Oral Estradiol Dosages: Your GoodRx Guide

Estradiol is a lab-made version of estrogen. It has several different uses, but is most commonly prescribed to replace estrogen when levels are low, such as during menopause. It’s also taken as part of estrogen-based gender-affirming hormone therapy (GAHT), although this is considered an off-label use.

This guide will cover typical oral estradiol dosages. Keep in mind that these are general dosing recommendations. Your healthcare provider may have you take estradiol differently than discussed below.

What dosage forms does estradiol come in?

Estradiol comes in many different dosage forms, including oral tablets and vaginal cream, rings, and tablets. It also comes in topical patches, gels, and sprays that are applied to the skin. Vaginal and topical forms of estrogen are covered in separate dosage guides.

Oral estradiol is available in 0.5 mg, 1 mg, and 2 mg tablets. You can take estradiol tablets with or without food, and at any time of day — but it’s best to be consistent with when you take it.

What’s considered a low dose of estradiol?

When taking estradiol, especially as part of hormone replacement therapy, you may hear that a lower estradiol dose is better. That’s because higher doses of estradiol are more likely to cause vaginal bleeding and sore breasts. They may also carry a higher risk of uterine cancer and blood clots than lower doses.

Generally, 0.5 mg of oral estradiol daily is considered “low-dose” estradiol. And a “standard” estradiol dose is 1 mg daily. But keep in mind that the goal of estradiol treatment is to find the lowest effective dosage for your symptoms. And that varies from person to person. So it’s recommended to start with a low dose and slowly increase it until you find the lowest estradiol dosage that works for your symptoms.

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What’s the typical oral estradiol dosage for adults?

The typical oral estradiol dosage depends on why you’re taking it. There are several approved uses for estradiol tablets.

Menopause symptoms (vaginal irritation, hot flashes, and night sweats)

Menopause symptoms can affect the whole body, including vasomotor symptoms such as hot flashes and night sweats. Menopause can also cause changes to the vagina, including vaginal thinning, dryness, and irritation. Painful sex can also be an issue. Estradiol tablets are approved to treat moderate to severe vasomotor as well as vaginal symptoms of menopause.

The recommended oral estradiol tablet dosage for menopause symptoms is 1 mg to 2 mg by mouth once daily for 21 days, followed by no tablets for 7 days. You’ll repeat this 28-day cycle as recommended by your prescriber.

As mentioned, the lowest effective estradiol dosage is preferred. So, your prescriber may prefer to start you on a lower estradiol dosage and increase it slowly over time based on your response. Once you start taking estradiol tablets, they’ll likely check in every 3 to 6 months to see if you still need the medication. It’s best to take estradiol for the shortest time possible.

Good to know: If you have a uterus, it’s recommended to take a progestin along with estradiol for menopause symptoms. This helps lower the risk of uterine cancer caused by estrogen treatment.

Low estrogen levels

For low estrogen levels caused by conditions other than menopause, estradiol tablets are approved to restore estrogen levels to normal. The recommended estradiol dosage for low estrogen levels is 1 mg to 2 mg by mouth once daily. The lowest effective dose is best, so your prescriber may start you at a lower dose and slowly raise it as needed.

Osteoporosis

The oral estradiol dosage for preventing osteoporosis is typically 1 mg to 2 mg once daily. An exact dose isn’t recommended by the manufacturer, as it depends on several different factors and must be tailored to the needs and medical history of the person taking it.

Good to know: Oral estradiol isn’t considered a first-choice option for preventing osteoporosis in women after they’ve gone through menopause. Other treatments, such as bisphosphonates, are a preferred option.

Breast cancer

High doses of estradiol are sometimes used to help manage the symptoms of certain types of breast cancer. The recommended estradiol dosage for breast cancer treatment is 10 mg by mouth 3 times a day for at least 3 months.

Prostate cancer 

Oral estradiol tablets are also approved to help manage the symptoms of certain types of prostate cancer. The approved estradiol dosage for prostate cancer treatment is 1 mg to 2 mg by mouth 3 times a day.

Feminizing hormone therapy

Oral estradiol tablets are sometimes used as part of estrogen-based GAHT. They aren’t FDA-approved for this, so it’s considered an off-label use. The recommended oral estradiol dosage for feminizing hormone therapy is 2 mg to 4 mg daily. Your prescriber may raise the dose up to 8 mg per day based on your response.

What happens if you miss a dose of estradiol?

If you miss a dose of estradiol, take it as soon as you remember. But if it’s almost time for your next dose, skip the missed dose. It’s best not to double up on your doses, unless your healthcare provider tells you to do so.

If you’re taking estradiol tablets on a 21-day on, 7-day off cycle, and you forget to stop or restart taking them on the right day, it’s best to reach out to your medical care team or pharmacist. They’ll be able to help you get back on schedule safely.

If keeping track of your doses becomes challenging for you, consider setting a calendar alert or using a reminder app on your phone to help. You can also talk with your prescriber about other forms of estradiol that may be easier to use.

What should you do if you take too much estradiol?

If you accidentally take an extra estradiol dose, it’s unlikely to cause you serious harm. But large doses of estradiol can lead to uncomfortable symptoms such as:

• Abdominal pain

• Breast tenderness

• Drowsiness

• Fatigue

• Nausea

• Vomiting

• Vaginal bleeding

If you or a loved one takes too much estradiol, contact a healthcare professional or call Poison Control at 1-800-222-1222. They’ll let you know what the best course of action is.

How to save on estradiol tablets

Oral estradiol tablets are only available as a lower-cost generic medication. GoodRx can help you save over 90% off the average retail price of estradiol tablets. A 30-day supply of generic estradiol tablets is as low as $7.92 with a free GoodRx discount.

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Written by:

Emilie White, PharmD

Emilie White is a clinical pharmacist with over a decade of hospital pharmacy experience. Her professional areas of interest include critical care as well as infectious and autoimmune diseases.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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