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
Sources: ClinicalTrials.gov, Novo Nordisk A/S

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

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PubMedInternational journal of surgical pathology2026-05-30

Tubulo-Squamous Vaginal Polyp: A Clinicopathologic Series with Literature Review.

Al-Tarawneh Bushra K BK, Islam Sadeq S, Quddus M Ruhul MR, Singh Kamaljeet K

Tubulo-squamous polyp (TSP) of vagina is a rare, benign, upper vaginal lesion of postmenopausal women. The origin of TSP is unclear, and the lesion is hypothesized to be arising from misplaced prostate-like vaginal skene glands. We describe the clinical, histological and immunohistochemical features of 6 TSPs we encountered in our routine practice. Histologically, TSPs are characterized by mass-forming, submucosal, cystic metaplastic transitional-type epithelium and prostate-like glands. The histological and immunohistochemical findings in TSP are identical to Mullerian (cervical and vaginal) epithelial metaplastic changes described in a setting of exogenous testosterone exposure.

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PubMedJournal of the American Association for Laboratory Animal Science : JAALAS2026-05-30

Reproductive Complication in Rhesus Macaques (Macaca mulatta): Prevalence, Risk Factors, and Successful Surgical Resolution of Vaginal Prolapse Postpartum.

Beckers Kalie F KF, Johnson Katherine K, Greely Joseph W JW, Falkenstein Kathrine P KP et al.

Pelvic organ prolapse (POP), including vaginal prolapse, is a prevalent reproductive condition in human and veterinary medicine, yet spontaneous cases are underreported in rhesus macaques (Macaca mulatta). This case study describes the clinical progression and successful surgical intervention of severe, recurrent vaginal prolapse in 2 pregnant, multiparous rhesus macaques at the Tulane National Biomedical Research Center (TNBRC). Over a multiweek period, one of the females experienced multiple prolapse episodes, including postpartum recurrence and failure of conservative management (manual reduction, suture retention techniques, and supportive care). The other female experienced multiple episodes during late gestation that continued despite conservative management. Definitive treatment was achieved through a novel abdominal approach involving uterine and cervical fixation to the rectus abdominis fascia, which resulted in anatomic correction and postoperative stability. A retrospective review of TNBRC records from 2005 to 2024 revealed 21 cases of vaginal prolapse with varied outcomes ranging from spontaneous resolution to euthanasia. Over this 20-year period, the prevalence was 4.71 per 1,000 females, with the most severe cases occurring in obese, multiparous individuals. This report demonstrates a practical and effective surgical alternative for managing severe or recurrent prolapse in rhesus macaques, particularly in reproductive-aged females where preservation of fertility and welfare is prioritized. The findings support the need for a species-specific prolapse grading system and highlight key risk factors such as parity, gestational age, infant size, and pelvic tissue integrity. These cases underline the importance of early detection, comprehensive supportive care, and individualized surgical planning in nonhuman primates, while providing a translational model for POP in women.

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PubMedBioresource technology2026-05-30

Modular pathway engineering enables gram-scale de novo biosynthesis of narirutin in yeast.

Lu Qiyuan Q, Zhang Honghao H, Tan Xinjia X, Wang Yongtong Y et al.

Narirutin, a bioactive flavanone-7-O-disaccharide with antioxidant and lipid-lowering properties, is conventionally obtained via plant extraction, which suffers from low yields and seasonal dependence. In this study, we engineered Saccharomyces cerevisiae for de novo narirutin biosynthesis by partitioning the biosynthetic pathway into discrete functional modules for a stepwise optimization. First, a robust glycosylation chassis was developed by deleting the endogenous hydrolase EXG1 to prevent deglycosylation. Subsequently, an efficient two‑step glycosylation module was assembled through comprehensive enzyme screening to convert naringenin to narirutin. To achieve de novo production from glucose, a glycosylation module was genomically integrated into a high-yield naringenin-producing strain. Furthermore, enhancing the UDP-glucose (UDPG) supply through a "push-block" metabolic engineering strategy increased the titer to 216.8 mg/L. Finally, fed-batch fermentation with optimized stepwise feeding, dissolved oxygen (DO), and pH stabilization further boosted production to 1153.3 mg/L, representing the highest reported to date. This first demonstration of gram-scale narirutin biosynthesis establishes a sustainable microbial platform and offers a blueprint for producing other flavonoid glycosides.

PMID 42214635
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PubMedMolecular psychiatry2026-05-30

Assessing the de novo paradigm in sporadic early-onset Alzheimer disease trios.

Zarea Aline A, Cassinari Kevin K, Lecoquierre François F, Quenez Olivier O et al.

