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When considering the use of estrogens, whether alone or combined with a progestin, it is crucial to be aware of the potential severe side effects, though they are rare. It is important to have a thorough discussion with your healthcare provider about the potential risks and advantages of hormone therapy.

• Estrogens and progestins are not recommended for the prevention of heart disease or dementia.
• In women who are postmenopausal, the combination of estrogen with a progestin may elevate the risk of developing heart disease (including heart attacks), strokes, serious blood clots in the lungs or legs, dementia, and cancers of the breast or ovaries.
• The likelihood of experiencing these serious side effects may vary based on the dosage of estrogen and the duration of its use. Therefore, it is advised to use the lowest effective dose for the shortest possible time.
• Regular consultations with your doctor are necessary to assess the continued need for this medication, ideally every 3 to 6 months.
• For those on long-term therapy, regular comprehensive physical examinations should be conducted, at least annually, as recommended by your healthcare provider.

These precautions help ensure the safe and effective use of hormone therapy.

You may experience some mild side effects such as skin redness or irritation where the drug is applied, abdominal pain, nausea or vomiting, bloating, breast tenderness, headache, back pain, or changes in weight. These are common and usually not a cause for concern, but if they persist or worsen, it's a good idea to consult a healthcare professional.

More serious side effects require immediate attention. These include persistent nausea or vomiting, mental or mood changes like depression or memory loss, breast lumps, unusual vaginal bleeding or discharge, severe abdominal pain, jaundice (yellowing of the eyes or skin), dark urine, swelling in the hands, ankles, or feet, and increased thirst or urination.

In rare cases, the medication may lead to serious, sometimes life-threatening blood clot issues such as heart attacks, strokes, or clots in the lungs or legs. Seek emergency medical help if you experience chest pain, unusual sweating, sudden severe headaches, weakness on one side of the body, confusion, difficulty speaking, sudden vision changes, pain or swelling in the groin or calf, difficulty breathing, or sudden dizziness or fainting.

A very serious allergic reaction to the medication is rare, but requires immediate medical attention. Signs include rash, itching or swelling (especially of the face, tongue, or throat), severe dizziness, and difficulty breathing. Remember, this is not an exhaustive list of side effects. If you notice any other unusual symptoms, reach out to a healthcare provider.