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Ethinyl Estradiol

Drugs and Chemicals · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 5 min read

A semisynthetic alkylated estradiol with a 17-alpha-ethinyl substitution.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (941 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

A semisynthetic alkylated estradiol with a 17-alpha-ethinyl substitution. It has high estrogenic potency when administered orally, and is often used as the estrogenic component in oral contraceptives.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Estradiol, Ethinyl; 19-Norpregna-1,3,5(10)-trien-20-yne-3,17-diol, (17alpha)-; Ethynyl Estradiol; Estradiol, Ethynyl; Ethinyloestradiol; Microfollin; Microfollin Forte; Estinyl.

Where it fits in the MeSH classification

Broader topics
Norpregnatrienes; Estrogenic Steroids, Alkylated
Narrower topics
Ethinyl Estradiol-Norgestrel Combination; Mestranol; Quinestrol

Related concepts

  • Estradiol
  • Oral Contraceptives

Research landscape

PubMed indexes 11,341 records tagged with the MeSH heading “Ethinyl Estradiol” (counts retrieved 2026-10-31). 650 of them (5.7%) were published from 2020 onward, and the busiest period so far is through 1999 with 7,244 records.

Reviews account for 491 records (4.3%) and meta-analyses for 31. Randomized controlled trials number 1,015 (8.9%) as a share of all records on the topic. Randomized trials make up a comparatively large share of this literature, which means many treatment questions have been tested directly.

PubMed records by publication periodthrough 1999: 7,244 records; 2000-2009: 1,730 records; 2010-2019: 1,717 records; 2020 onward: 650 records7,244through 19991,7302000-20091,7172010-20196502020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19997,244
2000-20091,730
2010-20191,717
2020 onward650
Share of records by publication typeReviews: 4.3 percent; Meta-analyses: 0.3 percent; Randomized controlled trials: 8.9 percentReviews4.3% (491)Meta-analyses0.3% (31)Randomized controlled trials8.9% (1,015)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 11,341 PubMed records
TypeRecordsShare
Reviews4914.3%
Meta-analyses310.3%
Randomized controlled trials1,0158.9%

Method: PubMed query "Ethinyl Estradiol"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in drugs and chemicals

Studies of a chemical or drug can answer very different questions: what it is and how it behaves in cells and animals, how the body handles it, and whether it changes outcomes in people. Laboratory and animal findings often do not carry over to patients, and observational studies of exposures are confounded by who uses a substance and why. Nothing on this page is a recommendation to use, avoid, start or stop any substance or medicine; talk to a qualified clinician or pharmacist about your own situation. Check the dose, the species, the comparison group and whether a patient-relevant outcome was measured.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Long-term exposure to environmental concentrations of the pharmaceutical ethynylestradiol causes reproductive failure in fish
Nash JP, Kime DE, Van der Ven LT, Wester PW, Brion F, Maack G, et al.
2004Research article
Design not recorded in structured metadata
379cc0
PMID 15579420 · DOI · PMC1253666
Accurate prediction of the response of freshwater fish to a mixture of estrogenic chemicals
Brian JV, Harris CA, Scholze M, Backhaus T, Booy P, Lamoree M, et al.
2005Research article
Design not recorded in structured metadata
231cc0
PMID 15929895 · DOI · PMC1257597
Transgenerational effects from early developmental exposures to bisphenol A or 17α-ethinylestradiol in medaka, Oryzias latipes
Bhandari RK, vom Saal FS, Tillitt DE
2015Research article
Design not recorded in structured metadata
124cc by
PMID 25790734 · DOI · PMC4366817
Ethinyl estradiol and levonorgestrel coadministration induces hypophagia and increases energy expenditure in female rats
Lacasse JM, Mohammad A, Montgomery KR, Bellaflor S, MacPherson REK, Galea LAM, et al.
2026Research article
Design not recorded in structured metadata
2cc by
PMID 42219595 · DOI · PMC13284417

Long-term exposure to environmental concentrations of the pharmaceutical ethynylestradiol causes reproductive failure in fish [1]

