- What is esterified estrogens, and how does it work (mechanism of action)?
- What brand names are available for esterified estrogens?
- Is esterified estrogens available as a generic drug?
- Do I need a prescription for esterified estrogens?
- What are the side effects of esterified estrogens?
- What is the dosage for esterified estrogens?
- Which drugs or supplements interact with esterified estrogens?
- Is esterified estrogens safe to take if I'm pregnant or breastfeeding?
- What else should I know about esterified estrogens?
What is esterified estrogens, and how does it work (mechanism of action)?
Esterified estrogens are a mixture of several estrogens, a type of female hormone. Estrogens cause growth and development of female sex organs and the maintenance of sex characteristics, including growth of underarm and pubic hair and shaping of body contours and skeleton. Estrogens also increase secretions from the cervix and promote growth of the inner lining of the uterus (endometrium).
What are the side effects of esterified estrogens?
The most common endocrine side effects are
- breakthrough
- bleeding or spotting,
- loss of periods, or
- excessively prolonged periods,
- breast pain,
- breast enlargement, and
- changes in sexuality (increase or decrease in libido).
Other important side effects include:
- gallstones,
- hepatitis,
- migraine headaches, and
- fluid retention (swelling of the lower legs).
Melasma (tan or brown patches) may develop on the forehead, cheeks, or temples. These may persist even after the estrogen is stopped. Estrogens may cause an increase in the curvature of the cornea, and, therefore, patients with contact lenses may develop intolerance to their lenses.
Quick GuideMenopause & Perimenopause: Symptoms, Signs
What is the dosage for esterified estrogens?
The dose for menopause and related conditions is 0.3 to 1.25 mg daily for 3 weeks then 1 week off. Female hypogonadism is treated with 2.5 to 7.5 mg daily for 20 days then 10 days off. Breast cancer is treated with 10 mg three times daily for at least 3 months and the dose for prostate cancer is 1.25 to 2.5 mg 3 times daily.
Which drugs or supplements interact with esterified estrogens?
Estrogens increase the liver's ability to manufacture proteins that are required for blood to clot. Therefore, patients receiving warfarin (Coumadin), which reduces clotting ("thins" the blood) by inhibiting the production of proteins required for clotting, should receive clotting tests if an estrogen is added to their treatment. If blood clots too easily, the dose of warfarin may need to be increased.
Rifampin, barbiturates, carbamazepine (Tegretol), griseofulvin, phenytoin (Dilantin) and primidone can increase the elimination of estrogen by enhancing the liver's ability to metabolize (destroy) it. Use of these drugs may result in a reduction of the beneficial effects of estrogens. Conversely, drugs such as erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), and ritonavir (Norvir) may reduce the elimination of estrogens by the liver and lead to increased levels of estrogens in the blood. Grapefruit juice also may increase levels of estrogen by increasing the absorption of estrogens from the intestine. Increased levels of estrogens in the blood may result in more estrogen-related side effects.
Is esterified estrogens safe to take if I'm pregnant or breastfeeding?
Estrogens should not be used during pregnancy because of an increased risk of fetal abnormalities.
Estrogens are secreted in milk and cause unpredictable effects in the infant. Therefore, they generally should not be used during breastfeeding.
What else should I know about esterified estrogens?
What preparations of esterified estrogens are available?
Tablets: 0.3, 0.625, 1.25, and 2.5 mg.
How should I keep esterified estrogens stored?
Tablets should be stored between 2 C (36 F) and 30 C (86 F).
Medically reviewed by John Cunha, DO
Reference: FDA Prescribing Information
Quick GuideMenopause & Perimenopause: Symptoms, Signs
Summary
esterified estrogens (Estratab [discontinued]; Menest) are proscribed for treating the common symptoms of menopause, dysfunctional uterine bleeding, female castration, female hypogonadism, prostate cancer, and breast cancer. Side effects, drug interactions, warnings and precautions, and pregnancy information should be reviewed prior to taking any medication.
