From the Guidelines
Bioidentical estrogen gel (estradiol) should not be used for the primary prevention of chronic conditions in postmenopausal women, as the potential harms outweigh the benefits, according to the USPSTF recommendation statement 1. The use of bioidentical estrogen gel for the skin is not approved by the FDA for the prevention of chronic diseases in postmenopausal women, and its safety and effectiveness have not been evaluated through the FDA's drug approval process 1. Some key points to consider when using bioidentical estrogen gel include:
- The gel should be applied once daily to clean, dry skin, typically on the upper arms, shoulders, or inner thighs, rotating application sites to prevent skin irritation.
- The standard starting dose is typically 0.5-1.0 mg of estradiol daily, though this may vary based on individual needs.
- Apply the gel with clean hands and allow it to dry completely (about 5 minutes) before covering the area with clothing.
- Avoid washing the application site for at least one hour after application to ensure proper absorption.
- Do not apply the gel to breasts, face, irritated skin, or genital areas.
- After application, wash your hands thoroughly to prevent transferring the medication to others through skin contact.
- The gel should be stored at room temperature away from moisture and heat.
- Side effects may include breast tenderness, headaches, nausea, and skin irritation at the application site.
- Estradiol gel works by supplementing or replacing the body's natural estrogen, which helps manage menopausal symptoms like hot flashes and vaginal dryness by binding to estrogen receptors throughout the body.
- Regular follow-up appointments with your healthcare provider are important to monitor effectiveness and adjust dosage as needed. It's essential to note that the USPSTF recommends against the use of combined estrogen and progestin for the prevention of chronic conditions in postmenopausal women, and also recommends against the use of estrogen for the prevention of chronic conditions in postmenopausal women who have had a hysterectomy 1.
From the Research
Guidelines for Using Bioidentical Estrogen Gel on the Skin
- The use of bioidentical estrogen gel, specifically estradiol, on the skin is a topic of interest for menopausal hormone therapy 2, 3.
- Transdermal estradiol products, including gels, are preferred over oral conjugated equine estrogen due to their efficacy and superior safety profile 3.
- FDA-approved transdermal estradiol products are recommended for hormone replacement therapy, along with a progestogen for women with a uterus, due to their efficacy and safety profile 3.
- The benefits of hormone replacement therapy, including bioidentical estrogen gel, in improving menopausal symptoms are well-documented, but the potential risks associated with long-term use must also be considered 4.
- While bioidentical estrogen gel may be used on the skin, there is limited information available on its specific use for skin rejuvenation, although hyaluronic acid, a common ingredient in skin care products, has been shown to have promising effects on skin rejuvenation 5.
- Vaginal estrogen products, which are related to bioidentical estrogen gel, have been found to be effective and safe for the treatment of genitourinary syndrome of menopause, with few adverse effects reported 6.
Key Considerations
- Bioidentical estrogen gel should only be used under the guidance of a healthcare provider, as the risks and benefits of hormone replacement therapy must be carefully considered 2, 3.
- FDA-approved products are preferred over custom-compounded bioidentical products due to their superior consistency and safety standards 3.
- Women with a uterus should use a progestogen in combination with bioidentical estrogen gel to prevent endometrial hyperplasia 2, 3.