Short answer: The EstroGel label dose is 1.25 g of gel a day, one full press of the pump, holding 0.75 mg estradiol. It is spread thinly over one whole arm, inside and outside, from wrist to shoulder. This is the single approved dose, and the lowest effective dose has not been set. A new pump is primed with 5 presses first. The label has 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 EstroGel is approved for: EstroGel is an estrogen gel approved to treat moderate to severe hot flashes (vasomotor symptoms) and moderate to severe symptoms of vulvar and vaginal atrophy due to menopause (section 1). For vaginal symptoms alone, the label says topical vaginal products are considered first.
Source
ESTROGEL 0.06% (estradiol gel) for topical use, prescribing information, Patient Information and Instructions for Use. Ascend Therapeutics US. DailyMed, version published June 1, 2026. DailyMed setid 762ac371-bb8b-47e7-b48f-e80d452c9dd4
EstroGel 0.06% comes in a metered-dose pump. One full press delivers 1.25 g of gel containing 0.75 mg estradiol (section 3).
Once a day the gel is applied in a thin layer over the entire arm, inside and outside, from wrist to shoulder (sections 2.1, 2.2). The Instructions for Use say to use clean, dry, unbroken skin, not to massage or rub it in, and to let it dry for 5 minutes before dressing.
Hands are washed with soap and water right after, and others avoid contact with the treated skin for at least 1 hour. The gel is not applied to the breasts or in or around the vagina (Instructions for Use).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Item | What the label says |
|---|---|
| Dose | EstroGel 0.06% 1.25 g per day (1 pump depression) is the single approved dose |
| Estradiol per dose | 1.25 g of gel contains 0.75 mg estradiol |
| Where | Thin layer over the entire arm on the inside and outside from wrist to shoulder |
| Lowest effective dose | Has not been determined |
| Priming | Before first use, fully depress the pump 5 times and discard that gel |
| Pump size | 50-gram pump delivers 30 metered 1.25-g doses |
For a postmenopausal woman with a uterus, adding a progestogen is generally considered to reduce endometrial cancer risk. Women without a uterus generally do not need one, though some with a history of endometriosis may.
Estrogen, alone or with a progestogen, is used at the lowest effective dose for the shortest duration consistent with treatment goals, and women are re-evaluated periodically. The Patient Information gives every 3 to 6 months as an example.
If feasible, estrogen is stopped at least 4 to 6 weeks before surgery linked to a higher risk of blood clots, or during long immobilization.
The gel is flammable until dry, so fire, flame and smoking are avoided until it has dried.
After priming and 30 doses the canister is thrown away, even if it is not completely empty, because the dose may not be correct.
FSH and estradiol blood levels have not been shown to be useful in managing hot flashes or vaginal atrophy.
The EstroGel label gives no missed-dose instruction in the prescribing information, Patient Information or Instructions for Use. It says to use EstroGel exactly as the healthcare provider says. Ask your prescriber or pharmacist what to do if a dose is missed.
More on this: missed a dose of EstroGel.
In Dose Track you set up EstroGel 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.