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Medications & Supplements
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- Drug Interactions
- estradiol, Alora, Climara, Delestrogen, Depo-Estradiol, Divigel, Elestrin, Estrace, and Others
- Evista (raloxifene)
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Reference: FDA Prescribing Information
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Breast cancer is an invasive tumor that develops in the mammary gland. Breast cancer is detected via mammograms, breast self-examination (BSE), biopsy, and specialized testing on breast cancer tissue. Treatment of breast cancer may involve surgery, radiation, hormone therapy, chemotherapy, and targeted therapy. Breast cancer risk may be lowered by managing controllable risk factors.
Drug Interactions
Drug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.Drugs: What You Should Know About Your Drugs
Important information about your drugs should be reviewed prior to taking any prescription drug. Side effects, drug interactions, warnings and precauctions, dosage, what the drug is used for, what to do if you miss a dose, how the drug is to be stored, and generic vs. brand names.estradiol
Estradiol (Alora; Climara; Delestrogen; Depo-Estradiol; Divigel; Elestrin; Estrace; Estrasorb; Estrogel; Evamist; Femring; Menostar; Minivelle; Vivelle; Vivelle-Dot) is a drug prescribed to treat the symptoms of menopause, prevention of bone fractures (osteoporosis), painful uterine bleeding, vaginal pain, dryness and atrophy associated with menopause. Estradiol is also prescribed for the treatment of breast cancer, and some cases of prostate cancer. Side effects, drug interactions, patient information, and dosage should be reviewed prior to taking this medication.estrogens conjugated
Estrogens (Premarin) are prescribed for the treatment of the symptoms of menopause. Side effects, drug interactions, pregnancy safety, and warnings and precautions should be reviewed prior to taking this medication.Hot Flashes
Hot flashes (or flushing) is the most common symptom experienced by a woman prior to and during the early stages of menopause, and often is described as the feeling of warmth that spreads over the body, often starting at the head accompanied by sweating. In the Study of Women Across America the Nation (SWAN) women had hot flashes that lasted on average 7 1/2 years. Symptoms of hot flashes include:
- Flushing
- Excessive sweating
- Anxiety
- Palpitations
Diagnosis is made by taking a patient history and, at times, blood tests. Treatment options include hormone therapy, bioidentical hormone therapy, and medications. There are non-FDA approved natural home remedies such as:
- Black cohosh
- Licorice
- Evening primrose oil
- Wild yam
- Dong quai
Hot flashes also can be caused by other conditions. Scientific studies to prove the safety and effectiveness of these products in relieving hot flashes have not been adequately performed. Consult your health-care professional before taking any herbal supplement.
Menopause
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the "change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.Menopause and Sex
Menopause is often associated with a change in sexual functioning. Loss of estrogen, bladder control issues, anxiety, stress, health concerns, medications, and sleep disturbances often result in a decrease in libido. Though there are currently no good drugs for treating sexual problems in women, there are ways to increase intimacy with a partner and treat vaginal dryness.Osteoporosis
Learn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.Perimenopause
Perimenopause is the time in a woman's life when she is approaching menopause. During this time a woman starts to develop symptoms of declining estrogen levels that may include mood swings, painful sex, night sweats, hot flashes, and weight gain. Every adult woman eventually will experience perimenopause.Prostate Cancer
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Evista (raloxifene) is a medication that is prescribed for the treatment and prevention of osteoporosis in postmenopausal women. Black box warnings for Evista includes
- an increased risk of deep vein thrombosis (DVT),
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- stroke.
Other side effects, drug interactions, dosage, and pregnancy and breastfeeding safety information should be reviewed prior to taking this medication.
Sexual Health Overview
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.Vaginal Bleeding
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding. Causes of abnormal may arise from a variety of conditions that may include:
- Uterine fibroids
- IUDs
- Hypothyroidism
- Hyperthyroidism
- Lupus
- STDs
- Pelvic inflammatory disease
- Emotional stress
- Anorexia nervosa
- Polycystic ovary syndrome (PCOS)
- Cancers
- Early pregnancy
The treatment for abnormal or irregular vaginal bleeding depends upon the cause.
Vaginal Dryness and Vaginal Atrophy
Vaginal dryness and vaginal atrophy occurs in women during perimenopause, menopause, and postmenopause. With vaginal atrophy, the lining of the vaginal wall becomes thinner, drier, less elastic, and light pink to bluish in color. Symptoms of vaginal atrophy include:- vaginal dryness,
- itching,
- irritation, and/or
- pain during intercourse.
