- What is esterified estrogens and methyltestosterone, and how does it work (mechanism of action)?
- What brand names are available for esterified estrogens and methyltestosterone?
- Is esterified estrogens and methyltestosterone available as a generic drug?
- Do I need a prescription for esterified estrogens and methyltestosterone?
- What are the side effects of esterified estrogens and methyltestosterone?
- What is the dosage for esterified estrogens and methyltestosterone?
- Which drugs or supplements interact with esterified estrogens and methyltestosterone?
- Is esterified estrogens and methyltestosterone safe to take if I'm pregnant or breastfeeding?
- What else should I know about esterified estrogens and methyltestosterone?
What is esterified estrogens and methyltestosterone, and how does it work (mechanism of action)?
Esterified estrogens are a mixture of related estrogens. Estrogens, when taken alone or in combination with a progestin, have been shown to reduce the risk for hip fracture due to osteoporosis by 25% as well as the risk of heart attack (myocardial infarction) and stroke by 40-50%. Esterified estrogens are used for numerous medical situations. Estrogens cause growth and development of female sex organs and the maintain sex characteristics, including growth of underarm and pubic hair and shaping of body contours and skeleton. Estrogens also increase secretions from the cervix and growth of the inner lining of the uterus (endometrium). Estrogens reduce LDL-cholesterol ("bad" cholesterol) and increase HDL-cholesterol ("good" cholesterol) concentrations.
Testosterone is the major male sex hormone that is responsible for many male sexual characteristics, but women also produce small amounts of testosterone. Following menopause, a woman's production of testosterone decreases. When testosterone in the form of methyltestosterone is added to estrogens, there may be a further alleviation of the hot flashes seen after menopause, and there also may be an improvement in a woman's sexual function.
What brand names are available for esterified estrogens and methyltestosterone?
Estratest (discontinued), Covaryx, Covaryx H.S., EEMT HS, EEMT
What are the side effects of esterified estrogens and methyltestosterone?
For side effects, please read the esterified estrogens article.
Important side effects of methyltestosterone can have masculinizing effects in women, including:
- the development of acne,
- growth of facial hair,
- enlargement of the clitoris,
- reduction in breast size, and
- deepening of the voice.
If treatment is discontinued when these symptoms first appear, they usually diminish or disappear; however, prolonged treatment can cause irreversible masculinizing effects.
What is the dosage for esterified estrogens and methyltestosterone?
Estratest usually is prescribed as 1 or 2 tablets daily for 21 consecutive days followed by 7 days without medication.
Which drugs or supplements interact with esterified estrogens and methyltestosterone?
For drug interactions for esterified estrogens, please read the esterified estrogens article.
Methyltestosterone can increase the effects of warfarin (Coumadin), increasing the risk of bleeding. Taking methyltestosterone and imipramine (Tofranil) together has led to paranoia in a few patients. Methyltestosterone can increase blood concentrations of cyclosporine (Sandimmune; Neoral), which can increase the risk of kidney damage.
Is esterified estrogens and methyltestosterone safe to take if I'm pregnant or breastfeeding?
Both methyltestosterone and estrogens should not be used during pregnancy due to an increased risk of fetal abnormalities.
Estrogens are secreted in milk and cause unpredictable effects in the infant. They should not be used during breast-feeding.
What else should I know about esterified estrogens and methyltestosterone?
What preparations of esterified estrogens and methyltestosterone are available?
Estratest tablets: esterified estrogens 0.625mg plus methyltestosterone 1.25mg; esterified estrogens 1.25mg plus methyltestosterone 2.5mg. Estratest HS is one-half the strength of Estratest.
How should I keep esterified estrogens and methyltestosterone stored?
Tablets should be stored at 36 F - 86 F (20 C - 30 C).
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Esterified estrogens and methyltestosterone (Estratest [discontinued], Covaryx, Covaryx H.S., EEMT HS, EEMT) is a mixture of different types of estrogens and methyltestosterone used to treat a variety of medical conditions in women. Therapy with this medication can promote development of and help maintain sexual characteristics and function. Estrogen therapy may also reduce the risk of heart attack, stroke, high cholesterol, hot flashes, and hip fracture due to osteoporosis. Side effects, drug interactions, warnings and precautions, and pregnancy information should be reviewed prior to taking this medication.
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Menopause is the time in a woman's life when menstrual periods permanently stop, also called the "change of life." Menopause symptoms and signs 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.
High cholesterol and triglyceride levels increase the risk of cardiovascular disease. Getting your cholesterol and triglyceride levels in an optimal range will help protect your heart and blood vessels. Cholesterol management may include lifestyle interventions (diet and exercise) as well as medications to get your total cholesterol, LDL, HDL, and triglycerides in an optimal range.
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include weakness, numbness, double vision or vision loss, confusion, vertigo, difficulty speaking, or understanding speech. A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
Low Testosterone (Low-T)
Low testosterone (low-T) can be caused by conditions such as type 2 diabetes, obesity, liver or kidney disease, hormonal disorders, certain infections, and hypogonadism. Signs and symptoms that a person may have low-T include insomnia, increased body fat, weight gain, reduced muscle, infertility, decreased sex drive, depression, and worsening of congestive heart failure or sleep apnea. Low-T can be treated with testosterone therapy in the form of gels, injections, pellets, or skin patches. Side effects of testosterone treatment include acne, anxiety, hair loss, headache, and change in sex drive (libido).
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.
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.
What Are the Benefits of Taking Estrogen?
Estrogen therapy, also known as hormone replacement therapy, is a treatment for alleviating the symptoms caused by menopausal transition. Estrogen therapy can alleviate symptoms like hot flashes, painful intercourse and bone loss.
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. Treatment options for vaginal dryness and vaginal atrophy include hormone treatment and over-the-counter vaginal lubricating and moisturizing products.
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Reference: FDA Prescribing Information