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pellets for hormone balance

Estradiol Pellets

10 mg | 12.5 mg | 15 mg | 18 mg | 20 mg | 25 mg

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Disclaimer: Images are for reference only; actual products may vary.

Product Overview

Estradiol Pellets Description1-7

Micronized estradiol is a bioidentical form of 17β-estradiol, the primary estrogen produced by the ovaries in premenopausal women. It is used in various hormone therapy (HT) regimens and is often considered a preferred estrogen formulation for menopausal women due to its bioidentical structure and favorable risk profile when prescribed appropriately. When applied topically for transdermal absorption or implanted subcutaneously, micronized estradiol bypasses first-pass liver metabolism, contributing to its favorable risk profile, as first-pass metabolism of estradiol can significantly increase thromboembolic factors. Estradiol can also be administered continuously via subcutaneous implantation using a compounded pellet, typically lasting around three months.

Mechanism of Action1-7

Estradiol binds to estrogen receptors, which are widely distributed in reproductive tissues, the brain, bone, liver, and vasculature. Upon receptor binding, estradiol influences gene transcription, leading to a broad range of systemic and local effects:

  • Endometrial stimulation: Promotes proliferation in the endometrial lining.
  • Thermoregulatory effects: May relieve hot flashes by stabilizing hypothalamic activity.
  • Bone preservation: May reduce osteoclast-mediated bone resorption, maintaining bone mineral density.
  • Vaginal and urogenital health: Helps to maintain epithelial integrity, pH balance, and blood flow.
  • Neuroprotection: Modulates neurotransmitter systems that affect mood, cognition, and sleep.
  • Cardiovascular modulation: Promotes vasodilation and improves lipid profile, although the route of administration affects cardiovascular risk.

Common1-7

  • Breast tenderness
  • Nausea
  • Headache
  • Bloating or fluid retention
  • Breakthrough vaginal bleeding
  • Mood swings

Less Common / Serious Risks1-7

  • Increased risk of venous thromboembolism (VTE) (primarily with oral use)
  • Gallbladder disease
  • Endometrial hyperplasia or cancer if unopposed by a progestogen in women with a uterus

Contraindications1-7

  • Undiagnosed abnormal genital bleeding
  • Active or history of estrogen-dependent cancer (e.g., breast, endometrial)
  • Active or recent thromboembolic disorders (e.g., DVT, PE, stroke, heart attack)
  • Active liver disease
  • Known hypersensitivity to estradiol or formulation components

Precautions1-7

Use caution in women with:

  • Controlled hypertension
  • Migraine with aura
  • Hypertriglyceridemia
  • Diabetes mellitus
  • History of gallbladder disease
  • History of or active hormone-sensitive cancers (in remission)

 

*Use with Progesterone:

For women with an intact uterus, progesterone in some form should be included with systemic estradiol therapy to prevent endometrial hyperplasia or carcinoma.

Store in a cool, dry place, away from direct light and heat; Room temperature (20°C–25°C / 68°F–77°F) is ideal. Keep out of reach of children and pets.

  1. Cynthia A. Stuenkel, Susan R. Davis, Anne Gompel, Mary Ann Lumsden, M. Hassan Murad, JoAnn V. Pinkerton, Richard J. Santen, Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 100, Issue 11, 1 November 2015, Pages 3975–4011, accessed July 2025 through: https://doi.org/10.1210/jc.2015-2236
  2. FDA Drug Label – Estradiol cream by Teva Pharmaceuticals accessed July 2025 through: https://fda.report/DailyMed/8cb31c7c-fba8-4201-833d-844ea1a8a4de
  3. MedlinePlus Drug Information – Estradiol: https://medlineplus.gov/druginfo/meds/a605021.html
  4. North American Menopause Society (NAMS) Position Statement (2022): “The 2022 Hormone Therapy Position Statement of The North American Menopause Society” https://www.menopause.org/docs/default-source/professional/2022-nams-ht-position-statement.pdf
  5. Sobel TH, Shen W. Transdermal estrogen therapy in menopausal women at increased risk for thrombotic events: a scoping review. Menopause. 2022 Jan 14;29(4):483-490. doi: 10.1097/GME.0000000000001938. PMID: 35357370.
  6. Canonico, M., Oger, E., Plu-Bureau, G., Conard, J., Meyer, G., Lévesque, H., … & Scarabin, P. Y. (2007). Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study. Circulation, 115(7), 840-845.
  7. Clinical Pharmacology estradiol clinical monograph accessed July 2025 through: https://www.clinicalkey.com/pharmacology/monograph/1330?n=Estradiol

WPPL operates as a 503A compounding pharmacy and prepares individualized prescription medications pursuant to provider direction. Compounded preparations are not reviewed, tested, or approved by the FDA.

This listing also includes commercially manufactured products for convenience; these items are not compounded by our pharmacy and are sold as provided by their manufacturers. Actual products in stock at time of dispensing may vary due to supply chain variability. Any statements regarding non-compounded products are manufacturer-supplied, have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease. WPPL does not verify or endorse any therapeutic claims made by manufacturers. Please refer to original labeling for complete product information.

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