Over-the-counter estrogen pills: What to know

Estrogen is a hormone commonly known for its role in female sexual and reproductive health. It’s present in males as well. Estrogen also helps your bones, skin, heart, and cognitive health.

You may experience an imbalance in estrogen levels due to menopause. A doctor or healthcare professional may recommend estrogen therapy or prescribe estrogen medications. But there are also OTC alternatives.

Let’s take a look at these alternatives, as well as estrogen pills, their effects, and their advantages and disadvantages.

Note: Sex and gender exist on spectrums. In this article, we use the terms “male” and “female” to refer to a person’s sex assigned at birth.

OTC alternatives to estrogen products

OTC alternatives to estrogen products may help relieve menopausal symptoms. Some come in the form of creams. These will often have different application instructions than prescription creams and work differently.

There are also some menopausal supplements available. These include brands such as Amberen and Estroven, both of which claim to help manage menopause symptoms. Each of these brands have several products. The primary ingredients in Amberen are antioxidants, amino acids, minerals, and vitamin E. Estroven’s main ingredient is rhapontic rhubarb root extract.

Additionally, flaxseed may help with night sweats, while black cohosh may help with both night sweats and hot flashes. Still, research results so far prove inconclusive.

Isoflavones are a popular, more recent supplement for menopausal symptoms, and some studies show benefits while others show inconsistent results.

The Food and Drug Administration (FDA) does not regulate supplements in the same way as it does prescription medications. For example, Amberen and Estroven don’t have FDA approval, though their manufacturers say their products comply with FDA standards.

Before taking any menopausal supplements or other OTC options to ease your symptoms, it’s best to first consult with a doctor or healthcare professional, as they will be able to assess your current medications. They’ll ensure there are no interactions that could worsen underlying health conditions. 

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Estrogen pill uses

Doctors or healthcare professionals may prescribe estrogen pills to balance estrogen in your body. Estrogen pills are one type of estrogen replacement therapy, also known as hormone therapy. People also use estrogen pills in gender affirming therapy.

Estrogen replacement therapy can address an estrogen imbalance due to menopause.

Estrogen pills can help address symptoms that come with menopause, such as:

• vaginal dryness
• hot flashes
• changes in mood
• problems with sleep
• anxiety

If you’re experiencing symptoms of an estrogen imbalance, your doctor or healthcare professional may prescribe or recommend taking estrogen pills.

The types of estrogen include:

• estrone
• estradiol
• estriol

Estrogen medications usually require a prescription. Some of these medications include: 

• estradiol (Estrace)
• conjugated estrogens (Premarin)
• esterified estrogens (Menest)

There are also OTC options to help you relieve menopausal symptoms in the form of supplements, as discussed earlier. 

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What are the pros and cons of taking estrogen pills?

Estrogen pills can help relieve symptoms of menopause and can also lower the risk of osteoporosis and coronary artery disease.

But estrogen pills can also cause some side effects (also referred to as adverse effects), such as:

• vaginal discharge and itching
• headache
• breast tenderness
• vomiting
• nausea
• liver damage
• possible increased risk of cervical and breast cancer

Researchers have looked into the safety, benefits, and disadvantages of estrogen pills.

One of the more serious risks of estrogen pills is an increase in the risk of thrombosis (blood clots), particularly in those with a history of the condition. Your doctor or healthcare professional will consider this before prescribing estrogen medications. It’s important to note that the same risks may not apply to other forms of estrogen, such as patches or vaginal rings. But there is currently insufficient evidence to suggest one form is better than the other.

A 2002 report from the Women’s Health Initiative (WHI) notes that estrogen therapy’s disadvantages, such as an increased risk of cancer and cardiovascular disease, outweigh its benefits. WHI proposed that, should a doctor prescribe estrogen pills, they do so in the smallest dosage and for the shortest amount of time possible.

But 2017 research suggests that estrogen therapy may reduce the risk of coronary artery disease and improve quality of life if you take it at the onset of menopause or soon after. Still, there may also be some risk increases in other areas, including gallbladder disease, urinary incontinence, and stroke.

Discussing estrogen pills with a doctor

If you’re experiencing symptoms of menopause, you may be considering taking estrogen pills or OTC treatments or supplements. Talk with your doctor first about your symptoms. Your healthcare professional may suggest other therapies to best address your symptoms. For a look at treatment options for menopausal symptoms, see this article on medications for menopause.

Remember that the FDA does not regulate supplements. If you’re considering taking supplements for menopausal symptoms, consult with your doctor first.

Summary

Estrogen pills can balance the levels of this hormone in your body. They most commonly help relieve symptoms of menopause, such as hot flashes, vaginal dryness, and mood changes. You can also take estrogen pills as part of gender affirming therapy.

In the United States, you can only purchase estrogen with a valid prescription. There are OTC options to relieve menopausal symptoms in the form of supplements, vaginal tablets, and creams. The FDA does not regulate supplements. They may also not be as efficient as prescribed medication.

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