Estradiol (medication)
Estradiol is also available in the U.S. in combination with progestogens for the treatment of menopausal symptoms and as a combined hormonal contraceptive:Estradiol and estradiol esters are also available in custom preparations from compounding pharmacies in the U.S. This includes subcutaneous pellet implants, which are not available in the United States as FDA-approved pharmaceutical drugs. In addition, topical creams that contain estradiol are generally regulated as cosmetics rather than as drugs in the U.S. and hence are also sold over-the-counter and may be purchased without a prescription on the Internet.
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.