Medication · hrt estrogen

Supplements and Estradiol.

Every documented pair, every citation. Below: 1 documented pair grouped by mechanism.

Estradiol, sold under the brand names Evorel, Estraderm, Elleste Solo, Zumenon, Oestrogel, Sandrena, is hormone replacement therapy (oestrogen component) for menopausal symptoms.

Below are the 1 documented pair we have explicitly assessed against Estradiol in the Distil database: 1 red. The pairs cluster around 1 mechanism: CYP3A4 induction. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.

Documented interactions

CYP3A4 induction

Red St John's Wort

St John's Wort can reduce circulating oestradiol levels by speeding up its breakdown. For people taking HRT, this can mean returning menopausal symptoms (hot flushes, sleep disruption) despite a prescribed dose that was previously working. We treat this as a do-not-combine pair without specialist sign-off.

PMID 14663455 · PMID 27444983 · BNF: Hypericum · BNF: Estradiol

Reviewer-flagged: awaiting clinical-reviewer sign-off.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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Your supplements

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Your medications

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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

Read the full methodology

Something missing?

If a supplement or medication you take isn't in our autocomplete, tell us and we'll add it in the next quarterly update.

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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a comprehensive personalised stack reasoned against this same database, the Distil report is the next step up.