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

Related Research Articles

PubMedInternational journal of obstetric anesthesia2026-07-25

Neuraxial anesthetic failures for postpartum tubal ligation after vaginal delivery: a single center retrospective cohort study (2013-2023).

Thomas Caroline L CL, Nizamuddin Sarah L SL, Dewey Allyson J AJ, Iqbal Syed S SS et al.

Postpartum tubal ligation procedures have high anesthetic failure rates. The objective of this study was to compare our institution's failure rates to previous studies. This retrospective single-center study analyzed patients undergoing tubal ligation after vaginal delivery from 2013 to 2023, comparing successful and failed neuraxial anesthetics. The primary outcome was the failed neuraxial anesthesia rate, defined as performance of a second neuraxial procedure, administration of moderate-to-deep sedation, or conversion to general anesthesia. Of 363 patients, there were 294 (81.0%) successful neuraxial anesthetics and 69 (19%) failures. Amongst successes, 39 (10.7%) were de novo spinal anesthetics, and 255 (70.3%) were labor epidural catheter reactivations. There were no statistical differences in failure rates between modes of anesthesia (18.3% with reactivation of in situ labor epidural catheter vs. 23.5% with de novo spinal anesthesia; P = 0.44). The most common clinical scenario for a neuraxial anesthetic to have qualified as a failure was administration of moderate-to-deep sedation in 41 of 69 cases of failure (59.4%), followed by neuraxial replacement in 20 cases (29.0%) The overall conversion rate to general anesthesia in this cohort was 2.8% (10/363). Neuraxial anesthesia failure rates were similar to previously described rates of failure, with no difference between spinal anesthetics and labor epidural catheter reactivations. Sedation administration was the most common reason for defining a failed neuraxial anesthetic in this cohort, with few conversions to general anesthesia overall. Standardized definitions of neuraxial anesthesia failure and intended vs. unintended sedation administration for postpartum tubal ligation are warranted to further report failure rates and characterize why failures occur.

PMID 42497507
Read full article →
PubMedRevista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia2026-07-25

Surgical treatment of apical prolapse Number 9 - 2026.

Sartori Marair Gracio Ferreira MGF, Brito Luiz Gustavo de Oliveira LGO, Schreiner Lucas L, do Rego Aljerry Dias AD et al.

Apical genital prolapse represents a failure of DeLancey's level I support. Isolated vaginal hysterectomy does not correct apical prolapse. All surgery for uterine or vaginal vault prolapse should include apical suspension. Sacrocolpopexy is the most durable technique for correcting vaginal vault prolapse, with the exception of colpocleisis. Vaginal techniques remain valid options in selected patients. Uterine preservation, when based on shared decision-making, is possible and safe for carefully evaluated patients. Recognition of the apical component in advanced cystocele is essential to prevent recurrence. Correction of the genital hiatus reduces the risk of recurrence, regardless of the surgical approach. Intraoperative cystoscopy is mandatory in vaginal uterosacral suspensions. Concomitant correction of stress urinary incontinence should be considered when diagnosed clinically or functionally.

PMID 42500195
Read full article →
PubMedThe journal of obstetrics and gynaecology research2026-07-25

Oral Misoprostol Versus Vaginal Dinoprostone for Labor Induction: A Systematic Review and Meta-Analysis.

Yeretsian Tiffany T, Mogharbel Hussain H, Rozzah Rayyan R, Ashraf Rizwana R et al.

Pharmacologic cervical ripening is frequently used for labor induction, yet the comparative effectiveness, safety, and resource utilization of available agents remain uncertain. This review compared oral misoprostol with vaginal dinoprostone for labor induction in singleton pregnancies at ≥ 34 weeks' gestation. We conducted a systematic review and meta-analysis of randomized controlled trials, searching 11 databases to May 2025. Eligible studies compared oral misoprostol with vaginal dinoprostone in singleton pregnancies ≥ 34 weeks undergoing induction without contraindications to vaginal birth. Seven critical outcomes were assessed: cesarean birth, uterine hyperstimulation, 5-min Apgar score < 7, neonatal intensive care unit (NICU) admission, oxytocin augmentation, vaginal birth within 24 h, and induction-to-birth interval. Study selection and data extraction were performed in duplicate. Random-effects meta-analysis was applied, with risk of bias, certainty of evidence, and subgroup credibility assessed using Cochrane RoB 2.0, GRADE, and ICEMAN. Eleven trials including 3783 participants were analyzed. Oral misoprostol was associated with lower cesarean birth (RR 0.83, 95% CI 0.74-0.94) and reduced oxytocin augmentation (RR 0.89, 95% CI 0.82-0.97). Vaginal dinoprostone was associated with higher vaginal birth within 24 h (RR 0.91, 95% CI 0.86-0.96) and a shorter induction-to-birth interval. No significant differences were observed in uterine hyperstimulation, 5-min Apgar score < 7, or NICU admission. Oral misoprostol is associated with reduced cesarean birth and probably reduces the need for oxytocin augmentation, while vaginal dinoprostone is associated with higher rates of vaginal birth within 24 h and probably a shorter induction-to-birth interval. Maternal and neonatal safety outcomes appear comparable; these findings support consideration of oral misoprostol in selected populations and settings, while acknowledging underlying clinical and methodological heterogeneity.

PMID 42499212
Read full article →
PubMedFrontiers in medicine2026-07-25

Associations between vaginal microecological status and high-risk human papillomavirus positivity in women from Eastern China: a retrospective cross-sectional study.

Wang Junxia J, Liu Xinyong X, Liu Fangfei F, Liu Juan J et al.