Research article Nash JP, Kime DE, Van der Ven LT, Wester PW, Brion F, Maack G, et al. · · 2004 · cited 379 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Heightened concern over endocrine-disrupting chemicals is driven by the hypothesis that they could reduce reproductive success and affect wildlife populations, but there is little evidence for this expectation.
Closing excerpt
Our findings raise major concerns about the population-level impacts for wildlife of long-term exposure to low concentrations of estrogenic endocrine disruptors.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (251 words)

Heightened concern over endocrine-disrupting chemicals is driven by the hypothesis that they could reduce reproductive success and affect wildlife populations, but there is little evidence for this expectation. The pharmaceutical ethynylestradiol (EE2) is a potent endocrine modulator and is present in the aquatic environment at biologically active concentrations. To investigate impacts on reproductive success and mechanisms of disruption, we exposed breeding populations (n = 12) of zebrafish (Danio rerio) over multiple generations to environmentally relevant concentrations of EE2. Life-long exposure to 5 ng/L EE2 in the F1 generation caused a 56% reduction in fecundity and complete population failure with no fertilization. Conversely, the same level of exposure for up to 40 days in mature adults in the parental F0 generation had no impact on reproductive success. Infertility in the F1 generation after life-long exposure to 5 ng/L EE2 was due to disturbed sexual differentiation, with males having no functional testes and either undifferentiated or intersex gonads. These F1 males also showed a reduced vitellogenic response when compared with F0 males, indicating an acclimation to EE2 exposure. Depuration studies found only a partial recovery in reproductive capacity after 5 months. Significantly, even though the F1 males lacked functional testes, they showed male-pattern reproductive behavior, inducing the spawning act and competing with healthy males to disrupt fertilization. Endocrine disruption is therefore likely to affect breeding dynamics and reproductive success in group-spawning fish. Our findings raise major concerns about the population-level impacts for wildlife of long-term exposure to low concentrations of estrogenic endocrine disruptors.

Abstract reproduced from the open-access article under the recorded cc0 licence; © the authors. PMID 15579420 · DOI · PMC1253666

Accurate prediction of the response of freshwater fish to a mixture of estrogenic chemicals [2]

Research article Brian JV, Harris CA, Scholze M, Backhaus T, Booy P, Lamoree M, et al. · · 2005 · cited 231 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Existing environmental risk assessment procedures are limited in their ability to evaluate the combined effects of chemical mixtures.
Closing excerpt
These findings highlight the potential for existing environmental risk assessment procedures to underestimate the hazard posed by mixtures of chemicals that act via a similar mode of action, thereby leading to erroneous conclusions of absence of risk.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (245 words)

Existing environmental risk assessment procedures are limited in their ability to evaluate the combined effects of chemical mixtures. We investigated the implications of this by analyzing the combined effects of a multicomponent mixture of five estrogenic chemicals using vitellogenin induction in male fathead minnows as an end point. The mixture consisted of estradiol, ethynylestradiol, nonylphenol, octylphenol, and bisphenol A. We determined concentration-response curves for each of the chemicals individually. The chemicals were then combined at equipotent concentrations and the mixture tested using fixed-ratio design. The effects of the mixture were compared with those predicted by the model of concentration addition using biomathematical methods, which revealed that there was no deviation between the observed and predicted effects of the mixture. These findings demonstrate that estrogenic chemicals have the capacity to act together in an additive manner and that their combined effects can be accurately predicted by concentration addition. We also explored the potential for mixture effects at low concentrations by exposing the fish to each chemical at one-fifth of its median effective concentration (EC50). Individually, the chemicals did not induce a significant response, although their combined effects were consistent with the predictions of concentration addition. This demonstrates the potential for estrogenic chemicals to act additively at environmentally relevant concentrations. These findings highlight the potential for existing environmental risk assessment procedures to underestimate the hazard posed by mixtures of chemicals that act via a similar mode of action, thereby leading to erroneous conclusions of absence of risk.