The genetic architecture of sporadic Early-Onset Alzheimer Disease (sEOAD, onset ≤65 years) remains largely unknown. To assess the de novo mutation (DNM) hypothesis, we performed a nationwide recruitment of 37 novel sEOAD patients-unaffected parents trios. After assessing known monogenic genes, we performed trio-based exome sequencing and jointly analyzed novel trios with 12 previously reported ones. Of these, we selected 16 trios for genome sequencing. We identified three patients with a pathogenic DNM in APP or PSEN1. Then, from the 46 remaining trios, we identified 38 non-synonymous coding DNM and 4 de novo copy number variants (CNVs) in exome data. Four DNM (2 novel, in SPHK2 and DDR1) and bi-allelic inherited variants in two genes affected Alzheimer disease-related genes. No significant burden of rare coding variants in exome/genome data from 5643 EOAD cases and 16097 controls was identified using nested windows centered on each DNM position, at the transcript level. From genome data, one non-coding DNM was predicted to affect splicing in an AD-associated gene, PINX1. Overall, 48% probands carried ≥1 inherited risk factor with odds ratio (OR) > 1.5 and GWAS-defined Genetic Risk Scores (GRS) distribution was more consistent with random distribution than enrichment in higher scores in probands. We confirm that DNMs in known monogenic genes explain sEOAD in a minority of cases, while candidate DNMs in other genes might account for a small proportion of additional cases. The majority of sEOAD patients may have a complex etiology including multiple inherited variants, however, GRS might not explain most of its genetic component.

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PubMedSocial science & medicine (1982)2026-05-30

"Gold standard" Birth: Unmet birth expectations and the ought-maternal-self.

Matthews Rebecca R, Harman Vicki V, Finlay Katherine K

Unmet birth expectations are strongly associated with poorer maternal mental health, yet the processes underlying this association remain underexplored. This study addresses critical theoretical and empirical gaps by being the first qualitative investigation to recruit women specifically on the basis of unmet birth expectations and to theoretically account for how sociocultural discourses translate into psychological harm. Twenty-one semi-structured interviews were conducted with first-time mothers in the U.K. and analysed using reflexive thematic analysis. Three inductive themes were generated: (1) The Intensive Birthing Expectation Trap; (2) 'Failed' at the First Hurdle of Motherhood; and (3) Disrupted Maternal Identity. Antenatally, women were immersed in messaging which promoted 'natural' vaginal birth. When births diverged from this, women experienced distress rooted in perceived failure, self-blame, and shame. To account for these experiences, the study introduces the concept of intensive birthing ideology, a cultural framework positioning unassisted vaginal birth as maternally optimal, representing an extension of intensive mothering ideology into the birthing context. Through the first application of Self-Discrepancy Theory to childbirth, this study reveals how intensive birthing ideology creates an "ought-maternal-self"- an internalised representation of maternal obligations. This research advances theory by conceptualising intensive birthing ideology and demonstrating how sociocultural narratives generate psychological vulnerability through specific cognitive processes. It further underscores the urgent need for antenatal education reform, and critical reflection on cultural narratives privileging particular birth modes. With immediate relevance to U.K. maternity policy, this research explains how unmet birth expectations disrupt maternal identity and contribute to psychological harm.

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PubMedNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2026-05-30

Concurrent de novo glioblastoma and meningiomatosis: a case report and systematic review of clinical, molecular, and topographical characteristics.

Alioğlu Halit H, Alomari Omar O, Abasova Fatima F, Osama Mahmoud M et al.

The co-occurrence of glioblastoma (GBM) and meningioma in a single patient is an exceptionally rare clinical phenomenon, often associated with prior irradiation or genetic syndromes. This study presents a unique case of concurrent de novo GBM and meningiomatosis and provides a systematic review of the literature to characterize this rare association. A 78-year-old female with a known history of untreated meningiomatosis presented with refractory seizures and aphasia. Imaging revealed multiple stable extra-axial lesions and a new, distinct intra-axial right temporal lesion. The patient underwent a temporal lobectomy with gross total resection. Histopathology confirmed WHO grade 4 GBM (IDH-wildtype). Following multidisciplinary review, she completed adjuvant radiotherapy. At 6-month follow-up, she remained clinically stable with no recurrence. A systematic review was conducted, identifying 34 cases of concurrent GBM and meningioma. Data regarding demographics, topography, molecular profiles, and survival were analyzed. The median age was 63 years (range 30-86), with a slight male predominance (52.9%). Tumors were synchronous in 88.2% of cases. Topographically, 47.1% were "collision" or adjacent tumors, while 32.3% occurred in different hemispheres. Most meningiomas were WHO grade I (79.4%), while 97.1% of glial tumors were grade 4 GBM. Molecular analysis revealed classic independent drivers: 22q loss/NF2 mutations in meningiomas and 10q loss/EGFR amplification in GBMs. Median overall survival was 7 months (range 0.5-24 months), with modern trimodal therapy (Stupp protocol) showing a trend toward extended survival compared to older cohorts (Fig. 1). The coexistence of GBM and meningioma appears mostly coincidental, driven by distinct molecular pathways rather than a common progenitor. Despite the benign nature of the associated meningioma, prognosis is dictated by the aggressive GBM component. Early surgical intervention and modern adjuvant therapy remain essential for optimizing survival in these complex cases.

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