Medication·Interactions·Reviewed June 9, 2026
Estradiol interactions.
Estradiol has 4 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. The full interaction list is below. None of this is a substitute for your prescriber's advice.
Estradiol at a glance.
A quick, data-grounded summary. The full tables are below.
Estradiol has 4 documented interactions in the NutriStack database, including 1 flagged to avoid or as a serious conflict. The full interaction list is below. None of this is a substitute for your prescriber's advice.
Substances that interact with estradiol.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| St. John's Wort | Conflict | St. John's Wort induces CYP3A4, which metabolizes estradiol. This can reduce estradiol levels by 20-40%, potentially causing breakthrough bleeding,... details → |
| Black Cohosh | Caution | Black cohosh (Cimicifuga racemosa) is used for menopausal symptoms and has mild estrogenic and serotonergic activity. Combining it with prescribed... details → |
| DIM | Caution | DIM shifts estrogen metabolism toward 2-hydroxy metabolites (less potent), potentially reducing estradiol's effectiveness for menopausal symptom... |
| Maca Root | Caution | Maca has been used for menopausal symptoms and sexual function with modest positive findings in small trials, and does not contain phytoestrogens.... |
The full estradiol profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common estradiol questions.
Quick answers drawn from the tables above.
What interacts with Estradiol?
In the NutriStack database, Estradiol has 4 documented interactions. The most notable include St. John's Wort, Black Cohosh, DIM, and Maca Root. Check any specific combination before taking it and confirm with your prescriber.
Which substances should I avoid with Estradiol?
Estradiol is flagged against 1 substance in the database, including St. John's Wort. These pairings carry a higher risk and should be reviewed with a clinician before combining.
Is it safe to take St. John's Wort with Estradiol?
NutriStack classifies the St. John's Wort and Estradiol pairing as conflict: St. John's Wort induces CYP3A4, which metabolizes estradiol. This can reduce estradiol levels by 20-40%, potentially causing breakthrough bleeding, hot flashes, or loss... Avoid St. John's Wort while on estradiol HRT. Breakthrough bleeding and return of menopausal symptoms may occur. Always confirm with your prescriber.
Check your whole stack
See how estradiol fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.