Estriol
Summary
Persistence. It cannot be excluded that estriol is persistent, due to the lack of data.
Bioaccumulation. Estriol has low potential for bioaccumulation.
Toxicity. It cannot be excluded that estriol is toxic, due to the lack of data.
Risk. "An overall assessment is that E1–E4 occur in water bodies in a few ng/L or even lower concentrations. At the same time, estrogens, especially EE2, are very potent and can interfere with reproduction in fish. The greatest evidence for effects in the environment is for EE2 with measured concentrations that relatively often exceed safe effect levels. How the risk would change when replacing EE2 with E2 or E4 is discussed under the heading "risk assessment when replacing." EE2 = ethinylestradiol, E2 = estradiol, E3 = estriol och E4 = estetrol. For more information see the report from Goodpoint 2024.
This summary information comes from fass.se (company CampusPharma) with the exception of the risk that comes from the report from Goodpoint 2024.
Detailed information
Comment on Fass environmental information
Estriol has different classifications on fass.se. According to Lif (the trade association for the research-based pharmaceutical industry in Sweden) the various pharmaceutical companies compile environmental information for their active substances based on internal studies and published data. Based on data, which may thus differ between different pharmaceutical companies, the companies assess the environmental risk with guidance from “Environmental classification of pharmaceuticals at www.fass.se – Guidance for pharmaceutical companies 2012”. The Swedish Environmental Institute (IVL) reviews the assessment but does not have the task of coordinating/harmonizing environmental information from different pharmaceutical companies for the same active substance.
Fass environmental information for Blissel
Fass environmental information for Blissel (estriol) from CampusPharma (downloaded 2025-02-27).
Hazard
Persistence: Data is missing.
Bioaccumulation: Log Kow = 2.45.
Toxicity: Data is missing.
Risk
Risk of environmental impact of estriol cannot be excluded, due to the lack of environmental toxicity data.
Fass environmental information for Oestriol Aspen
Fass environmental information for Oestriol Aspen (estriol) from Aspen Nordic (downloaded 2025-02-27).
Hazard
Persistence: Data is missing.
Bioaccumulation: Data is missing.
Toxicity: Data is missing.
Risk
Risk of environmental impact of estriol cannot be excluded, due to the lack of environmental toxicity data.
Report Goodpoint 2024
The report from Goodpoint 2024 aims to present an overall, comparative assessment for the treatment options recommended for all indications under the therapeutic area of gynecology and obstetrics in the 2024 Wise list (the formulary for Region Stockholm, Sweden) containing either estrogens or progestogens + estetrol. The risk assessment does not aim to assess absolute or quantitative risk (which, for example, strongly depends on dilution in different recipients) but is primarily of a comparative nature, i.e., a ranking of the risk between different treatment options. For more information see the report.
Pharmaceutial residues in the aquatic environment in Sweden
Report Pharmaceutial residues in the Stockholm aquatic environment. Estriol has been measured in treated wastewater at concentrations up to 20 ng/L in Stockholm, Sweden. The reduction rate in the wastewater treatment plants Henriksdal and Bromma is reported to be 98 %.
Author: Health and Medical Care Administration, Region Stockholm