Conjugated Estrogens Topical Dosage

Medically reviewed by Drugs.com. Last updated on Mar 18, 2025.

Usual Adult Dose for Atrophic Vaginitis

Initial dose: 0.5 grams intravaginally in a cyclic regimen: daily for 21 days, then off for 7 days
Maintenance dose: 0.5 to 2 grams intravaginally in a cyclic regimen: daily for 21 days, then off for 7 days

Comments:

• Adjust dose based on individual response

Uses: Treatment of atrophic vaginitis and kraurosis vulvae

Usual Adult Dose for Postmenopausal Symptoms

0.5 grams intravaginally twice weekly (e.g. Monday and Thursday)
OR
0.5 grams intravaginally in a cyclic regimen: daily for 21 days, then off for 7 days

Uses: Treatment of moderate to severe dyspareunia, a symptom of vulvar and vaginal atrophy, due to menopause

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Contraindicated

Precautions

BOXED WARNINGS:
Endometrial cancer, cardiovascular disorders, breast cancer and probable dementia:

Estrogen Only Therapy:

• There is an increased risk of endometrial cancer in women with uteruses using unopposed estrogens.
• The Women's Health Initiative (WHI) estrogen along substudy reported increased risk of stroke and deep vein thrombosis (DVT).
• The WHI Memory Study (WHIMS) reported an increased risk of probable dementia in postmenopausal women 65 years and older on estrogen-alone therapy.
• Estrogen alone therapy should not be used for prevention of cardiovascular disease or dementia.

Estrogen Plus Progestin Therapy:

• Estrogen plus progestin increased risks of stroke, DVT, pulmonary embolism (PE), and myocardial infarction (MI) in the WHI substudy.
• Estrogen plus progestin increased the risk of invasive breast cancer in the WHI substudy.
• Estrogen plus progestin therapy increased the risk of probable dementia in postmenopausal women 65 years and older in the WHIMS study.
• Estrogen plus progestin should not be used for prevention of cardiovascular disease or dementia.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Generally, a postmenopausal woman with a uterus should have a progestin added to reduce the risk of endometrial cancer.
• Women without a uterus do not need progestin, except some patients with a history of endometriosis may need a progestin.
• Use at the lowest effective dose for the shortest duration consistent with treatment goals.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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