Comprehensive medication guide to Estrogens, Esterified including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$10–$50 copay; typically covered as Tier 2–3 generic, step therapy or prior authorization may apply.
Estimated Cash Pricing
$80–$200+ retail per month; as low as $80–$86 with a GoodRx coupon for 30 tablets of 0.625 mg.
Medfinder Findability Score
58/100
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Estrogens, Esterified is a synthetic estrogen medication used primarily for hormone replacement therapy (HRT) in menopausal and postmenopausal women. It contains a mixture of esterified estrogens — synthetic compounds that mimic the effects of naturally produced estrogen in the body.
It is FDA-approved for treating moderate to severe hot flashes and vaginal atrophy associated with menopause, as well as female hypogonadism, primary ovarian failure, prevention of postmenopausal osteoporosis, and as palliative therapy for certain breast and prostate cancers. It is available as oral tablets under the brand name Menest and in generic form.
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Esterified estrogens bind to estrogen receptors (ERα and ERβ) throughout the body, mimicking the effects of the naturally occurring estrogen your ovaries produce. This helps:
The medication is metabolized in the liver via the CYP3A4 enzyme and undergoes enterohepatic recirculation, meaning it is partially reabsorbed through the gut for prolonged activity. It is typically taken on a cyclic schedule — 3 weeks on, 1 week off — to more closely mimic the natural menstrual cycle.
0.3 mg oral tablet — tablet
lowest dose, often used for osteoporosis prevention or starting therapy
0.625 mg oral tablet — tablet
most commonly prescribed dose for menopausal symptoms
1.25 mg oral tablet — tablet
higher dose for more severe symptoms or specific indications
Estrogens, Esterified scores a 58 out of 100 on our findability scale, meaning it can be moderately difficult to locate in stock. While there is no active FDA drug shortage specifically for esterified estrogen tablets, broader estrogen product shortages — particularly affecting transdermal patches and injectable estradiol — have driven increased demand for oral estrogen formulations. This has led to intermittent supply issues at some retail pharmacies.
Additionally, the brand-name product Menest (by Pfizer) is the primary remaining brand, as Estratab was discontinued. The 2.5 mg strength was also discontinued in 2018, limiting available doses to 0.3 mg, 0.625 mg, and 1.25 mg tablets. Generic versions are available, which helps with supply, but you may need to check a few pharmacies or use Medfinder to locate stock near you.
Several types of healthcare providers can prescribe Estrogens, Esterified:
Telehealth consultations are also available for hormone therapy prescriptions, making it easier to get care without an in-person visit.
No. Estrogens, Esterified is not a controlled substance and is not scheduled by the DEA. It does require a prescription from a licensed healthcare provider, but there are no special controlled substance prescribing restrictions. Refills and telehealth prescriptions are straightforward.
Like all estrogen products, Estrogens, Esterified may cause side effects. Common ones include:
Serious side effects (seek medical attention immediately):
Important: The FDA requires a boxed warning noting that estrogens increase the risk of endometrial cancer when used without a progestin. Women with an intact uterus should use concurrent progestin therapy.
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Conjugated Estrogens (Premarin)
an estrogen mixture derived from natural sources; available as tablets, vaginal cream, and injection. The most well-known estrogen alternative.
Estradiol (Estrace)
a bioidentical estrogen available as oral tablets, transdermal patches, topical gels/creams, vaginal rings, and vaginal creams. Often preferred for its bioidentical profile.
Estradiol/Norethindrone (Activella)
a combination estrogen-progestin product ideal for women with an intact uterus, reducing endometrial hyperplasia risk.
Conjugated Estrogens/Bazedoxifene (Duavee)
a tissue-selective estrogen complex (TSEC) that pairs estrogen with a SERM to reduce endometrial stimulation without a separate progestin.
Prefer Estrogens, Esterified? We can find it.
Aromatase Inhibitors
moderate(Anastrozole, Letrozole, Exemestane) — estrogens directly counteract these breast cancer drugs; contraindicated
Warfarin and anticoagulants
moderateestrogens boost clotting factor production, potentially reducing anticoagulant effectiveness; dose adjustments may be needed
Levothyroxine (thyroid hormones)
moderateestrogens increase thyroxine-binding globulin, potentially requiring thyroid dose adjustment
CYP3A4 inducers
moderate(Rifampin, Carbamazepine, Phenytoin) — can decrease estrogen blood levels, reducing effectiveness
CYP3A4 inhibitors
moderate(Ketoconazole, Erythromycin, Ritonavir) — can increase estrogen levels, raising side effect risk
Tamoxifen
moderateestrogens may reduce its effectiveness in breast cancer treatment
Corticosteroids
moderateestrogens may enhance their effects
Estrogens, Esterified is a well-established hormone therapy option that has been helping women manage menopausal symptoms and related conditions for decades. While not as commonly prescribed as estradiol or conjugated estrogens, it remains an effective and affordable option — especially in generic form.
The main challenge in 2026 is intermittent availability at some pharmacies, driven by broader HRT supply chain pressures rather than a specific shortage. If your pharmacy is out of stock, try using Medfinder to locate pharmacies near you that have it available. Generic versions offer the best pricing, and coupon programs like GoodRx can bring cash prices down to around $80–$86 per month.
As always, work closely with your prescribing doctor to find the right estrogen therapy and dosage for your specific needs.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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