Combination of | |
---|---|
Estrone | Estrogen |
17β-Estradiol | Estrogen |
Equilin | Estrogen |
Clinical data | |
Trade names | Amniotin, Estrogenic Hormones, Estrogenic Substances, Estrolin, Estromone, Folestrin, Follacro, Menformon, Oestroform, Ova-Estrin, Theelestrin, others |
Other names | Natural estrogens; Estrone-like preparations |
Routes of administration | By mouth (tablets, capsules), topical (ointment), vaginal (suppository), intramuscular injection (oil solution) |
Drug class | Estrogen |
Legal status | |
Legal status |
|
Estrogenic substances, also referred to as natural estrogens and sold under the brand name Amniotin among others, is an estrogen medication which was marketed in the 1930s and 1940s and is no longer available. [1] [2] [3] [4] [5] [6] It was a purified extract of animal material such as horse urine, placenta, and/or amniotic fluid, and contained a non-crystalline mixture of estrogens, including estrone, 17β-estradiol, 17α-estradiol, and/or equilin. [3] [1] [7] [8] [5] [9] The medication was thought to contain estrone as its major active ingredient [7] and was described as an estrone-like preparation, or as "essentially estrone". [1] [3] [5] Estrogenic substances was originally produced from the urine of pregnant women, placenta, and/or amniotic fluid, but by the early 1940s, it was manufactured exclusively from the urine of stallions or pregnant mares, similarly to almost all other estrogen preparations on the market. [8] [9] [7] [1]
Estrogenic substances was marketed under a variety of different brand names including Amniotin (Squibb), Equine Estrogenic Substances (Ayerst), Estrogenic Hormones (Upjohn, others), Estrogenic Substances (Reed & Carnrick, Sharp & Dohme, others), Estrolin (Lakeside), Estromone, Estronat (National Drug), Folestrin (Armour), Follacro (Schieffelin), Menformon (Roche-Organon), Neo-Amniotin (Squibb), Oestroform, Ova-Estrin, Theelestrin, and Urestrin (Upjohn), among others. [1] [2] [3] [4] [6] It was provided in various forms and routes of administration including oil solution and aqueous suspension for intramuscular injection, oral tablets and capsules, vaginal suppositories, and topical ointments. [2] [3] [4] [1] [6]
Estrogen medications similar to but distinct from estrogenic substances included conjugated estriol (Emmenin) and conjugated estrogens (Premarin). [1] They are also non-crystalline mixtures of estrogens. [1] Estrogenic substances were also distinct from pure crystalline preparations such as estrone, estradiol, estriol, estradiol benzoate, and estradiol dipropionate. [1] The medication should additionally be distinguished from estrogen ovarian extracts, which had little activity and were considered to be essentially inactive. [10] [2]
Progynon and Amniotin were both marketed by 1929. [11] Amniotin was originally prepared from the amniotic fluid of cattle, but was later prepared using other sources such as the urine of pregnant mares. [12] [9]
Estradiol (E2), also spelled oestradiol, is an estrogen steroid hormone and the major female sex hormone. It is involved in the regulation of female reproductive cycles such as estrous and menstrual cycles. Estradiol is responsible for the development of female secondary sexual characteristics such as the breasts, widening of the hips and a female-associated pattern of fat distribution. It is also important in the development and maintenance of female reproductive tissues such as the mammary glands, uterus and vagina during puberty, adulthood and pregnancy. It also has important effects in many other tissues including bone, fat, skin, liver, and the brain.
Estrone (E1), also spelled oestrone, is a steroid, a weak estrogen, and a minor female sex hormone. It is one of three major endogenous estrogens, the others being estradiol and estriol. Estrone, as well as the other estrogens, are synthesized from cholesterol and secreted mainly from the gonads, though they can also be formed from adrenal androgens in adipose tissue. Relative to estradiol, both estrone and estriol have far weaker activity as estrogens. Estrone can be converted into estradiol, and serves mainly as a precursor or metabolic intermediate of estradiol. It is both a precursor and metabolite of estradiol.