Abstract reproduced from the open-access article under the recorded cc0 licence; © the authors. PMID 15929895 · DOI · PMC1257597

Transgenerational effects from early developmental exposures to bisphenol A or 17α-ethinylestradiol in medaka, Oryzias latipes [3]

Research article Bhandari RK, vom Saal FS, Tillitt DE · · 2015 · cited 124 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
The transgenerational consequences of environmental contaminant exposures of aquatic vertebrates have the potential for broad ecological impacts, yet are largely uninvestigated.
Closing excerpt
These adverse outcomes may have negative impacts on populations of fish inhabiting contaminated aquatic environments.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (199 words)

The transgenerational consequences of environmental contaminant exposures of aquatic vertebrates have the potential for broad ecological impacts, yet are largely uninvestigated. Bisphenol A (BPA) and 17α-ethinylestradiol (EE2) are two ubiquitous estrogenic chemicals present in aquatic environments throughout the United States and many other countries. Aquatic organisms, including fish, are exposed to varying concentrations of these chemicals at various stages of their life history. Here, we tested the ability of embryonic exposure to BPA or EE2 to cause adverse health outcomes at later life stages and transgenerational abnormalities in medaka fish. Exposures of F0 medaka to either BPA (100 μg/L) or EE2 (0.05 μg/L) during the first 7 days of embryonic development, when germ cells are differentiating, did not cause any apparent phenotypic abnormalities in F0 or F1 generations, but led to a significant reduction in the fertilization rate in offspring two generations later (F2) as well as a reduction of embryo survival in offspring three generations later (F3). Our present observations suggest that BPA or EE2 exposure during development induces transgenerational phenotypes of reproductive impairment and compromised embryonic survival in fish of subsequent generations. These adverse outcomes may have negative impacts on populations of fish inhabiting contaminated aquatic environments.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 25790734 · DOI · PMC4366817

Ethinyl estradiol and levonorgestrel coadministration induces hypophagia and increases energy expenditure in female rats [4]

Research article Lacasse JM, Mohammad A, Montgomery KR, Bellaflor S, MacPherson REK, Galea LAM, et al. · · 2026 · cited 2 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Oral contraceptives containing ethinyl estradiol (EE) with levonorgestrel (LNG) are common in hormonal contraceptives.
Closing excerpt
Together, these results delineate an age-sensitive metabolic and endocrine profile of EE + LNG.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (246 words)

Oral contraceptives containing ethinyl estradiol (EE) with levonorgestrel (LNG) are common in hormonal contraceptives. EE+LNG suppresses weight gain in rodents, but the mechanisms for this remain unclear. Further, metabolic demands in adolescence are increased relative to adulthood. We tested the metabolic effect of a low dose of EE + LNG in adolescents and adult female Long-Evans rats. Rats were given EE (10 µg/kg) + LNG (20 µg/kg) or vehicle subcutaneous injections daily for 16 days. Body mass, food intake, whole-body oxygen consumption, respiratory exchange ratio, and energy expenditure were measured in Promethion phenotyping cages. Dual-energy X-ray absorptiometry (DXA), glucose tolerance, serum metabolic hormone levels, depot-specific adipose and reproductive tissues were collected. EE+LNG limited body-mass gain in both age groups by combining hypophagia with a marked elevation in total energy expenditure and no change in locomotion, implicating potential thermogenic pathways. Dual-energy X-ray absorptiometry scans showed curtailed fat accrual and the preservation of lean mass in EE + LNG-treated rats. White-adipose depots were smaller in all hormone-treated rats, whereas brown adipose tissue mass was reduced only in adults. EE+LNG-treated adults had lower leptin and C-peptide levels with enhanced glucose clearance, whereas adolescents had reductions in GLP-1, glucagon, and PYY levels without altered glucose clearance. Thus low-dose EE + LNG reduced caloric intake, increased energy expenditure, and limited white-adipose deposition irrespective of age. Age-specific effects on metabolic hormones and adipose depot UCP1 content were noted. Together, these results delineate an age-sensitive metabolic and endocrine profile of EE + LNG.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42219595 · DOI · PMC13284417

