Is Estradiol compatible with breastfeeding? Do we have alternatives for Estradiol?

Estradiol

April 19, 2018 (Low Risk)

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 birth-control compound (e.g. Estradiol + Dienogest)

Estradiol is excreted into breast milk in clinically non-significant amount (Nilson 1978) and no problems have been observed in infants whose mothers were treated (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).
There is greater passage to milk when the administration is vaginal.

There is evidence (albeit inconsistent) that estrogen-containing pills may decrease milk production, especially during the first few weeks postpartum
They may reduce the protein content of the milk.

No problems have been observed in infants whose mothers were treated, except some cases of transient gynecomastia in infants whose mothers were receiving a higher dose than usual.

Estrogen exposure in childhood or adolescence, does not influence the subsequent production of milk.

The American Academy of Pediatrics states that this medication is usually compatible with breastfeeding.


See below the information of this related product:

Alternatives

We do not have alternatives for Estradiol.

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Dihydrofolliculin
  • Estradiol Acetate
  • Estradiol Enantate
  • Estradiol Valerate

Writings

  • Οιστραδιόλη (Greek)
  • Эстрадиол (Cyrillic)
  • エストラジオール (Japanese)
  • C18 H24 O2 (Molecular formula)
  • Estra-1,3,5(10)-triene-3,17β-diol (Chemical name)
  • G03CA03 (ATC Code/s)

Drug trade names

References

  1. Pinheiro E, Bogen DL, Hoxha D, Wisner KL. Transdermal estradiol treatment during breastfeeding: maternal and infant serum concentrations. Arch Womens Ment Health. 2015Abstract Full text (link to original source) Full text (in our servers)
  2. 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. 2007Abstract
  3. Perheentupa A, Ruokonen A, Tapanainen JS. Transdermal estradiol treatment suppresses serum gonadotropins during lactation without transfer into breast milk. Fertil Steril. 2004Abstract
  4. Gjerdingen D. The effectiveness of various postpartum depression treatments and the impact of antidepressant drugs on nursing infants. J Am Board Fam Pract. 2003Abstract Full text (link to original source) Full text (in our servers)
  5. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001Abstract Full text (link to original source) Full text (in our servers)
  6. Perheentupa A, Critchley HO, Illingworth PJ, McNeilly AS. Enhanced sensitivity to steroid-negative feedback during breast-feeding: low-dose estradiol (transdermal estradiol supplementation) suppresses gonadotropins and ovarian activity assessed by inhibin B. J Clin Endocrinol Metab. 2000Abstract Full text (link to original source)
  7. Ball DE, Morrison P. Oestrogen transdermal patches for post partum depression in lactating mothers--a case report. Cent Afr J Med. 1999Abstract
  8. Illingworth PJ, Seaton JE, McKinlay C, Reid-Thomas V, McNeilly AS. Low dose transdermal oestradiol suppresses gonadotrophin secretion in breast-feeding women. Hum Reprod. 1995Abstract
  9. Baker VL. Alternatives to oral estrogen replacement. Transdermal patches, percutaneous gels, vaginal creams and rings, implants, other methods of delivery. Obstet Gynecol Clin North Am. 1994Abstract
  10. 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. 1993Abstract
  11. McGarrigle HH, Lachelin GC. Oestrone, oestradiol and oestriol glucosiduronates and sulphates in human puerperal plasma and milk. J Steroid Biochem. 1983Abstract
  12. Nilsson S, Nygren KG, Johansson ED. Transfer of estradiol to human milk. Am J Obstet Gynecol. 1978Abstract
  13. Koetsawang S, Bhiraleus P, Chiemprajert T. Effects of oral contraceptives on lactation. Fertil Steril. 1972Abstract
  14. Kamal I, Hefnawi F, Ghoneim M, Abdallah M, Abdel Razek S. Clinical, biochemical, and experimental studies on lactation. V. Clinical effects of steroids on the initiation of lactation. Am J Obstet Gynecol. 1970Abstract