Estriol (E3), also spelled oestriol, is a steroid, a weak estrogen, and a minor female sex hormone. It is one of three major endogenous estrogens, the others being estradiol and estrone. Levels of estriol in women who are not pregnant are almost undetectable. However, during pregnancy, estriol is synthesized in very high quantities by the placenta and is the most produced estrogen in the body by far, although circulating levels of estriol are similar to those of other estrogens due to a relatively high rate of metabolism and excretion. Relative to estradiol, both estriol and estrone have far weaker activity as estrogens.
Estradiol valerate (EV), sold for use by mouth under the brand name Progynova and for use by injection under the brand names Delestrogen and Progynon Depot among others, is an estrogen medication. It is used in hormone therapy for menopausal symptoms and low estrogen levels, hormone therapy for transgender people, and in hormonal birth control. It is also used in the treatment of prostate cancer. The medication is taken by mouth or by injection into muscle or fat once every 1 to 4 weeks.
Estrone sulfate, also known as E1S, E1SO4 and estrone 3-sulfate, is a natural, endogenous steroid and an estrogen ester and conjugate.
Estradiol benzoate (EB), sold under the brand name Progynon-B among others, is an estrogen medication which is used in hormone therapy for menopausal symptoms and low estrogen levels in women, in hormone therapy for transgender women, and in the treatment of gynecological disorders. It is also used in the treatment of prostate cancer in men. Estradiol benzoate is used in veterinary medicine as well. When used clinically, the medication is given by injection into muscle usually two to three times per week.
Estradiol cypionate (EC), sold under the brand name Depo-Estradiol among others, is an estrogen medication which is used in hormone therapy for menopausal symptoms and low estrogen levels in women, in hormone therapy for trans women, and in hormonal birth control for women. It is given by injection into muscle once every 1 to 4 weeks.
Estriol succinate, sold under the brand name Synapause among others, is an estrogen medication which is used in the treatment of menopausal symptoms. It is taken by mouth, in through the vagina, and by injection.
Estradiol dipropionate (EDP), sold under the brand names Agofollin, Di-Ovocylin, and Progynon DP among others, is an estrogen medication which has been used in hormone therapy for menopausal symptoms and low estrogen levels in women and in the treatment of gynecological disorders. It has also been used in feminizing hormone therapy for transgender women and in the treatment of prostate cancer in men. Although widely used in the past, estradiol dipropionate has largely been discontinued and is mostly no longer available today. It appears to remain in use only in Japan, Macedonia, and Australia. Estradiol dipropionate is given by injection into muscle at intervals ranging from once or twice a week to once every week and a half to two weeks.
Esterified estrogens (EEs), sold under the brand names Estratab and Menest among others, is an estrogen medication which is used hormone therapy for menopausal symptoms and low sex hormone levels in women, to treat breast cancer in both women and men, and to treat prostate cancer in men. It is formulated alone or in combination with methyltestosterone. It is taken by mouth.
Conjugated estrogens (CEs), or conjugated equine estrogens (CEEs), sold under the brand name Premarin among others, is an estrogen medication which is used in menopausal hormone therapy and for various other indications. It is a mixture of the sodium salts of estrogen conjugates found in horses, such as estrone sulfate and equilin sulfate. CEEs are available in the form of both natural preparations manufactured from the urine of pregnant mares and fully synthetic replications of the natural preparations. They are formulated both alone and in combination with progestins such as medroxyprogesterone acetate. CEEs are usually taken by mouth, but can also be given by application to the skin or vagina as a cream or by injection into a blood vessel or muscle.
Estriol glucuronide (E3G), or oestriol glucuronide, also known as estriol monoglucuronide, as well as estriol 16α-β-D-glucosiduronic acid, is a natural, steroidal estrogen and the glucuronic acid conjugate of estriol. It occurs in high concentrations in the urine of pregnant women as a reversibly formed metabolite of estriol. Estriol glucuronide is a prodrug of estriol, and was the major component of Progynon and Emmenin, estrogenic products manufactured from the urine of pregnant women that were introduced in the 1920s and 1930s and were the first orally active estrogens. Emmenin was succeeded by Premarin, which is sourced from the urine of pregnant mares and was introduced in 1941. Premarin replaced Emmenin due to the fact that it was easier and less expensive to produce.
