Public record

Estradiol: the public record

17 tables from US federal sources. Latest data date: Nov 11, 2026.

Each table is computed from the named federal dataset as of its data date; the method is under each one.

Label

FDA label facts for estradiol

The FDA label read for estradiol (Vivelle-Dot, application NDA020538) was last revised on 2026-10-30. It carries a boxed warning headed "WARNING: ENDOMETRIAL CANCER WITH UNOPPOSED ESTROGEN IN WOMEN WITH A UTERUS". Of the 4 population sections checked, 4 are present: pregnancy, lactation, pediatric use, geriatric use.

FDA label facts for estradiol: the figures
MeasureValueNote
Label revision date2026-10-30
Label readVivelle-DotNDA020538, brand-name application
Boxed warningYesheading as printed: "WARNING: ENDOMETRIAL CANCER WITH UNOPPOSED ESTROGEN IN WOMEN WITH A UTERUS"
Pregnancy sectionPresent
Lactation sectionPresent
Pediatric use sectionPresent
Geriatric use sectionPresent

Source: FDA drug label via openFDA, viewable on NIH DailyMed, data as of Nov 11, 2026

How this was calculated

Selected the most recently revised prescription label for this single ingredient from an original manufacturer, preferring a brand-name application. Checked which sections exist and quoted headings and sentences exactly as printed.

Scope: One label: the newest prescription label for single-ingredient estradiol from an original manufacturer

Read from one label. Labels for other brands, strengths or forms of the same ingredient can differ. A missing section heading does not mean there is no guidance. Read the full label before relying on it.

Download the data (CSV)

Approvals

FDA approval history for estradiol

The earliest FDA approval on file for a estradiol product is 1975-07-23. Drugs@FDA lists 65 applications for it and 437 approved supplements, the most recent on 2026-10-30.

FDA approval history for estradiol: the figures
MeasureValueNote
Earliest FDA approval on file1975-07-23
Applications with an approval on file65
New drug applications (NDA)22
Generic applications (ANDA)43
Approved supplements437label, manufacturing and efficacy changes
Most recent supplement approval2026-10-30
Sponsoring companies44

Source: FDA, Drugs@FDA, data as of Nov 11, 2026

How this was calculated

Selected applications with a product whose only active ingredient is this substance, then counted approved original and supplemental submissions. The earliest approved original submission is the first approval.

Scope: Applications with a single-ingredient estradiol product in Drugs@FDA, all sponsors and strengths

Older approvals can be missing dates, and tentative approvals are not counted. An approved application does not mean the product is currently marketed.

Download the data (CSV)

Patents and generics

Patents and generic approvals for estradiol

The FDA Orange Book lists 41 approved generic applications for estradiol, the first approved on 1984-01-31. 24 listed patents on specific brand products have not yet expired, the last on 2034-02-02; generics of other versions are already approved.

Patents and generic approvals for estradiol: the figures
MeasureValueNote
Brand-name applications (NDA)20
Approved generic applications (ANDA)41first approved 1984-01-31
Companies with a generic not marked discontinued19
Listed patents not yet expired24
Latest listed patent expiry2034-02-02on any product; may cover only one brand formulation
Earliest approval date on filebefore 1982
Products not marked discontinued121 of 170

Source: FDA, Orange Book (Approved Drug Products with Therapeutic Equivalence Evaluations), data as of Oct 9, 2026

How this was calculated

Selected Orange Book products whose only active ingredient is this substance, then counted applications by type and the distinct patents and exclusivities listed against them. Expired patents are left out.

Scope: All single-ingredient estradiol products in the Orange Book, every brand and strength, files dated 2026-10-09

An approved generic or an expired patent does not show that a generic is on sale. Launch timing also depends on litigation, settlements and supply. Biologics and compounded products are not in the Orange Book.

Download the data (CSV)

Medicare Part D

Medicare Part D claims for estradiol by age group

Of 5,130,549 Medicare Part D claims for estradiol in 2024, 4,443,430 (86.6%) were for enrollees aged 65 and over and 687,119 were for enrollees under 65.

