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Please review the following important safety and warning information regarding the use of estrogen medications like estradiol gel (EstroGel). It is crucial to discuss any concerns or questions with your healthcare provider to ensure safe and effective use of this medication.

• Serious Side Effects: Although rare, estrogens alone or with progestin can cause serious side effects. It is important to balance the risks and benefits with your doctor. Estrogens should not be used to prevent heart disease or dementia.

• Cancer Risks:

  • Uterine (Endometrial) Cancer: Estrogens can increase the risk of endometrial cancer by altering the uterine lining. Taking progestin can help reduce this risk. Report any unusual vaginal bleeding to your healthcare provider immediately.
  • Breast and Ovarian Cancer: There is an increased risk of breast and ovarian cancer with estrogen use, especially when used long-term or with progestin. Regular breast exams and mammograms are recommended. Notify your doctor if you notice any changes in your breasts.

• Blood Clots: Estrogens may increase the risk of blood clots, which can be life-threatening. Risk factors include age over 50, high blood pressure, obesity, high cholesterol, diabetes, smoking, and recent surgery or bedrest. Seek immediate medical attention if you suspect a blood clot.

• Heart Disease and Stroke: Estrogens and progestin together can raise the risk of heart attacks and strokes. Use the lowest effective dose for the shortest time necessary and regularly evaluate the need for continued treatment with your healthcare provider.

• Dementia: There is a potential increased risk of dementia, especially if treatment is started after age 65. Discuss any concerns with your prescriber.

• Gallbladder and Liver Issues: Estrogens can cause gallbladder problems and liver issues, such as jaundice. Report symptoms like persistent stomach pain or yellowing of the skin to your doctor immediately.

• Calcium Levels: Estrogens may affect blood calcium levels, particularly in those with breast cancer that has spread to the bones. Symptoms of high calcium include thirst, nausea, and confusion. Notify your doctor if you experience these symptoms.

• Vision Problems: Though rare, estrogens can cause vision issues from blood clots in the eyes. Discontinue use and contact your provider if you experience sudden vision changes or migraines.

• Triglycerides: Estrogens can elevate triglyceride levels, increasing the risk of heart problems or pancreatitis. Regular blood tests may be recommended. Seek medical help if you experience severe stomach pain or a rapid heartbeat.

• Thyroid Hormone Levels: Estrogens may affect thyroid hormone levels. If you are on thyroid medication, you may need adjustments. Regular monitoring is advised.

• Fluid Retention: Estrogens can cause fluid retention, which may worsen heart or kidney conditions. Report sudden swelling or weight gain to your care team.

• Worsening of Other Conditions: Estrogens can exacerbate conditions like asthma, diabetes, migraines, seizures, and endometriosis. Discuss your medical history with your healthcare provider.

• Potential Skin Transfer: Ensure the gel is dry and covered with clothing to prevent transfer to others through skin contact.

Contraindications: Do not use if you have undiagnosed abnormal vaginal bleeding, a history of breast cancer, estrogen-dependent cancer, blood clots, stroke, heart attack, or liver problems. Always consult your healthcare provider if any of these conditions apply to you.

When taking this medication, some individuals may experience common side effects such as breast tenderness, headaches, and bloating. Other mild effects include nausea, passing gas, dizziness, trouble sleeping, and weight changes. While these are generally manageable, it's important to consult a healthcare provider if they persist or worsen.

In some cases, more serious side effects may occur, requiring prompt medical attention. These include persistent nausea or vomiting, mental changes like depression or memory loss, unusual vaginal bleeding, severe abdominal pain, yellowing of the skin or eyes, dark urine, and swelling in the hands or feet. Additionally, any new or increased vaginal irritation should be reported.

Rarely, this medication can lead to severe complications such as blood clots, potential heart attacks, or strokes. Symptoms of these conditions include chest pain, severe headaches, sudden weakness on one side of the body, difficulty speaking, or changes in vision. If you experience any of these symptoms, seek immediate medical care. Furthermore, signs of a serious allergic reaction, such as a rash, swelling, or difficulty breathing, also require urgent attention.

Lastly, though infrequent, some may experience skin rashes, diarrhea, or hair loss. While this is not an exhaustive list of all potential side effects, any unusual symptoms should be discussed with a healthcare professional.