Estradiol (E2) is a medication and naturally occurring steroid hormone. It is an estrogen and is used mainly in menopausal hormone therapy and to treat low sex hormone levels in women. It is also used in hormonal birth control for women, in feminizing hormone therapy for transgender women, and in the treatment of hormone-sensitive cancers like prostate cancer in men and breast cancer in women, among other uses. Estradiol can be taken by mouth, held and dissolved under the tongue, as a gel or patch that is applied to the skin, in through the vagina, by injection into muscle or fat, or through the use of an implant that is placed into fat, among other routes.
Estrin, or oestrin, also known as estra-1,3,5(10)-triene, is an estrane steroid. It is dehydrogenated estrane with double bonds specifically at the C1, C3, and C5(10) positions. Estrin is a parent structure of the estrogen steroid hormones estradiol, estrone, and estriol, which have also been known as dihydroxyestrin, ketohydroxyestrin, and trihydroxyestrin, respectively.
An estrogen (E) is a type of medication which is used most commonly in hormonal birth control and menopausal hormone therapy, and as part of feminizing hormone therapy for transgender women. They can also be used in the treatment of hormone-sensitive cancers like breast cancer and prostate cancer and for various other indications. Estrogens are used alone or in combination with progestogens. They are available in a wide variety of formulations and for use by many different routes of administration. Examples of estrogens include bioidentical estradiol, natural conjugated estrogens, synthetic steroidal estrogens like ethinylestradiol, and synthetic nonsteroidal estrogens like diethylstilbestrol. Estrogens are one of three types of sex hormone agonists, the others being androgens/anabolic steroids like testosterone and progestogens like progesterone.
Estriol (E3), sold under the brand name Ovestin among others, is an estrogen medication and naturally occurring steroid hormone which is used in menopausal hormone therapy. It is also used in veterinary medicine as Incurin to treat urinary incontinence due to estrogen deficiency in dogs. The medication is taken by mouth in the form of tablets, as a cream that is applied to the skin, as a cream or pessary that is applied in the vagina, and by injection into muscle.
Estrone (E1), sold under the brand names Estragyn, Kestrin, and Theelin among many others, is an estrogen medication and naturally occurring steroid hormone which has been used in menopausal hormone therapy and for other indications. It has been provided as an aqueous suspension or oil solution given by injection into muscle and as a vaginal cream applied inside of the vagina. It can also be taken by mouth as estradiol/estrone/estriol and in the form of prodrugs like estropipate and conjugated estrogens.
The pharmacology of estradiol, an estrogen medication and naturally occurring steroid hormone, concerns its pharmacodynamics, pharmacokinetics, and various routes of administration.
Conjugated estriol, sold under the brand names Progynon and Emmenin, is an estrogen medication which was previously used for estrogen-type indications such as the treatment of menopausal symptoms in women. The term specifically refers to formulations of estriol conjugates which were manufactured from the estrogen-rich urine of pregnant women and were used as medications in the 1920s and 1930s. Conjugated estriol is analogous to and was superseded by conjugated estrogens, which is manufactured from the urine of pregnant mares. Conjugated estriol was among the first forms of pharmaceutical estrogen to be used in medicine. It was taken by mouth.
Estradiol pivalate/progesterone (ETMA/P4), sold under the brand name Estrotate with Progesterone, is a combination medication of estradiol pivalate, an estrogen, and progesterone (P4), a progestogen, which was used in menopausal hormone therapy and the treatment of gynecological disorders but is no longer available. It contained 1 mg/mL ETMA and 10 mg/mL P4 in oil solution provided in vials and was administered by intramuscular injection at regular intervals.
Complex Estrogenic Preparations. 1. Amniotin (Squibb). This is a highly purified but not crystalline preparation derived from pregnant mares' urine. The chief active ingredient is apparently ketohydroxyestrin (estrone).
Amniotin, E. R. Squibb & Sons: This is an estrogenic preparation originally derived from amniotic fluid; it is not reduced to the crystalline state during manufacture. More recently, according to the firm, the urine of pregnant mares has served as an added source of active material.