Medicare Part D claims for estradiol by age group: the figures
MeasureValueNote
All Part D claims, 20245,130,549
Claims for enrollees aged 65 and over4,443,430
Claims for enrollees under 65687,119mostly people who qualify through disability
Share of claims for enrollees aged 65 and over86.6%share of claims, not of patients

Source: CMS, Medicare Part D Prescribers by Geography and Drug, data as of 2024

How this was calculated

Summed the national rows for every brand and generic row with this generic name. Claims under 65 are total claims minus claims for enrollees 65 and over.

Scope: National Part D claims for single-ingredient estradiol products, 2024, split at age 65

Medicare mostly covers people 65 and over, so this split describes Medicare enrollees and not use in the general population.

Download the data (CSV)

Medicare Part D

Medicare Part D claims for estradiol by state

California had the most Medicare Part D claims for estradiol in 2024 (640,273), followed by Texas (390,081) and Florida (342,985). Prescribers in 59 states and territories wrote 5,129,996 claims in all.

Medicare Part D claims for estradiol by state: the figures
MeasureValueNote
All states and territories, 20245,129,996 claims
States and territories with reported claims59
California640,273 claims$63.5M gross drug cost
Texas390,081 claims$25.4M gross drug cost
Florida342,985 claims$23.4M gross drug cost
New York246,054 claims$26.8M gross drug cost
North Carolina182,223 claims$13.0M gross drug cost

Source: CMS, Medicare Part D Prescribers by Geography and Drug, data as of 2024

How this was calculated

Summed claims and drug cost by prescriber state over every brand and generic row with this generic name. Combination products excluded. Rows CMS suppressed for small counts are left out.

Scope: Part D claims for single-ingredient estradiol products by the prescriber's state, 2024

State counts follow population size and where the prescriber practises. They are not per-person rates and do not show any state's coverage rules.

Download the data (CSV)

Medicare Part D

Medicare Part D spending on estradiol

Medicare Part D spending on estradiol products was $398.7M in 2024 across 5,132,890 claims, compared with $417.8M in 2023 (-4.6%). Average spending per claim was $77.68, before rebates.

Medicare Part D spending on estradiol: the figures
MeasureValueNote
Total spending, 2024$398.7M
Total spending, 2023$417.8M
Change in spending, 2023 to 2024-4.6%
Claims (prescription fills), 20245,132,890
Average spending per claim, 2024$77.68
Estradiol*: spending, 2024$218.2M4,055,858 claims
Estring: spending, 2024$49.2M90,750 claims
Estradiol (Twice Weekly): spending, 2024$30.6M319,673 claims

Source: CMS, Medicare Part D Spending by Drug, data as of 2024

How this was calculated

Summed total spending and claims over every brand and generic row with this generic name in the CMS file, using the Overall manufacturer rows. Combination products excluded. Average per claim is spending divided by claims.

Scope: Every single-ingredient estradiol product in Part D (Estradiol*, Estring, Estradiol (Twice Weekly)), 2024.

Gross drug cost before manufacturer rebates, so net cost is lower. Part D excludes some uses by law (for example erectile dysfunction, weight loss and hair growth), so claims reflect covered uses only. Compounded products are not included.

Download the data (CSV)

Medicaid

Medicaid prescriptions for estradiol by state

State Medicaid programmes paid for 1,646,048 estradiol prescriptions in 2025, with $82.4M reimbursed before rebates. California reported the most (244,801), followed by New York (119,511) and Oregon (99,444); 52 states and territories reported any.

Medicaid prescriptions for estradiol by state: the figures
MeasureValueNote
Prescriptions paid by Medicaid, 20251,646,048
Total reimbursed before rebates, 2025$82.4M
States and territories reporting52with at least one count CMS did not suppress
California244,801 prescriptions$16.8M reimbursed
New York119,511 prescriptions$6.7M reimbursed
Oregon99,444 prescriptions$3.9M reimbursed
Washington76,777 prescriptions$3.3M reimbursed
Ohio73,723 prescriptions$2.5M reimbursed

Source: CMS, Medicaid State Drug Utilization Data 2025, data as of 2025

How this was calculated

Matched each Medicaid product code to the FDA NDC Directory by labeler and product code, kept finished single-ingredient products, then summed prescriptions and reimbursement by state. National roll-up and suppressed rows dropped.

