Drug Database
ES

estradiol (Vagifem)

✓ Approved

Novo Nordisk A/S · ESR1 · Small Molecule

What is estradiol?

estradiol is a small molecule developed by Novo Nordisk A/S. It is approved for therapeutic indications via intravaginal.

Drug Profile

Brand NamesVagifem
CompanyNovo Nordisk A/S
Drug ClassSmall Molecule
Molecular TargetESR1
RouteIntravaginal
StatusApproved

Mechanism of Action

Molecular Targets

estradiol acts on 1 molecular target:

ESR1estrogen receptor 1 (ER, ESR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

estradiol is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Reproductive system and breast disordersAtrophic vulvovaginitis✓ Approved

Related Research Articles

PubMedBMC women's health2026-11-11

Case report: a rare case of congenital vulvar malformation that is often overlooked.

Rao Yangyang Y, Zhu Xialing X, Chen Min M, Zhu Aqiang A

In the spectrum of female vulvar and vaginal malformations, in addition to the well-known congenital absence of the vagina, vaginal atresia, vaginal septum, vaginal oblique septum, and vaginal vestibule atresia, there are also some rare types of vulvar-vaginal malformations that have received less attention in the literature. These malformations have complex and diverse clinical manifestations and often coexist with abnormalities in the urinary system, anus, and rectum. They are prone to misdiagnosis and also lack precise diagnostic and treatment principles as well as appropriate surgical timing. We report a case of a 17-year-old female patient who was diagnosed with fusion of the labia minora. The patient is unable to have sexual intercourse, and concurrently experiences progressively worsening dysmenorrhea.We performed a labiaplasty on her and the postoperative recovery was good. Three months after the surgery, the dysmenorrhea symptoms were significantly anesised and the outcome was satisfactory. Fusion of the labia minora is an underrecognized disease of vaginal outlet obstruction. Surgical reconstruction appears effective in relieving symptoms, though optimal timing remains unclear. Early recognition and individualized management are recommended. More data are needed to guide standardized care.

PubMedInternational braz j urol : official journal of the Brazilian Society of Urology2026-11-11

Peritoneal Flap Versus Sigmoid for Treatment of Vaginal Stenosis After Gender-Affirming Vaginoplasty.

Yin Anne A, Callahan Daniel D, Torres Camille C, Harb Amro A et al.

Vaginal stenosis after gender-affirming vaginoplasty is a known complication associated with decreased functionality and satisfaction rates. Revision vaginoplasty options include peritoneal flap (PFV) and sigmoid vaginoplasty (SV) but data on the optimal technique to correct stenosis is absent. We compared the two surgical procedures in order to have a better understanding of their outcomes and improve patient counselling. A single institution retrospective chart review was conducted between 2020 and 2024. All patients who underwent revision vaginoplasty due to vaginal stenosis were included. Information such as demographics, intraoperative data, complication profile and subjective outcomes were collected. A total of 42 patients underwent revision vaginoplasty. 18 patients underwent PFV while 24 patients underwent SV. Baseline demographics were similar between the two cohorts except for ethnicity. PFV was associated with lower estimated blood loss and a shorter hospitalization; however, functional outcomes were similar between the two cohorts. Return of bowel function, complication profile, satisfaction rates and sexual activity were equal. SV was associated with a longer vaginal canal, with a mean 3.28cm increase over depth compared to PFV when controlling for all other variables. Both PFV and SV are viable options for revision vaginoplasty after vaginal stenosis in gender affirming cases. They have similar complication profiles and functional outcomes however the SV is associated with an increased vaginal canal depth.

PubMedVeterinary research communications2026-11-11

Characterization of the vaginal microbiota of dairy cows treated with probiotics.

Baioco Aline Policarpo AP, de Moraes Fabiane Pereira FP, Vargas Júnior Sergio Farias SF, Vieira Arnaldo Diniz AD et al.

