Short answer: The Delestrogen label's usual dose for menopause hot flashes, vaginal atrophy and low estrogen from hypogonadism is 10 to 20 mg every four weeks, injected deep into the buttock muscle. For advanced prostate cancer (palliation only) it is 30 mg or more every one or two weeks. The label says to start at the lowest dose and to try tapering or stopping every 3 to 6 months.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Delestrogen is approved for: Delestrogen is an estrogen injection approved to treat moderate to severe hot flashes and moderate to severe vulvar and vaginal atrophy due to menopause, low estrogen from hypogonadism, castration or primary ovarian failure, and, for palliation only, advanced androgen-dependent prostate cancer (Indications and Usage). For vaginal symptoms alone, topical vaginal products should be considered.
Source
DELESTROGEN (estradiol valerate injection, USP), prescribing information and Patient Information. Endo USA (Par Health USA). DailyMed, version published May 20, 2026. DailyMed setid e8f94df9-0692-4462-a7f0-fe019a0a3f07
Delestrogen is an oil-based solution injected deeply into the upper, outer quadrant of the gluteal (buttock) muscle. A small needle (20 gauge, 1 1/2 inches long) can be used because of the low viscosity (Dosage and Administration).
It comes in 5 mL multiple-dose vials of 10 mg/mL (in sesame oil), 20 mg/mL and 40 mg/mL (in castor oil). The label says particular care is needed to give the full dose of the 40 mg strength (How Supplied, Dosage and Administration).
A dry needle and syringe are used; a wet one can make the solution cloudy without changing its potency. Crystals that form in the cold redissolve on warming (Dosage and Administration).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Use | Usual dosage | Notes from the label |
|---|---|---|
| Moderate to severe hot flashes, vulvar and vaginal atrophy due to menopause | 10 to 20 mg every four weeks | Lowest dose and regimen that controls symptoms; discontinue as promptly as possible; attempt to taper or discontinue at 3-month to 6-month intervals |
| Hypoestrogenism due to hypogonadism, castration or primary ovarian failure | 10 to 20 mg every four weeks | Start at the lowest dose for the indication |
| Advanced androgen-dependent carcinoma of the prostate (palliation only) | 30 mg or more every one or two weeks | Not given |
Patients start at the lowest dose for the indication. The lowest effective dose of Delestrogen has not been determined for any indication.
When estrogen is prescribed for a postmenopausal woman with a uterus, a progestin is also started to reduce the risk of endometrial cancer. A woman without a uterus does not need a progestin.
Estrogen is used at the lowest effective dose for the shortest duration consistent with treatment goals, and patients are re-evaluated periodically, for example every 3 to 6 months, to see if treatment is still needed.
If feasible, estrogens are stopped at least 4 to 6 weeks before surgery linked to a higher risk of blood clots, or during prolonged immobilization.
Vials are stored at 20 to 25 C (68 to 77 F).
The Delestrogen label gives no missed-dose rule. Neither the prescribing information nor the Patient Information says what to do if an injection is missed or late.
In Dose Track you set up Delestrogen as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.