My doctor has me taking 5 mg of conjugated estrogens (Premarin®) daily. Do you think I would do better with estradiol (Estrace®), or with ethinyl estradiol (Estinyl®)?
Of the three, I personally prefer estradiol . Estradiol is the major naturally-occurring female hormone. Oral preparations of estradiol are relatively cheap, and have low hepatic toxicity. Moreover, most clinical laboratories can perform estradiol blood levels, allowing you and your doctor to meaningfully compare your blood levels to normal female values. It is far more difficult to obtain meaningful laboratory measurements of blood levels for either conjugated estrogens or ethinyl estradiol. There are no other data I’m aware of suggesting that one estrogen is superior to another, except that ethinyl estradiol is superior to conjugated estrogens in suppressing testosterone when used alone (i.e., without an anti-androgen); and that estradiol and conjugated estrogens are less toxic to the liver than is ethinyl estradiol.
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