. It is not a conjugated estrogen and it is not a synthetic hormone. Estradiol valerate and Evalon vaginal cream work same as estradiol.

Q. Can I take estrogen for polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome (PCOS) is mainly a result of a hormonal disturbance in which there are high levels of male hormones in the body. Oral contraceptive pills containing low-dose estrogen and progestogen are commonly prescribed to reduce the levels of the endogenous hormone, which helps regularize the menstrual cycle, reduce male hormone levels, and decrease acne associated with PCOS. Always consult your doctor before using any medication.

Q. What can I take for estrogen dominance?

A balanced diet, exercise, a healthy lifestyle, and less exposure to environmental pollutants are what work best to restore the normal hormone balance and reduce estrogen dominance. Your doctor may also start progesterone therapy, compounds that promote bile secretion, lipotropic formulas (which excrete extra estrogen from the body), substances that deactivate toxic substances, and excess hormones to remove extra estrogen from your body.

Q. What can I take for estrogen deficiency?

For estrogen deficiency, treatment is based on the underlying cause. Your doctor may choose from a variety of medications depending upon your condition e.g. young or old with menopause, estrogen deficiency, or high progesterone levels, etc. You may be given bio-identical estradiol or estriol or counterbalance with natural progesterone in the form of micronized capsules, etc.

Q. Can I take estrogen forever?

The length of the necessity of hormone therapy varies from person to person and the condition for which it is being treated.

Q. Can I take estradiol or estrogen without progesterone/ with food/ with Synthroid (levothyroxine)/ with Mirena (levonorgestrel)/ with Estroven (multivitamins)/ with melatonin/ paracetamol?

In some cases, progesterone therapy may be given simultaneously to reduce the risk associated with estrogen therapy. You may take estradiol with food but eating or drinking grapefruit juice should be avoided as it may increase the risk of estradiol's side effects. Estrogen is known to have a moderate interaction with Synthroid (levothyroxine), Mirena, and minor with melatonin. No interactions have been found with paracetamol. Tell your doctor if you also have any other medicinal or herbal products before using estrogen in any form.

Q. Is estradiol safe/ stop your period/ increase libido/cause constipation/ cause high blood pressure/ make you sleepy/ cause blood clots/ cause insomnia/ cause bloating/ make you emotional?

Estradiol is safe if used at recommended dosage and duration. Estradiol can stop your periods. It may cause high blood pressure and blood clots on long-term use. Other side effects are not confirmed but may occur in some patients. Consult your doctor if you experience one of them.

Q. Is estriol gluten-free?

Estradiol preparations are gluten-free. However, as the content of excipients differs according to the manufacturer, please refer to the package insert of the particular preparation/brand that you have been prescribed.

Q. Is estradiol a conjugated estrogen/ better than Premarin?

Estradiol is a synthetic hormone, whereas Premarin contains conjugated estrogen. Both are different types of estrogen and have comparable benefits and side-effect profiles.