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Estrogen therapy, whether used alone or combined with another hormone like progestin, can rarely lead to very serious side effects. It is important to discuss the potential risks and benefits of hormone therapy with your doctor. Estrogens should not be used as a preventive measure for heart disease or dementia.

• There is an increased risk of uterine (endometrial) cancer associated with estrogen use. To reduce this risk, follow your doctor's instructions regarding the use of progestin. Report any unusual vaginal bleeding to your doctor immediately.

• In postmenopausal women, the use of estrogens, with or without progestin, may elevate the risk of breast or ovarian cancer, stroke, dementia, and severe blood clots. When combined with progestin, estrogens could also increase the risk of heart disease, including heart attacks.

• The likelihood of experiencing serious side effects is influenced by the estrogen dose and the duration of use. It is recommended to use the lowest effective dose for the shortest possible time. Regular consultations with your doctor are crucial to assess the ongoing need for this medication, ideally every 3 to 6 months.

• For long-term use, ensure you have comprehensive physical examinations as advised by your healthcare provider, typically on an annual basis.

When taking this medication, you might experience mild side effects such as nausea, vomiting, bloating, breast tenderness, headaches, or changes in weight. These are common and usually not a cause for concern. However, if they persist or worsen, it is important to seek medical advice.

There are more serious side effects that require immediate attention. These include persistent nausea or vomiting, mood changes like depression or memory loss, breast lumps, and unusual vaginal bleeding or discharge. Severe abdominal pain, yellowing of the skin or eyes, dark urine, swelling in extremities, and increased thirst or urination also warrant prompt medical consultation.

Rarely, this medication can lead to severe complications from blood clots, potentially resulting in heart attacks, strokes, or clots in the lungs or legs. Urgently seek medical help if you experience chest pain, severe headaches, sudden weakness, confusion, speech difficulties, vision changes, or pain in the groin or calf.

In very rare cases, use of vaginal rings has been linked to toxic shock syndrome, a potentially fatal bacterial infection. Symptoms include high fever, dizziness, muscle pain, sunburn-like rash, and diarrhea. If these occur, remove the product and get medical assistance immediately.

Additionally, a serious allergic reaction is uncommon, but if you notice a rash, itching, swelling, severe dizziness, or trouble breathing, seek emergency medical help. If you observe any other side effects not listed here, consult your healthcare provider for advice.