Estradiol benzoate

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Estradiol Benzoate

Estradiol benzoate structure

Estradiol benzoate is a synthetic form of the naturally occurring hormone estradiol, which is an estrogen. It is an estradiol ester, specifically the 3-benzoate ester of estradiol, and is used in hormone replacement therapy and other medical applications.

Pharmacology

Estradiol benzoate is administered via intramuscular injection. Once in the body, it is slowly hydrolyzed into estradiol, the active form of the hormone. This process allows for a prolonged duration of action compared to estradiol itself. The pharmacokinetics of estradiol benzoate involve its absorption, distribution, metabolism, and excretion, which are influenced by the esterification of the estradiol molecule.

Estradiol levels after single intramuscular injections of different doses of estradiol benzoate in premenopausal women

Medical Uses

Estradiol benzoate is used in various clinical settings, including:

Hormone levels with twice-daily injectable estradiol benzoate in transgender women

Mechanism of Action

As an estrogen, estradiol benzoate binds to and activates the estrogen receptor, which then modulates the expression of various genes involved in the development and maintenance of female secondary sexual characteristics and reproductive tissues.

Side Effects

Common side effects of estradiol benzoate include:

Serious side effects can include an increased risk of thrombosis and breast cancer.

Pharmacokinetics

The pharmacokinetics of estradiol benzoate are characterized by its slow release from the injection site and gradual conversion to estradiol. This results in a sustained elevation of estradiol levels in the blood.

Estradiol levels after a single 5 mg intramuscular injection of estradiol esters

Comparative Pharmacokinetics

Estradiol benzoate is one of several estradiol esters used in clinical practice. Others include estradiol valerate and estradiol cypionate. Each ester has different pharmacokinetic properties, influencing the duration and intensity of estradiol's effects.

Estradiol levels after injections of estradiol, estradiol benzoate, estradiol valerate, and estradiol undecylate in women

Vaginal Effects

Estradiol benzoate can induce vaginal cornification, a process where the vaginal epithelium becomes keratinized, which is a marker of estrogenic activity.

Vaginal cornification with a single intramuscular injection of different estradiol esters in women

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Contributors: Prab R. Tumpati, MD