Estradiol valerate
In addition to single-drug formulations, oral estradiol valerate is available in combination with the progestin dienogest as a combined oral contraceptive and intramuscular estradiol valerate is marketed in combination with the progestins hydroxyprogesterone caproate and norethisterone enantate as combined injectable contraceptives. Intramuscular estradiol valerate has also been marketed in combination with testosterone enantate, but this formulation has been discontinued. The availability of estradiol valerate-containing products varies throughout the world.
Pharmacokinetics of estradiol
Estradiol is well-absorbed regardless of route of administration. However, the bioavailability of estradiol differs substantially with different routes of administration. Oral estradiol has an average bioavailability of around 5%, requiring relatively high dosages of estradiol for effects. Conversely, transdermal estradiol has much higher potency, with a 20-fold lower dosage of transdermal estradiol being equivalent in potency to oral estradiol. Estradiol administered in the form of an ester by intramuscular or subcutaneous injection has complete bioavailability.