Who should avoid estriol or get extra medical review before using it?

Your physician needs a full health history before prescribing estriol. Important concerns include unexplained vaginal bleeding, breast cancer or another estrogen-sensitive cancer, blood clots, stroke, heart disease, and liver disease. These conditions may make estrogen inappropriate or call for specialist input.

If you have had breast cancer, do not start estriol without discussing it with your cancer care team. Nonhormonal options are often considered first for vaginal symptoms. Any decision about vaginal estrogen should account for your cancer history, current cancer treatment, and the proposed estrogen product.

Tell your physician if you are pregnant, could become pregnant, or are breastfeeding. Estriol is not birth control. Also share whether you have a uterus, whether you have had a hysterectomy, and whether you take any other hormones.

A licensed physician in your state decides whether treatment is appropriate. An online review may not be enough if symptoms call for an exam or testing. Compounded medications are prepared by a licensed pharmacy for one patient and are not FDA-approved.