Estriol, the forgotten estrogen?

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Abstract
There is a definite need for a safe estrogen supplement [for osteoporosis, severe menopausal symptoms, post-oophorectomy changes and after treatment of breast or endometrial cancer] for women who are at risk of breast or endometrial carcinoma but who are denied such therapy because of recent evidence that exogenous estrogen can induce carcinoma in susceptible women. The role of supplemental estrogen in the induction of carcinoma is controversial, but the consensus is that high risk contraindicates its use. Estriol is discussed as a safer and possibly a noncarcinogenic estrogen that has been neglected, one that can be administered orally, maintains its unique identity, and is as effective as estrone or estradiol. There have been many animal or retrospective studies, but there has been a dearth of clinical studies. Enough presumptive and scientific evidence has been accumulated that orally administered estriol is safer than estrone or estradiol. The popular estrogens in use for many years can still be used for the low-risk patients, but for the high-risk patient who desperately needs estrogen what shall be done? A need for clinical trials is emphasized.

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