Evidence regarding the associations between vaginal microecological status and high-risk human papillomavirus (hrHPV) genotype categories remains limited, particularly in large-sample studies. Using a large hospital-based laboratory dataset with same-visit vaginal and cervical sampling, this study assessed the associations between vaginal microecological status and hrHPV infection. A total of 14,359 women were included in this retrospective cross-sectional study. Vaginal and cervical specimens collected during the same hospital visit were used for vaginal microecological assessment and hrHPV genotyping, respectively. HrHPV-positive cases were further assigned to two mutually exclusive analytical genotype categories: HPV16/18 positivity and hrHPV12 (12 non-HPV16/18 high-risk genotypes) positivity. Associations were examined using the chi-square test or Fisher's exact test, and univariable and multivariable logistic regression analyses. Sensitivity analyses excluding women with mixed vaginitis were conducted to assess the robustness of the primary findings. Overall hrHPV positivity was 15.99% (2,296/14,359, 95% CI, 15.39-16.60) and differed significantly by age (p < 0.001), with the highest rate in women aged ≤20 years (35.46%). Detection rates of bacterial vaginosis (BV), aerobic vaginitis (AV), trichomonal vaginitis (TV), and vulvovaginal candidiasis (VVC) also differed across age groups (all p < 0.001). In the multivariable analyses, BV (OR = 1.572, 95% CI: 1.052-2.218) and TV (OR = 1.738, 95% CI: 1.126-2.684) were associated with higher odds of overall hrHPV positivity after adjustment for available variables. In models stratified by hrHPV genotype category, BV (OR = 1.599, 95% CI: 1.036-2.467) and TV (OR = 1.653, 95% CI: 1.004-2.723) were associated with hrHPV12 positivity, whereas TV (OR = 1.970, 95% CI: 1.015-3.823) was associated with HPV16/18 positivity. Sensitivity analyses after excluding women with mixed vaginitis showed generally similar effect directions for the main associations. HrHPV positivity and vaginal microecological abnormalities showed age-specific distributions, and the associations between vaginal microecological status and hrHPV positivity showed heterogeneity across hrHPV genotype categories. These findings provide large-scale epidemiological evidence suggesting that age and hrHPV genotype category may need to be considered when interpreting the relationship between vaginal microecological status and hrHPV positivity.

PMID 42500543
Read full article →
PubMedEnvironmental toxicology2026-07-25

Effect of Propylparaben on In Vitro Maturation of Porcine Oocytes and Embryo Development.

Núñez-Macías Elivier E, Casillas Fahiel F, Ramírez-Jara Yenny Y, Casas Eduardo E et al.

Parabens are synthetic chemicals that, due to their antibacterial and fungicidal effects, are widely used as preservatives in food, cosmetics, and personal care products, such as shampoos, hair conditioners, body creams, soaps, deodorants, makeup, wet wipes, lotions, female hygiene products, and vaginal lubricants. Several years ago, they were considered noncytotoxic, but studies have since shown that parabens act as endocrine disruptors due to their similarity to estradiol and could interfere with fertility. In recent decades, they have been associated with decreased fertility in the population. Although there are studies showing the effect of various parabens on reproduction, there are few related to the effect of propylparaben (PrPB) on oocyte maturation and embryo development. The present study aimed to evaluate the in vitro effect of PrPB on oocyte maturation and embryo development. The calculated lethal concentration (LC50) and concentration of inhibition of maturation (IM50) for both events was 140 μM. After 144 h post fertilization, the viability of developed embryos was reduced according to the PrPB increased. The total number of dividing embryos was classified from two blastomeres to late blastocyst. In all concentrations, there was embryo development, except in the concentration 300 μM, in which all were dead. The results of this study provide evidence that PrPB could affect female reproductive health by reducing oocyte maturation and delaying early embryo development. Therefore, further studies are required to explore the possible mechanisms producing the damage caused by the constant use of products containing PrPB.

PMID 42498988
Read full article →
PubMedJournal of minimally invasive gynecology2026-07-25

Comparison of Synthetic Osmotic Dilators and Vaginal Misoprostol for Cervical Preparation Prior to Hysteroscopy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Baradwan Saeed S, Khadawardi Khalid K, Himayda Samah S, Aljassem Amina A et al.

Hysteroscopy is a widely used minimally invasive procedure for the diagnosis and treatment of intrauterine pathologies. Adequate cervical preparation is essential for safe and effective hysteroscope insertion. This systematic review and meta-analysis aimed to compare the efficacy and safety of synthetic osmotic dilators and vaginal misoprostol for cervical ripening prior to hysteroscopy. A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials, covering all records from database inception through October 2025. Randomized controlled trials (RCTs) comparing synthetic osmotic dilators versus vaginal misoprostol for cervical preparation before hysteroscopy were included. The primary outcome was the degree of cervical dilatation achieved. Secondary outcomes included procedural pain, incidence of difficult cervical dilatation, systemic adverse events, and procedural complications. Statistical pooling was performed using Review Manager (RevMan) software. Four RCTs comprising 348 participants were included. Synthetic osmotic dilators demonstrated significantly greater cervical dilatation and lower procedural pain scores during hysteroscopy compared to vaginal misoprostol (p < 0.001). The incidence of difficult cervical dilatation was lower in the osmotic dilator group (15%) compared to the misoprostol group (42%). Additionally, nausea, vomiting, abdominal pain, and hysteroscopic complications were all significantly less frequent in the osmotic dilator group (p < 0.001). Although synthetic osmotic dilators appear to be a more effective and better-tolerated option than vaginal misoprostol for cervical ripening prior to hysteroscopy, this evidence is drawn from a limited number of small trials and should be considered preliminary. Larger multicenter randomized trials with standardized outcome definitions are needed before these findings can guide clinical practice.

PMID 42498215
Read full article →

+9996 more articles available with a free account

Sign up free to view all articles →

Ask about estradiol