Last update March 29, 2022

Estradiol

Low Risk

Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.

A natural Estrogen that is marketed for oral, injection and topical administration (skin and vaginal). On the chemical form of valerate, it is used in association with a progestin as a combined contraceptive. Estradiol is found naturally in breast milk. (McGarrigle 1983)

Estradiol is excreted into breast milk in clinically insignificant (Nilson 1978) or null amounts (Pinheiro 2016, Perheentupa 2004) and no problems have been observed in infants whose mothers were treated. (Reisman 2018, Pinheiro 2016)

Plasma levels of these infants were undetectable or very low. (Pinheiro 2016)

After administration in the form of transdermal patches milk levels have been undetectable. (Pinheiro 2016, Perheentupa 2004)

Despite these data, an older publication associated the use of transdermal estradiol with a case of jaundice and poor weight gain. (Ball 1999).

Estrogens, alone or associated with progestogens, have been used in the treatment of excess milk production(Johnson 2020) and to suppress lactation (Piya 2004, Balmer 1971), although with very little effectiveness.(Kaern 1967)

There is evidence (albeit inconsistent) that estrogen-containing pills may decrease milk production or the duration of breastfeeding, especially if given during the first few weeks postpartum with a daily dose equal to or greater than 30 micrograms (0,03 mg) diarios. (WHO 2002, AAP 2001, Moretti 2000, WHO 1988, Nilsson 1986, Tankeyoon 1984, Díaz 1983, Peralta 1983, Croxatto 1983, Guiloff 1974, Kaern 1967)

Treatment with high doses of estrogens during adolescence does not affect later ability to breastfeed. (Jordan 2007)

The American Academy of Pediatrics states that this medication is usually compatible with breastfeeding. (AAP 2001)

 

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No short-term or long-term clinical, physical or psychomotor developmental problems have been observed in infants whose mothers were taking combined oral contraceptives (Nilsson 1986), except for a few cases published years ago of transient gynecomastia in infants whose mothers were taking a combined oral contraceptive with ethinyl estradiol. (Madhavapeddi 1985, Nilsson 1978, Marriq 1974, Curtis 1964)

Hormonal contraceptives, both combined and progestogen-only, do not alter the composition of milk, neither in minerals (Mg, Fe, Cu, Ca, P) nor in fats, lactose, proteins or calories. (Urzica 2013, Dórea 2000, 1999 y 1998, Costa 1992)

No study has found negative effects on breast milk production or infant weight gain when combined oral contraceptives (estrogen + progestin) are started after the first 2, or better 6, weeks postpartum. (Tepper 2015, Espey 2012)

During lactation progestin-only drugs are preferred or in combination with estrogen for birth control, but whatever, the ones with the lower doses of estrogen should be used. (CDC 2016, 2013 y 2010, WHO 2015, Berens 2015, CLM 2012)

For the first 6 weeks postpartum, non-hormonal methods are of choise. (Berens 2015, Rowe 2013)


See below the information of these related products:

Alternatives

We do not have alternatives for Estradiol.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Estradiol is also known as


Estradiol in other languages or writings:

Group

Estradiol belongs to this group or family:

Tradenames

Main tradenames from several countries containing Estradiol in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. Oral: 5 %
Molecular weight 272 daltons
Protein Binding 98 %
pKa 10.33 -
Tmax 1 - 4 hours
oral: 16.9 ± 6.0 hours
M/P ratio 0.1 -

