<unk>  is used as an intramuscular injection for estrogen therapy of prostate cancer in men. It is also used to treat breast cancer in women who are at least 5 years postmenopausal. In addition,<unk>  is used in hormone replacement therapy for low estrogen levels due to hypogonadism or menopause in women. It is also used in feminizing hormone therapy for transgender women.<unk>  is a form of high-dose estrogen therapy. After an injection, it very slowly releases the active agent estradiol over at least several months.<unk>  has been compared to combined androgen blockade (CAB; castration plus flutamide) for the treatment of prostate cancer in a large randomized clinical trial of 915 patients. At 18.5 months, there was no difference in survival or cardiovascular toxicity between the two treatment modalities. These findings suggest that parenteral forms of estradiol may have similar effectiveness and safety relative to androgen deprivation therapy (ADT) in the treatment of prostate cancer. In addition, estrogens may have significant advantages relative to ADT in terms of bone loss and fractures, hot flashes, sexual function, and quality of life, as well as considerable cost savings with parenteral forms of estradiol compared to analogue therapy. On the other hand, breast tenderness and gynecomastia occur at very high rates with estrogens, whereas incidences are low with castration and CAB. However, gynecomastia with estrogens is generally only mild-to-moderate in severity and is usually only modestly discomforting. In addition, gynecomastia caused by estrogens can be prevented with prophylactic irradiation of the breasts or can be remediated with mastectomy.<unk>  has been studied for the treatment of prostate cancer at dosages of 160 mg/month (three studies) and 240 mg/month (four studies). At a dosage of 160 mg/month,<unk>  incompletely suppresses testosterone levels, failing to reach the castrate range, and is significantly inferior to orchiectomy in slowing disease progression. Conversely,<unk>  at a dosage of 240 mg/month results in greater testosterone suppression, into the castrate range similarly to orchiectomy, and is equivalent to orchiectomy in effectiveness. For prostate cancer in men,<unk>  is usually given at a dosage of 80 to 320 mg every 4 weeks for the first 2 to 3 months to rapidly build up estradiol levels. Thereafter, to maintain estradiol levels, the dosage is adjusted down usually to 40 to 160 mg every 4 weeks based on clinical findings and laboratory parameters. For breast cancer and low estrogen levels in women, the dosage is 40 to 80 mg every 4 weeks. For transgender women, the dosage is 80 to 160 mg every 4 weeks. Available forms<unk>  is provided in the form of powder or an aqueous solution in vials and ampoules alone or in combination with mepivacaine and/or nicotinamide (vitamin B3) for administration via intramuscular injection. Mepivacaine is a local anaesthetic and is used to avoid a burning sensation during injection of<unk> . Each vial/ampoule of Estradurin contains 80 mg<unk> , 5 mg mepivacaine hydrochloride, 40 mg nicotinamide, and 2 mL water.
Polyestradiol phosphate
Polyestriol phosphate
Progestogen ester
Androgen ester
Progestogen 
Progestogen
Estradiol sulfate
Estrogen ester