Approximately 50% of dairy cows develop postpartum uterine diseases, significantly affecting reproductive performance and economic returns. Treatment is usually based on antibiotics; however, alternative approaches have been investigated. This study evaluated the effects of intravaginal supplementation with lactic acid bacteria (LAB) on the vaginal microenvironment, focusing on microbial viability, pH, and taxonomic composition. A total of 21 non-pregnant, multiparous and non-lactating Jersey cows with synchronized estrous cycle were used. Animals were randomly assigned to two groups: Probiotic group (PRO; n = 11) received two intravaginal capsules containing Lactobacillus rhamnosus and Lactobacillus reuteri at 4.5 × 10¹⁰ CFU/capsule; and Control group (CTR; n = 10), receiving two intravaginal capsules without LAB. The recovery of Lactobacillus rhamnosus was significantly higher in the PRO group (p < 0.0001) vs. CTR. No significant differences were observed between CTR and PRO groups in vaginal pH (p > 0.05). Microbiota analysis based on the 16 S rRNA gene showed no significant differences in differential abundance between CTR and PRO groups at the genus level (q > 0.05). However, PERMANOVA with paired design revealed a significant effect of the group x timepoint model on microbial community composition (p = 0.004). This is the first study characterizing the vaginal microbiota of cows treated with probiotic LAB strains. Lactobacillus rhamnosus and Lactobacillus reuteri at the tested concentration did not alter vaginal pH up to Day 14 and did not significantly change individual taxon abundances at Days 4 or 7; however, paired analysis detected a significant compositional shift associated with treatment.

PubMedClinical cardiology2026-11-11

Association of ALI and mCONUT With In-Hospital De Novo Heart Failure in Patients With STEMI.

Dai Zhiyin Z, Yang Lijuan L, Chen Rui R, Zhou Ye Y et al.

De novo heart failure (HF) during the first ST-segment elevation myocardial infarction (STEMI) hospitalization significantly increases mortality and readmission. While nutritional and inflammatory indicators like the advanced lung cancer inflammation index (ALI) and modified Controlling Nutritional Status (mCONUT) score are gaining attention, their exact association with post-STEMI de novo HF remains unclear. This retrospective study (January 2016 to June 2025) included 1598 first-time STEMI patients undergoing percutaneous coronary intervention. Patients were categorized into de novo HF and non-HF groups to evaluate the association of ALI and mCONUT scores with HF development. The HF group exhibited significantly lower ALI and higher mCONUT scores compared to the non-HF group. Multivariate logistic regression identified lower ALI and higher mCONUT scores as independent predictors of HF risk. Receiver operating characteristic analysis demonstrated that mCONUT possessed better predictive performance than ALI, with effects remaining highly consistent across subgroups. Sensitivity analyses and NRI/IDI results confirmed that mCONUT provides independent incremental predictive value beyond traditional risk models (optimism-corrected C-statistic 0.785 vs. 0.751). These associations were independent of admission hemodynamic status (Killip class) and treatment era. Both ALI and mCONUT scores are independently associated with in-hospital de novo HF in STEMI patients. The mCONUT score demonstrates superior predictive performance, serving as a promising indicator for early risk stratification.

PubMedNature biotechnology2026-11-11

De novo design of proteases.

Ummarino Dario D

PubMedFrontiers in cellular and infection microbiology2026-11-11

A translational-readiness framework for natural and engineered probiotics.

Hribernik Nives N, Maan Harsh H, Povolotsky Tatyana L TL

The human microbiome has become a major source of therapeutic candidates, yet clinical translation has progressed far more slowly than mechanistic and preclinical discovery. In this review we ask: what determines whether a microbial therapeutic reaches the clinic? We compare traditional probiotics, next-generation probiotics and engineered live biotherapeutics using representative examples from metabolic disease, oncology and the vaginal microbiome. Together, these examples show that translational success depends less on biological sophistication than on the ability to achieve durable colonization, demonstrate meaningful clinical benefit and satisfy biocontainment and regulatory requirements. We explore the vaginal niche as a case study because it illustrates these challenges particularly well. Its relatively simple microbial community, local delivery and measurable ecological and clinical endpoints allow colonization, activity and recurrence to be assessed together. We integrate these observations into a translational-readiness framework that evaluates microbial therapeutics according to target specificity, colonization durability, biocontainment and safety, demonstrated benefit and regulatory precedent. This framework provides a practical approach for comparing emerging microbial therapeutic candidates and for identifying the factors most likely to accelerate their progression from promising biological discoveries to reliable clinical translation.

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