Scope: All single-ingredient estradiol products in the FDA NDC Directory, fee-for-service and managed care, 2025

Counts under 11 are suppressed by CMS and left out, so totals are a floor. Amounts are before rebates. Differences between states reflect programme size and coverage rules. Compounded products are not included.

Download the data (CSV)

Pharmacy cost

Pharmacy acquisition cost (NADAC) for estradiol

Retail pharmacies paid an average of $5.50 per unit for ESTRADIOL 10 MCG VAGINAL INSRT as of 2026-11-11, compared with $7.00 twelve months earlier (-21.5%). This is a pharmacy purchase cost, not a patient price.

Pharmacy acquisition cost (NADAC) for estradiol: the figures
MeasureValueNote
ESTRADIOL 10 MCG VAGINAL INSRT$5.50 per unit12 months earlier $7.00 (-21.5%)
ESTRADIOL 1 MG TABLET$0.0632 per unit12 months earlier $0.0702 (-10.0%)
ESTRADIOL 0.025 MG PATCH(2/WK)$8.01 per unit12 months earlier $6.30 (+27.2%)
ESTRADIOL 0.0375 MG PATCH(2/WK)$8.26 per unit12 months earlier $7.01 (+17.7%)
ESTRADIOL 0.05 MG PATCH (2/WK)$8.61 per unit12 months earlier $7.51 (+14.7%)
ESTRADIOL 0.075 MG PATCH(2/WK)$8.23 per unit12 months earlier $6.86 (+20.1%)

Source: CMS, National Average Drug Acquisition Cost (NADAC), data as of Nov 11, 2026

How this was calculated

Matched NADAC product codes to the FDA NDC Directory, kept finished single-ingredient products, and listed the product descriptions with the most package codes. The earlier price is the same package code in the file one year before.

Scope: Generic versions of estradiol in the weekly NADAC file of 2026-11-11, compared with the file of 2025-11-12

NADAC is the average invoice price retail pharmacies pay, from a voluntary survey. It leaves out rebates, dispensing fees and markups, and it is not what a patient or insurer pays. Compounded products are not surveyed.

Download the data (CSV)

Adverse event reports

FDA adverse event reports naming application site skin reactions and estradiol

Through 2026-10-28, FDA had received 2,936 adverse event reports for estradiol that name application site skin reactions, out of 75,081 reports for the drug in all. 2,666 of these reports concerned female patients and 8 male patients.

FDA adverse event reports naming application site skin reactions and estradiol: the figures
MeasureValueNote
Reports naming application site skin reactions2,936
All reports for estradiol75,081
Share of this drug's reports naming it3.9%share of reports received, not of people taking the drug
Of those: female patients2,666reflects who takes the drug and who files reports
Of those: male patients8
Of those: sex not recorded262

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, data as of Oct 28, 2026

How this was calculated

Counted FAERS reports listing this active substance and at least one of these reaction terms: application site irritation, application site erythema, application site pruritus, application site rash. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.

Scope: Reports with estradiol as a single-ingredient active substance (any brand), 4 MedDRA terms for application site skin reactions

FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.

Download the data (CSV)

Adverse event reports

FDA adverse event reports naming blood clots and estradiol

Through 2026-10-28, FDA had received 481 adverse event reports for estradiol that name blood clots (deep vein thrombosis or pulmonary embolism), out of 75,081 reports for the drug in all. 399 of these reports concerned female patients and 41 male patients.

FDA adverse event reports naming blood clots and estradiol: the figures
MeasureValueNote
Reports naming blood clots (deep vein thrombosis or pulmonary embolism)481
All reports for estradiol75,081
Share of this drug's reports naming it0.6%share of reports received, not of people taking the drug
Of those: female patients399reflects who takes the drug and who files reports
Of those: male patients41
Of those: sex not recorded41

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, data as of Oct 28, 2026

How this was calculated

Counted FAERS reports listing this active substance and at least one of these reaction terms: deep vein thrombosis, pulmonary embolism. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.