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Occurrence of 17α-ethynylestradiol (EE2) in the environment and effect on exposed biota: a review [5]
    Aris AZ, Shamsuddin AS, Praveena SM · Environ Int · 2014 · cited 306 times (Europe PMC)
  • Research article Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis [6]
    Stegeman BH, de Bastos M, Rosendaal FR, van Hylckama Vlieg A, Helmerhorst FM, Stijnen T, et al. · BMJ · 2013 · cited 257 times (Europe PMC)
  • Research article Effects of the environmental estrogenic contaminants bisphenol A and 17α-ethinyl estradiol on sexual development and adult behaviors in aquatic wildlife species [7]
    Bhandari RK, Deem SL, Holliday DK, Jandegian CM, Kassotis CD, Nagel SC, et al. · Gen Comp Endocrinol · 2015 · cited 186 times (Europe PMC)
  • Research article Ethinyl estradiol and 17β-estradiol in combined oral contraceptives: pharmacokinetics, pharmacodynamics and risk assessment [8]
    Stanczyk FZ, Archer DF, Bhavnani BR · Contraception · 2013 · cited 136 times (Europe PMC)
  • Research article Pharmacokinetic drug interactions involving 17alpha-ethinylestradiol: a new look at an old drug [9]
    Zhang H, Cui D, Wang B, Han YH, Balimane P, Yang Z, et al. · Clin Pharmacokinet · 2007 · cited 135 times (Europe PMC)
  • Research article Effect of oral contraceptives on haemostasis variables [10]
    Kluft C, Lansink M · Thromb Haemost · 1997 · cited 106 times (Europe PMC)

References

  1. Nash JP, Kime DE, Van der Ven LT, Wester PW, Brion F, Maack G, et al.. Long-term exposure to environmental concentrations of the pharmaceutical ethynylestradiol causes reproductive failure in fish. . 2004. PMID 15579420 · DOI · PMC1253666
  2. Brian JV, Harris CA, Scholze M, Backhaus T, Booy P, Lamoree M, et al.. Accurate prediction of the response of freshwater fish to a mixture of estrogenic chemicals. . 2005. PMID 15929895 · DOI · PMC1257597
  3. Bhandari RK, vom Saal FS, Tillitt DE. Transgenerational effects from early developmental exposures to bisphenol A or 17α-ethinylestradiol in medaka, Oryzias latipes. . 2015. PMID 25790734 · DOI · PMC4366817
  4. Lacasse JM, Mohammad A, Montgomery KR, Bellaflor S, MacPherson REK, Galea LAM, et al.. Ethinyl estradiol and levonorgestrel coadministration induces hypophagia and increases energy expenditure in female rats. . 2026. PMID 42219595 · DOI · PMC13284417
  5. Aris AZ, Shamsuddin AS, Praveena SM. Occurrence of 17α-ethynylestradiol (EE2) in the environment and effect on exposed biota: a review. Environ Int. 2014. PMID 24825791 · DOI
  6. Stegeman BH, de Bastos M, Rosendaal FR, van Hylckama Vlieg A, Helmerhorst FM, Stijnen T, et al.. Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis. BMJ. 2013. PMID 24030561 · DOI · PMC3771677
  7. Bhandari RK, Deem SL, Holliday DK, Jandegian CM, Kassotis CD, Nagel SC, et al.. Effects of the environmental estrogenic contaminants bisphenol A and 17α-ethinyl estradiol on sexual development and adult behaviors in aquatic wildlife species. Gen Comp Endocrinol. 2015. PMID 25277515 · DOI
  8. Stanczyk FZ, Archer DF, Bhavnani BR. Ethinyl estradiol and 17β-estradiol in combined oral contraceptives: pharmacokinetics, pharmacodynamics and risk assessment. Contraception. 2013. PMID 23375353 · DOI
  9. Zhang H, Cui D, Wang B, Han YH, Balimane P, Yang Z, et al.. Pharmacokinetic drug interactions involving 17alpha-ethinylestradiol: a new look at an old drug. Clin Pharmacokinet. 2007. PMID 17253885 · DOI
  10. Kluft C, Lansink M. Effect of oral contraceptives on haemostasis variables. Thromb Haemost. 1997. PMID 9198173 · DOI

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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At a glance

11,341
PubMed records on this heading
6%
published since 2020
491
review articles
1,015
randomized trials
10
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

Related topics See all →

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