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This medication, containing estrogens and progestins, carries certain risks that necessitate careful consideration and regular consultation with your healthcare provider. Below are key safety and warning details to keep in mind:

• Serious Side Effects: Estrogens, whether used alone or with a progestin, can sometimes lead to severe side effects. It is crucial to discuss the risks and benefits of hormone therapy with your doctor. These medications are not recommended for the prevention of heart disease or dementia.

• Increased Risk for Cardiovascular Events: Use of estrogen/progestin therapy can elevate the risk of blood clots, heart attacks, and strokes. Individuals with a personal or family history of blood clots, high blood pressure, diabetes, high cholesterol, tobacco use, obesity, or systemic lupus erythematosus (SLE) should exercise caution.

• Cancer Risks:

  • Breast Cancer: Hormone therapy may increase the risk of invasive breast cancer, particularly with prolonged use. Those with a personal or family history of breast cancer or those who have had breast cancer should avoid this medication.
  • Uterine Cancer: Estrogens can alter the uterine lining, increasing the risk of endometrial cancer. Progestin helps mitigate this risk. Regular monitoring is advised for individuals with a healthy uterus.
  • Ovarian Cancer: There may be an elevated risk of ovarian cancer with menopausal hormone therapy. Notify your doctor of any unusual symptoms such as vaginal bleeding, discharge, or pelvic pain.

• Dementia Risk: Hormonal therapy in individuals over 65 may heighten the risk of dementia. It is not advisable to use this medication to prevent dementia.

• Liver and Gallbladder Issues: Estrogens might increase the risk of gallbladder disease and liver problems. Report any signs of jaundice to your healthcare provider.

• Vision Problems: Although rare, estrogen use can cause eye-related issues. Discontinue use and seek medical attention if you experience sudden vision changes.

• Triglyceride Levels: Estrogens can raise blood triglyceride levels, potentially leading to pancreatitis. Inform your doctor if you experience symptoms like abdominal pain or nausea.

• Fluid Retention: Estrogen/progestin therapy may cause fluid retention, leading to swelling in limbs. This is particularly relevant for those with heart failure or kidney problems.

• Thyroid Hormone Levels: Estrogens can interfere with thyroid hormone levels, especially in those with hypothyroidism.

• Worsening of Existing Conditions: This medication can exacerbate conditions such as asthma, diabetes, epilepsy, migraines, and lupus. Discuss all medical conditions with your healthcare provider before starting therapy.

Contraindications:

• Avoid use if you have abnormal vaginal bleeding that hasn't been evaluated, a history of breast cancer, estrogen-dependent tumors, blood clots, heart attacks, strokes, liver issues, or blood-clotting disorders.

Regular discussions with your healthcare provider are essential to assess the need for continued use of this medication and to manage any potential risks effectively.

When taking this medication, some individuals may experience common side effects such as stomach upset, nausea, vomiting, bloating, breast tenderness, headache, and weight changes. Although these effects are generally mild, if they persist or become bothersome, it's advisable to consult your healthcare provider. Additionally, some individuals have reported vaginal discharge and bleeding, pelvic pain, and changes in sleep patterns, such as insomnia or sleepiness.

In some cases, users may encounter more serious side effects requiring prompt medical attention. These include persistent nausea or vomiting, mental or mood changes like depression or memory loss, breast lumps, unusual vaginal bleeding, or increased vaginal irritation and odor. Severe abdominal pain, yellowing of the eyes or skin, dark urine, and swelling in the extremities are also significant concerns that warrant immediate consultation with a healthcare professional.

Rarely, this medication may lead to serious and potentially fatal blood clot issues, such as heart attacks, strokes, or clots in the lungs or legs. Symptoms of these conditions include chest pain, unusual sweating, sudden severe headaches, weakness on one side of the body, confusion, trouble speaking, sudden vision changes, or pain, swelling, and warmth in the groin or calf. If any of these symptoms occur, seek emergency medical help immediately.

Lastly, although a very serious allergic reaction to this medication is rare, it is important to be aware of symptoms such as rash, itching or swelling—particularly of the face, tongue, or throat—severe dizziness, or difficulty breathing. If these occur, urgent medical attention is required. Always report any other unexpected side effects to your healthcare provider.