References

  1. Johnson HM, Eglash A, Mitchell KB, Leeper K, Smillie CM, Moore-Ostby L, Manson N, Simon L; Academy of Breastfeeding Medicine.. ABM Clinical Protocol #32: Management of Hyperlactation. Breastfeed Med. 2020 Mar;15(3):129-134. Abstract Full text (link to original source)
  2. Reisman T, Goldstein Z. Case Report: Induced Lactation in a Transgender Woman. Transgend Health. 2018 Jan 1;3(1):24-26. Abstract Full text (link to original source) Full text (in our servers)
  3. Pinheiro E, Bogen DL, Hoxha D, Wisner KL. Transdermal estradiol treatment during breastfeeding: maternal and infant serum concentrations. Arch Womens Ment Health. 2015 Abstract Full text (link to original source) Full text (in our servers)
  4. Tepper NK, Phillips SJ, Kapp N, Gaffield ME, Curtis KM. Combined hormonal contraceptive use among breastfeeding women: an updated systematic review. Contraception. 2015 Abstract
  5. OMS. Criterios médicos de elegibilidad para el uso de anticonceptivos Quinta edición. Who Library. 2015 Full text (link to original source) Full text (in our servers)
  6. Urzica D, Gales C, Zamfir C, Nechifor M. The influence of oral steroidal contraceptives on magnesium concentration in breast milk. Magnes Res. 2013 Abstract
  7. CLM - Comité de Lactancia Materna de la AEP. Preguntas frecuentes sobre lactancia materna. Folleto. 2012 Full text (link to original source) Full text (in our servers)
  8. Espey E, Ogburn T, Leeman L, Singh R, Ostrom K, Schrader R. Effect of progestin compared with combined oral contraceptive pills on lactation: a randomized controlled trial. Obstet Gynecol. 2012 Abstract
  9. Jordan HL, Bruinsma FJ, Thomson RJ, Amir LH, Werther GA, Venn AJ. Adolescent exposure to high-dose estrogen and subsequent effects on lactation. Reprod Toxicol. 2007 Abstract
  10. Piya-Anant M, Worapitaksanond S, Sittichai K, Saechua P, Nomrak A. The combined oral contraceptive pill versus bromocriptine to suppress lactation in puerperium: a randomized double blind study. J Med Assoc Thai. 2004 Jun;87(6):670-3. Abstract
  11. Perheentupa A, Ruokonen A, Tapanainen JS. Transdermal estradiol treatment suppresses serum gonadotropins during lactation without transfer into breast milk. Fertil Steril. 2004 Abstract
  12. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  13. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  14. Dórea JG. Oral contraceptives do not affect magnesium in breast milk. Int J Gynaecol Obstet. 2000 Abstract
  15. Moretti ME, Lee A, Ito S. Which drugs are contraindicated during breastfeeding? Practice guidelines. Can Fam Physician. 2000 Sep;46:1753-7. Review. Abstract Full text (link to original source) Full text (in our servers)
  16. Dorea JG, Miazaki ES. The effects of oral contraceptive use on iron and copper concentrations in breast milk. Fertil Steril. 1999 Abstract
  17. Ball DE, Morrison P. Oestrogen transdermal patches for post partum depression in lactating mothers--a case report. Cent Afr J Med. 1999 Abstract
  18. Dorea JG, Myazaki E. Calcium and phosphorus in milk of Brazilian mothers using oral contraceptives. J Am Coll Nutr. 1998 Abstract
  19. Kuhnz W, Gansau C, Mahler M. Pharmacokinetics of estradiol, free and total estrone, in young women following single intravenous and oral administration of 17 beta-estradiol. Arzneimittelforschung. 1993 Abstract
  20. Costa TH, Dorea JG. Concentration of fat, protein, lactose and energy in milk of mothers using hormonal contraceptives. Ann Trop Paediatr. 1992 Abstract
  21. World Health Organization (WHO) Task Force on Oral Contraceptives. Effects of hormonal contraceptives on breast milk composition and infant growth. Stud Fam Plann. 1988 Abstract
  22. Croxatto HB, Díaz S, Peralta O, Juez G, Herreros C, Casado ME, Salvatierra AM, Miranda P, Durán E. Fertility regulation in nursing women: IV. Long-term influence of a low-dose combined oral contraceptive initiated at day 30 postpartum upon lactation and infant growth. Contraception. 1983 Abstract
  23. McGarrigle HH, Lachelin GC. Oestrone, oestradiol and oestriol glucosiduronates and sulphates in human puerperal plasma and milk. J Steroid Biochem. 1983 Abstract
  24. Nilsson S, Nygren KG, Johansson ED. Transfer of estradiol to human milk. Am J Obstet Gynecol. 1978 Abstract

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