Several forms of estrogen occur naturally in a woman's body. The ovary produces a form named estradiol, which is converted into another important estrogen called estrone. Estriol is yet another form of estrogen metabolized from estradiol, weaker than the other two, but still active.

The estrogen tablets prescribed for menopausal symptoms usually contain estradiol, estrone, or a combination of the two. Some alternative medicine physicians have popularized the use of estriol as an alternative, and there is no doubt that estriol is also effective for symptoms of menopause. However, despite claims that it is safer than other forms of estrogen, the balance of evidence suggests that, in fact, estriol presents precisely the same risks (see Safety Issues below).

Estriol is manufactured in the body from estrone, estradiol, and androstenedione. When taken as a drug, it is manufactured synthetically, or extracted from animal products.