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Estradiol increases the risk that you will develop endometrial cancer (cancer of the lining of the uterus [womb]). The longer you use estradiol, the greater the risk that you will develop endometrial cancer. If you have not had a hysterectomy (surgery to remove the uterus), you should be given another medication called a progestin to take with topical estradiol. This may decrease your risk of developing endometrial cancer but may increase your risk of developing certain other health problems, including breast cancer. Before you begin using topical estradiol, tell your doctor if you have or have ever had cancer and if you have abnormal or unusual vaginal bleeding. Call your doctor immediately if you have abnormal or unusual vaginal bleeding during your treatment with topical estradiol. Your doctor will watch you closely to help ensure you do not develop endometrial cancer during or after your treatment.
Talk to your doctor regularly about the risks and benefits of using topical estradiol.
WHY is this medicine prescribed?
Estradiol topical may be used for the following:
Estradiol is in a class of medications called estrogen hormones. It works by replacing estrogen that is normally produced by the body.
HOW should this medicine be used?
Topical estradiol comes as a gel in single dose packets and in a pump that dispenses measured amounts of the medication to apply to the skin once a day. Topical estradiol also comes as a spray to apply to the skin as 1 to 3 sprays once a day in the morning. Estradiol gel may be applied at any time of day, but should be applied at around the same time of day every day.
Use topical estradiol exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Topical estradiol products are manufactured differently and are used in slightly different ways. Be sure that you know which topical brand you are using and how and where you should apply it. Read the manufacturer's instructions for use that came with your topical estradiol product carefully. These instructions describe how to apply topical estradiol gel or spray. Be sure that you understand these directions. Ask your healthcare provider if you have any questions about how to apply this medication.
If you are using estradiol gel in a pump, you should apply it in a thin layer to one arm, from the wrist to the shoulder. If you are using estradiol gel in single dose packets, you should apply it in a thin layer to one thigh, on the front of the thigh. If you are using estradiol spray, you should apply it to the inner arm. Do not apply estradiol gel or spray to your breasts or your genital area. Be sure that the skin where you will apply topical estradiol is clean and completely dry, and is not red, irritated, or broken.
If you take a bath or a shower, apply topical estradiol after you have dried your skin completely. Read the manufacturer's patient information about your topical estradiol product for information about when you can wash, shower, bathe, or swim after you apply the medication.
Estradiol gel and spray may catch fire. When you apply topical estradiol, do not smoke or go near a fire or open flame until the medication dries.
Topical estradiol is only for use on the skin. Be careful not to get topical estradiol in your eyes. If you do get topical estradiol in your eyes, wash them with plenty of warm water right away. Call a doctor if your eyes become irritated.
You should apply topical estradiol yourself. If someone else applies the medication to your skin, they should wear disposable gloves and wash their hands well with soap and water after removing the gloves.
Talk to you doctor or pharmacist about applying other skin preparations, including sunscreen, to skin where topical estradiol gel or spray is applied.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
Are there OTHER USES for this medication?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What SPECIAL PRECAUTIONS should I follow?
Before using topical estradiol,
What SPECIAL DIETARY instructions should I follow?
Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.
What should I do IF I FORGET to take a dose?
If you forget to apply a dose of estradiol gel but remember more than 12 hours before you are scheduled to apply your next dose, apply the missed dose right away. If you remember less than 12 hours before you are scheduled to apply your next dose, skip the missed dose and continue your regular dosing schedule the next day. Do not apply extra gel to make up for a missed dose.
If you forget to apply estradiol spray in the morning, apply it as soon as you remember. Do not apply extra spray to make up for a missed dose and do not apply estradiol spray more than once each day.
What SIDE EFFECTS can this medicine cause?
Topical estradiol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
Topical estradiol may increase your risk of developing cancer of the ovaries and gallbladder disease that may need to be treated with surgery. Talk to your doctor about the risks of using this medication.
Topical estradiol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What should I do in case of OVERDOSE?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at http://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
What should I know about STORAGE and DISPOSAL of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not freeze topical estradiol. Keep estradiol gel away from open flame. Dispose of your estradiol gel pump after you have used 64 doses even if it is not completely empty.
Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website http://goo.gl/c4Rm4p for more information.
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org
What OTHER INFORMATION should I know?
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to topical estradiol.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are using topical estradiol.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.
¶ This branded product is no longer on the market. Generic alternatives may be available.
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS® Patient Medication Information™ Copyright, 2026. The American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.
Selected Revisions: May 15, 2026.