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This medication carries several important safety considerations and potential risks. It is crucial to discuss these with your healthcare provider to fully understand the implications for your health. Below is a summary of the key safety information:

• Uterine (Endometrial) Cancer: Use of estrogen products alone, such as estradiol, can increase the risk of this cancer. Adding progestin may reduce the risk for those with a uterus. Notify your doctor if you experience unusual vaginal bleeding.

• Breast Cancer: There is an elevated risk of developing breast cancer when using estradiol, both alone and with progestin, particularly with long-term use. Regular self-exams and annual medical check-ups are recommended.

• Blood Clots and Strokes: Postmenopausal women using estradiol, with or without progestin, face increased risks of strokes and blood clots. Seek immediate medical attention if you experience symptoms like leg pain, chest pain, or sudden numbness.

• Heart Disease and Heart Attacks: Estradiol should not be used to prevent heart disease, as it can increase the risk of heart attacks in postmenopausal women. Emergency help is necessary for any signs of a heart attack.

• Dementia: Estradiol does not lower dementia risk and may increase it in women over 65. Report any cognitive changes to your healthcare provider.

• Gallbladder and Liver Issues: Estradiol can exacerbate gallbladder and liver problems, especially in those with a history of these conditions. Regular monitoring may be necessary.

• Calcium Level Changes: Estradiol may cause elevated calcium levels, particularly in women with breast cancer or bone metastases. Symptoms like nausea or confusion should be reported immediately.

• Vision Problems: Estradiol has been linked to retinal vascular thrombosis. Discontinue use and contact your doctor if you experience sudden vision changes.

• High Triglycerides: This medication can increase triglycerides, potentially leading to pancreatitis. Dietary adjustments and regular monitoring may be required.

• Low Thyroid Hormone Levels: Estradiol can affect thyroid hormone levels, necessitating dosage adjustments for thyroid medication. Regular blood tests might be necessary.

• Fluid Retention (Edema): The use of estradiol may cause fluid retention, especially in individuals with heart or kidney issues. Report any unusual swelling.

• Worsening of Other Conditions: Estradiol might aggravate conditions such as asthma, diabetes, or seizures. Consult your healthcare provider if you have these conditions.

Contraindications: Do not use this medication if you have abnormal vaginal bleeding, breast cancer, estrogen-dependent tumors, blood clots, a history of stroke or heart attack, liver problems, or if you are pregnant. Always consult your healthcare provider under these conditions.

When taking this medication, some common side effects might occur, such as stomach upset, nausea or vomiting, bloating, breast tenderness, and headaches. These are usually mild but consult your healthcare provider if they persist or worsen. Other possible effects include weight changes, hair loss, irregular vaginal bleeding, spotting, and vaginal yeast infections.

Some users may experience changes in vaginal discharge, mood changes, stomach cramps, and variations in sex drive. These effects should be monitored, and if they become bothersome, it's advisable to seek medical advice.

Rare but serious side effects demand immediate medical attention. These include persistent nausea or vomiting, depression, memory loss, breast lumps, unusual vaginal bleeding, severe abdominal pain, yellowing eyes or skin, dark urine, and swelling of the hands, ankles, or feet.

Severe allergic reactions are also possible, albeit rare, presenting symptoms such as rash, itching or swelling, severe dizziness, and breathing difficulties. Furthermore, the medication may rarely lead to life-threatening conditions like blood clots, heart attacks, or strokes, indicated by symptoms such as chest pain, sudden severe headaches, weakness on one side of the body, confusion, and trouble speaking. If any of these occur, seek urgent medical help. Always consult your healthcare provider if you notice any side effects not listed here.