Estriol
Studies suggest that when this lower-potency estrogen, estriol, is administered topically, it does not increase the risk of hormone-dependent cancers of the breast or endometrium (uterine lining). However, having weaker estrogenic effects does not mean that estriol has none of the benefits that come with more potent estrogens. Studies suggest that estriol reduces symptoms of menopause, such as hot flashes and vaginal dryness, but with a better safety profile compared with more potent estrogens.This makes estriol an excellent choice for bioidentical hormone-replacement treatment regimes.
That is not all this hormone is good for! Research suggests that estriol has benefits for bone density, heart health, multiple sclerosis, and postmenopausal urinary tract health.
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Estriol Clinical Information
What Estriol Is
Estriol is a weaker estrogen produced in larger amounts during pregnancy. In compounded hormone therapy, it is often combined with estradiol (called “Biest” — typically 80% estriol / 20% estradiol) or used alone in vaginal preparations. Its weaker activity makes it a useful option for sensitive applications.
Common Uses
- Genitourinary syndrome of menopause — vaginal dryness, irritation, recurrent UTIs
- Component of compounded Biest formulations for systemic perimenopausal symptoms
- Adjunct in women who want a milder estrogen profile than estradiol monotherapy
Contraindications
Same as estradiol: personal history of estrogen-sensitive cancer, active VTE, active liver disease, unexplained vaginal bleeding, pregnancy.
Important Notes
Estriol is not FDA-approved as a finished drug in the United States; it is legally compounded by FDA-registered pharmacies pursuant to a valid prescription. Women with an intact uterus on systemic estriol/estradiol still require progesterone for endometrial protection.
Medically reviewed by: Diana Medina, MMS, PA-C — Florida-licensed Physician Assistant
Medical Director: Luis Campillo, MD
Last reviewed: May 20, 2026
This page is for educational purposes only and does not constitute medical advice. All treatments require an individualized medical evaluation. DMHealth provides services via telehealth to Florida residents under the medical supervision of Luis Campillo, MD, in accordance with Florida Statutes § 458.347 governing physician assistant practice. Some statements have not been evaluated by the U.S. Food and Drug Administration; products mentioned are not intended to diagnose, treat, cure, or prevent any disease.