Estrogen Therapy for Recurrent Epistaxis: Case Histories and Literature Review

Abstract

Four cases that exemplify the nonapproved use of estrogens in the treatment of epistaxis are presented. The literature on estrogen treatment of recurrent epistaxis is reviewed, with an emphasis on efficacy and toxicity, and the various types of estrogens and dosage forms available are discussed. Estrogen use in the treatment of epistaxis is supported by a number of published patient studies. The optimal dose of estrogen has not been determined, but treatment seems to require a systemic dose higher than that used for birth control. Estrogen products applied topically to the nostrils at the site of epistaxis have also controlled bleeding. There are, however, no randomized, controlled trials to confirm these beneficial effects. Estrogens should thus be reserved for recurrent epistaxis that does not respond to more conservative measures.