Short answer: For menopausal hot flashes or vaginal atrophy, the estradiol tablets label starts at 1 to 2 mg daily, adjusted to control symptoms, given cyclically (for example 3 weeks on and 1 week off), at the lowest effective dose. Women with a uterus also take a progestin. Treatment is reviewed every 3 to 6 months. The label gives no missed-dose rule.
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 Estradiol Tablets is approved for: Oral estradiol tablets are approved to treat moderate to severe menopausal hot flashes and night sweats; moderate to severe vulvar and vaginal atrophy from menopause; low estrogen from hypogonadism, castration or primary ovarian failure; to prevent postmenopausal osteoporosis in women at significant risk who cannot use non-estrogen medicines; and, for palliation only, certain metastatic breast cancer and advanced prostate cancer (Indications and Usage).
Source
Estradiol Tablets, USP 0.5 mg, 1 mg and 2 mg, prescribing information and Patient Information. Epic Pharma. DailyMed, version published October 2, 2026. DailyMed setid 9333d92f-2585-4b99-aaea-87c01c95125e
Estradiol tablets are taken by mouth and come in 0.5 mg, 1 mg and 2 mg scored tablets (How Supplied).
A postmenopausal woman with a uterus also starts a progestin to lower the risk of uterine cancer; a woman without a uterus does not need one (Dosage and Administration).
Treatment starts at the lowest dose for the use, is kept to the lowest effective dose and shortest duration, and is reevaluated at 3- to 6-month intervals (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 | Dose on the label | Notes |
|---|---|---|
| Moderate to severe vasomotor symptoms, vulvar and vaginal atrophy of menopause | Usual initial dosage range 1 to 2 mg daily, adjusted as necessary to control symptoms | Cyclic (e.g., 3 weeks on and 1 week off); taper or stop attempts at 3- to 6-month intervals |
| Female hypoestrogenism (hypogonadism, castration, primary ovarian failure) | 1 to 2 mg daily, adjusted as necessary | Minimal effective maintenance dose found by titration |
| Metastatic breast cancer, palliation only | 10 mg three times daily | For at least three months |
| Advanced androgen-dependent prostate cancer, palliation only | 1 to 2 mg three times daily | Judged by phosphatase levels and symptoms |
| Prevention of postmenopausal osteoporosis | The lowest effective dose has not been determined | Only for women at significant risk who cannot use non-estrogen medicines |
In women with a uterus, undiagnosed persistent or recurring abnormal vaginal bleeding is investigated, including endometrial sampling when indicated.
If feasible, estrogens are stopped at least 4 to 6 weeks before surgery linked to a higher clot risk, or during prolonged immobilization.
CYP3A4 inducers such as St. John's Wort, phenobarbital, carbamazepine and rifampin may lower estrogen levels; inhibitors such as erythromycin, clarithromycin, ketoconazole, itraconazole, ritonavir and grapefruit juice may raise them.
Estrogens raise thyroid-binding globulin, so women on thyroid hormone may need more of it; thyroid function is monitored.
Tablets are stored at 20 to 25 C (68 to 77 F) in a tight, light-resistant container.
The estradiol tablets label gives no missed-dose rule. Neither the prescribing information nor the Patient Information says what to do if a tablet is missed.
More on this: missed a dose of Estradiol Tablets.
In Dose Track you set up Estradiol Tablets 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.