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When considering the use of estrogen medications, either alone or in combination with progestin, it is important to be aware of potential risks and necessary precautions. Please review the following information carefully and discuss any concerns with your healthcare provider.

• Cancer Risks:

  • Uterine Cancer: Using estrogen, especially without progestin, can increase the risk of uterine (endometrial) cancer. Report any unusual vaginal bleeding to your doctor immediately.
  • Breast Cancer: Estrogen combined with progestin may elevate the risk of breast cancer, particularly with long-term use. Ensure regular breast exams and discuss your personal and family history of breast cancer with your healthcare provider.

• Cardiovascular Risks:

  • Blood Clots, Heart Attacks, and Strokes: Estrogen, with or without progestin, can heighten the risk of blood clots, potentially leading to heart attacks, strokes, or pulmonary embolism. This risk increases with certain conditions such as high blood pressure, diabetes, tobacco use, and obesity. Immediate medical attention is required if you experience symptoms like leg pain, chest pain, sudden headaches, or changes in speech or vision.

• Dementia Risk: Starting estrogen therapy at age 65 or older might increase the risk of dementia. Discuss these concerns with your provider, as estrogen should not be used to prevent dementia.

• Gallbladder and Liver Concerns: Estrogen use may cause gallbladder issues or exacerbate liver problems. Be alert to symptoms such as persistent stomach pain, jaundice, or nausea, and inform your doctor if they occur.

• Pancreatitis: High triglycerides due to estrogen use can lead to pancreatitis. Regular monitoring through blood tests is advised.

• Vaginal Irritation: Some users may experience vaginal irritation from the applicator. If this persists or worsens, consult your healthcare provider.

• Eye Issues: Estrogen can cause eye problems due to blood clot formation. Notify your provider of any vision changes or headaches.

Contraindications:

• Do not use estrogen if you have undiagnosed abnormal vaginal bleeding, a history of breast cancer or estrogen-dependent cancers, active or past blood clots, liver disease, or are pregnant (for certain brands).

Ensure you are using the lowest effective dose for the shortest duration necessary, and maintain regular check-ups with your healthcare provider to assess the ongoing need for this medication.

When taking this medication, it's possible to experience a range of side effects. Common side effects include nausea, vomiting, bloating, diarrhea, breast tenderness, headaches, weight changes, vaginal yeast infections, itching in the vaginal or vulva area, and back pain. These are generally mild, but if they persist or worsen, it’s important to consult a healthcare provider.

Some users may also experience more persistent headaches or develop diarrhea. While these effects are typically manageable, it’s still advisable to inform your healthcare provider if they become bothersome or severe.

On rare occasions, serious side effects can occur that require immediate medical attention. These include persistent nausea or vomiting, mental or mood changes like depression or memory loss, breast lumps, unusual vaginal bleeding, increased vaginal irritation, signs of liver problems, swelling in the hands, ankles, or feet, and increased thirst or urination. Additionally, the medication may rarely lead to serious blood clot issues, resulting in symptoms such as chest pain, sudden severe headaches, weakness on one side of the body, confusion, trouble speaking, or sudden vision changes.

Lastly, although very rare, there is a risk of a severe allergic reaction. Signs include rash, itching, swelling, especially of the face, tongue, or throat, severe dizziness, and trouble breathing. If you experience any of these symptoms, seek medical help immediately. As this is not an exhaustive list of side effects, contact your healthcare provider if you notice other unusual symptoms.