Scope: Reports with estradiol as a single-ingredient active substance (any brand), 2 MedDRA terms for blood clots

FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.

Download the data (CSV)

Adverse event reports

FDA adverse event reports naming breast tenderness or pain and estradiol

Through 2026-10-28, FDA had received 713 adverse event reports for estradiol that name breast tenderness or pain, out of 75,081 reports for the drug in all. 657 of these reports concerned female patients and 1 male patients.

FDA adverse event reports naming breast tenderness or pain and estradiol: the figures
MeasureValueNote
Reports naming breast tenderness or pain713
All reports for estradiol75,081
Share of this drug's reports naming it0.9%share of reports received, not of people taking the drug
Of those: female patients657reflects who takes the drug and who files reports
Of those: male patients1
Of those: sex not recorded55

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, data as of Oct 28, 2026

How this was calculated

Counted FAERS reports listing this active substance and at least one of these reaction terms: breast tenderness, breast pain. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.

Scope: Reports where FDA recorded estradiol as a single-ingredient active substance (any brand, any route or form), MedDRA terms breast tenderness, breast pain

FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.

Download the data (CSV)

Adverse event reports

FDA adverse event reports naming headache and estradiol

Through 2026-10-28, FDA had received 4,641 adverse event reports for estradiol that name headache, out of 75,081 reports for the drug in all. 4,245 of these reports concerned female patients and 41 male patients.

FDA adverse event reports naming headache and estradiol: the figures
MeasureValueNote
Reports naming headache4,641
All reports for estradiol75,081
Share of this drug's reports naming it6.2%share of reports received, not of people taking the drug
Of those: female patients4,245reflects who takes the drug and who files reports
Of those: male patients41
Of those: sex not recorded355

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, data as of Oct 28, 2026

How this was calculated

Counted FAERS reports listing this active substance and at least one of these reaction terms: headache. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.

Scope: Reports where FDA recorded estradiol as a single-ingredient active substance (any brand, any route or form), MedDRA term headache

FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.

Download the data (CSV)

Adverse event reports

FDA adverse event reports naming unexpected vaginal or uterine bleeding and estradiol

Through 2026-10-28, FDA had received 1,198 adverse event reports for estradiol that name unexpected vaginal or uterine bleeding, out of 75,081 reports for the drug in all. 1,084 of these reports concerned female patients and 0 male patients.

FDA adverse event reports naming unexpected vaginal or uterine bleeding and estradiol: the figures
MeasureValueNote
Reports naming unexpected vaginal or uterine bleeding1,198
All reports for estradiol75,081
Share of this drug's reports naming it1.6%share of reports received, not of people taking the drug
Of those: female patients1,084reflects who takes the drug and who files reports
Of those: male patients0
Of those: sex not recorded114

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, data as of Oct 28, 2026

How this was calculated

Counted FAERS reports listing this active substance and at least one of these reaction terms: vaginal haemorrhage, intermenstrual bleeding, uterine haemorrhage. A report can name several reactions and several drugs. Counts by year use the date FDA received the report.

Scope: Reports with estradiol as a single-ingredient active substance (any brand), 3 MedDRA terms for unexpected vaginal or uterine bleeding

FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.

Download the data (CSV)

Adverse event reports

Most reported events in FDA adverse event reports for estradiol

Through 2026-10-28, FDA had received 75,081 adverse event reports for estradiol, 28,845 of them marked serious by the reporter. The symptom terms named most often were headache (4,641), fatigue (4,124) and nausea (4,084).

Most reported events in FDA adverse event reports for estradiol: the figures
MeasureValueNote
All reports received75,081
Reports the reporter marked serious28,845death, hospitalisation, disability or similar outcome
Headache4,641 reports
Fatigue4,124 reports
Nausea4,084 reports
Hot flush2,985 reports
Pain2,980 reports

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, data as of Oct 28, 2026

How this was calculated

Counted FAERS reports listing this active substance, then the reaction terms named most often. A report can name several reactions, and a term can describe the illness being treated and not an effect of the drug. Terms about product use or complaints rather than symptoms (for example drug ineffective) were left out of the list.

