Estetrol (E4) — a naturally occurring estrogen produced by the fetal liver — has emerged as a novel hormonal option with a distinct receptor-activity profile, generating significant interest in the oncomenopause space. Unlike traditional estrogens, E4 demonstrates selective tissue activity that may confer meaningful advantages in terms of breast safety, making it a compelling candidate for menopause management in cancer survivors for whom conventional hormone therapy has historically been contraindicated or approached with significant caution. In this session, Dr. Ekta Kapoor reviews the pharmacology and mechanism of E4, examines the current clinical and preclinical evidence on its efficacy and tissue-specific effects, and explores the emerging data on its potential role in menopause symptom management for survivors — situating this novel agent within the broader and evolving landscape of hormonal options in oncomenopause care.

Ekta Kapoor, MBBS, is Associate Professor of Medicine at Mayo Clinic College of Medicine and a physician in the Division of Endocrinology, General Internal Medicine, and the Menopause and Women's Sexual Health Clinic in Rochester, Minnesota. Board-certified in both Internal Medicine and Endocrinology, Diabetes & Metabolism by the American Board of Internal Medicine, Dr. Kapoor's clinical and research focus centers on menopausal hormone therapy, premature menopause, bilateral oophorectomy management, and the intersection of weight and metabolic health with the menopause transition. She serves as a Member of the Board of Trustees of The Menopause Society and has served on its Education Committee, and is Co-Director of Women's Health Grand Rounds at Mayo Clinic. Her research has been recognized with multiple GIM Research Awards and a Benefactor-Funded Career Development Award in Endocrinology.