Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Breast cancer: Studies indicate an increased risk of breast cancer with long-term use of estrogen replacement therapy. Women who have breast nodules, fibrocystic disease, abnormal mammograms, or a strong family history of breast cancer should speak to their doctor about the use of estrogens. Women taking estrogens should have regular breast examinations and should be instructed in breast self-examination.
Blood pressure: Increased blood pressure is not uncommon in women using this medication. Blood pressure should be monitored with estrogen use, especially if high doses are used.
Blood problems:People with blood clotting or circulation disorders, varicose veins, severe obesity, and those on bedrest for 3 weeks or more should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Smoking can increase the risk of blood clots. Women who take estrogen are strongly advised not to smoke. Inform your doctor if you are planning an upcoming surgery, as there is an increased risk of blood clot formation when using this medication. If you experience sharp pain in the chest, pain in the calf, sudden shortness of breath, or are coughing blood, contact your doctor immediately, as these symptoms could indicate a possible blood clot.
Cholesterol: Oral estrogens can increase triglycerides in the blood. Your doctor may check your cholesterol while on estrogen.
Diabetes: Estrogens may affect blood glucose control. Anyone with diabetes should carefully monitor their blood glucose levels while taking any product containing estrogen.
Endometrial cancer: There is evidence from several studies that estrogens, when taken without progestogens, increase the risk of endometrial (uterine) cancer. Taking a progestogen appropriately along with the estrogen reduces this risk to the same level as that of a woman who does not take estrogen. For this reason, all women who have not had their uteruses removed should also take a progestogen if they use estrogens.
Fibroids: This medication may worsen fibroids, causing sudden enlargement, pain, or tenderness. If you notice these effects, contact your doctor.
Fluid retention: Estrogen may cause fluid retention. Women with heart or kidney dysfunction, epilepsy, or asthma should speak to their doctor about what signs and symptoms to watch for and monitor their condition closely.
Gallbladder disease: An increased risk of gallbladder disease has been reported in postmenopausal women taking estrogens.
Pregnancy: Estrogen should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor.
Breast-feeding: Estrogen is not safe for use during breast-feeding. A decision should be made whether to discontinue breast-feeding or to discontinue the estrogen, taking into account the importance of the medication to the mother.
Children: The safety and effectiveness of this medication have not been established for use by children.