Scope: Reports where FDA recorded estradiol as a single-ingredient active substance (any brand, any route or form), all years to 2026-10-28

FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.

Download the data (CSV)

Recalls

FDA drug recalls naming estradiol

FDA enforcement reports list 22 drug recall entries naming estradiol from 2015 to 2026-10-07. 0 of them are for compounded or other unlisted products and 22 for products FDA lists under a label. The most common stated reason was other reasons (8 of 22).

FDA drug recalls naming estradiol: the figures
MeasureValueNote
Recall entries on record22
For products FDA lists under an approved or registered label22
For compounded or other unlisted products0matched by the name in the product description
Class I (most serious)0
Class II18
Class III4
Most recent recall reported2026-10-07
Most common stated reasonother reasons8 of 22 entries

Source: FDA, Enforcement Reports (drug recalls) via openFDA, data as of Nov 10, 2026

How this was calculated

Counted enforcement report entries matched by FDA's listed active substance, or by the name in the product description where FDA lists none. Reasons were grouped by keywords in FDA's stated reason.

Scope: Recalls of single-ingredient estradiol products, plus compounded or unlisted products whose description names it

Each recall covers specific lots from one firm and is not a statement about every product with this ingredient. One event can appear as several entries, one per product.

Download the data (CSV)

Clinical studies

Registered clinical studies of estradiol

ClinicalTrials.gov lists 2,024 registered studies that name estradiol as an intervention as of 2026-11-11. Of these, 207 are recruiting, 1,146 are completed and 358 are phase 3 studies.

Registered clinical studies of estradiol: the figures
MeasureValue
Registered studies2,024
Recruiting now207
Not yet recruiting59
Completed1,146
Terminated, withdrawn or suspended244
Phase 3 (including phase 2/3)358
Phase 2 (including phase 1/2)538
Phase 1383

Source: NIH National Library of Medicine, ClinicalTrials.gov, data as of Nov 11, 2026

How this was calculated

Searched the ClinicalTrials.gov intervention field for the name, downloaded every matching record and counted by overall status and phase. Combined phases are counted under the higher phase. Phase not applicable covers observational, device and behavioural studies.

Scope: Studies whose intervention field matches estradiol, any condition, any country, all statuses

A registered study is not a result. Counts include studies where the drug is a comparator or background treatment, and studies that never finished or reported.

Download the data (CSV)

Population data

How estradiol is distributed in US adults

In the 2021 to 2023 US national health survey, the median estradiol was 23.0 pg/mL in men aged 20 to 39 and 74.5 pg/mL in women aged 20 to 39. Half of people in each group fall below the median; the row notes give the range covering the middle 90%.

How estradiol is distributed in US adults: the figures
MeasureValueNote
Men 20 to 39, median23.0 pg/mLmiddle 90% of people: 10.8 to 41.7; 608 people tested
Men 40 to 59, median24.6 pg/mLmiddle 90% of people: 11.6 to 42.1; 711 people tested
Men 60 and over, median23.6 pg/mLmiddle 90% of people: 8.9 to 43.3; 1,184 people tested
Women 20 to 39, median74.5 pg/mLmiddle 90% of people: 5.5 to 420; 787 people tested
Women 40 to 59, median19.4 pg/mLmiddle 90% of people: 1.2 to 246; 900 people tested
Women 60 and over, median4.3 pg/mLmiddle 90% of people: 1.2 to 20.5; 1,342 people tested

Source: CDC National Center for Health Statistics, NHANES August 2021 to August 2023, data as of 2023

How this was calculated

Computed survey-weighted 5th, 50th and 95th percentiles from the CDC public file by sex and age band, using the sample weight WTPH2YR. Groups with fewer than 50 people are left out.

Scope: US adults aged 20 and over who gave a sample in NHANES 2021 to 2023, CDC variable LBXEST (Estradiol (pg/mL))

These are population distributions, not clinical reference ranges or treatment targets. They include people with and without health conditions and people on medication. Laboratories differ in method and units.

Download the data (CSV)

Articles on Estradiol