Does Estrace Cream Come In A Vaginal Tablet?

Answer

Thanks for reaching out! There are a number of different vaginal estradiol products available on the market, including the one you are taking, Estrace, which is a vaginal cream. There are vaginal estradiol tablets available as well, but the tablets are lower strength and don't have exactly the same absorption properties, so it's challenging to determine an exact dose for dose change.

You specifically asked whether or not there is an oral estradiol tablet available, which there is, but they are not intended for vaginal administration. They are available in higher dosages than vaginal products too. While I certainly have seen some prescribers prescribe their patient's oral estradiol for vaginal use, it generally isn't recommended as there is little safety and efficacy data when they are used this way.

Since cost is an issue, vaginal tablets may be a good option for you. They are a lower strength than Estrace but are available generically and may be less expensive under your insurance. Generic estradiol tablets include:

• Estradiol 10mcg (generic Vagifem)
• Yuvafem 10mcg

Even though the tablets are a lower strength from Estrace cream, most studies show that they produce similar improvement in symptoms.

What Are The Options For Vaginal Estrogen?

I've made a chart below that details all of the vaginal estradiol options (including Premarin, which is a conjugated estrogen product):

Tablet Options For Estrace

As you can see in the table in the above section, the vaginal tablet options come in doses of 4mcg and 10mcg, far less than the 100mcg you get per gram of Estrace.

Now, it is important to note that vaginal estrogen tablets and vaginal cream can't be directly compared on a strength-strength basis as they each have different absorption profiles but studies do show the Estrace, when used at the usual dosages, does produce, generally, higher systemic concentrations of estrogen (i.e., estrogen in your blood) than the tablets do.

While most studies show that all vaginal estrogen products are fairly comparable in regard to how well they treat menopausal symptoms, I would expect some differences in how you respond to one product compared to another.

Since you mentioned oral estradiol, I'll say here that they come in doses of 0.5mg (500mcg), 1mg (1,000mcg), and 2mg (2,000mcg), clearly higher than what is available in the vaginal dosage forms.

I have seen some patients use oral estradiol tablets vaginally but it's not common. There is little data to go on regarding the safety of using the higher-strength oral tablets this way and little data regarding how well they work when used vaginally (i.e., they are not formulated for vaginal administration like the vaginal tablets are).

I think your safer options are to use the vaginal estradiol tablets (generic Vagifem or Yuvafem), but be sure to speak with your doctor about what options are best for you.

Estrace also is available generically, so that could be an option too.

Final Words

Thanks again for contacting us!