Absorption of vaginal estrogen cream during sexual intercourse: a prospective, randomized, controlled trial

J Reprod Med. 2008 Jan;53(1):29-32.


Objective: To determine if intercourse changed serum estradiol levels in women using vaginal E2 cream or in their male partners.

Study design: Prospective, randomized, placebo-controlled, crossover, blinded study of 10 postmenopausal women and their male sexual partners. Subjects were randomized to estradiol or placebo cream and intercourse, then crossed over after 7-14 days. Seven to 14 days later, the woman used vaginal estradiol cream and abstained from intercourse. Serum E2 levels were obtained 10-12 hours after each exposure.

Results: Serum E2 levels were higher in 8 of 10 men after intercourse with vaginal estradiol cream, and this resulted in a small but significant (p = 0.03) increase in the estradiol levels as compared to placebo. Paradoxically, intercourse resulted in markedly lower estradiol levels in women as compared to abstinence (p = 0.004).

Conclusion: Men absorb vaginal estradiol during intercourse, whereas intercourse reduces estradiol absorption in women. Although serum estradiol levels were only mildly elevated in men, it is possible that long-term exposure could cause feminizing changes. In women, estradiol levels were markedly reduced by intercourse.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorption / drug effects*
  • Administration, Intravaginal
  • Coitus*
  • Contraceptive Agents / metabolism*
  • Cross-Over Studies
  • Estradiol / blood
  • Estradiol / metabolism*
  • Estrogens / blood
  • Estrogens / metabolism*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postmenopause / blood
  • Prospective Studies
  • Sex Factors


  • Contraceptive Agents
  • Estrogens
  • Estradiol