- What are conjugated estrogens?
- What are examples of conjugated estrogens available in the US?
- What are the side effects of conjugated estrogens?
- What drugs interact with conjugated estrogens?
- What formulations of conjugated estrogens are available?
- What about taking conjugated estrogens during pregnancy or while breastfeeding?
What are conjugated estrogens?
Conjugated estrogens are mixtures of man-made or natural estrogens used as an external source and replacement for the natural female hormone. Estrogens have widespread effects on many tissues in the body. Estrogens cause growth and development of the female sexual organs and maintain female sexual characteristics such as the growth of underarm and pubic hair, body contours, and skeleton. Estrogens also increase secretions from the cervix and growth of the inner lining of the uterus (endometrium).
Menopausal women produce less estrogen which leads to symptoms of hot flashes, vaginal dryness, shrinking in vaginal tissue and painful intercourse. Using conjugated estrogens can help treat such symptoms in menopausal women. Conjugated estrogens can also help in prevention of bone loss in menopausal women.
What are examples of conjugated estrogens available in the US?
Examples of oral conjugated estrogens are:
Premarin vaginal cream is a topical form of estrogen.
Enjuvia and Cenestin are synthetic conjugated estrogens produced from plant material.
Premarin is derived from natural sources and blended to approximate the composition of estrogens found in urine of pregnant horses.
What are the side effects of conjugated estrogens?
There are many side effects of conjugated estrogens. Common side effects of conjugated estrogens are nausea, headache, pain, swelling of breasts, weight change, abdominal pain, anxiety, edema, vaginal bleeding, and mood disturbances.
Estrogens can cause salt (sodium) and water retention (edema). Therefore, patients with heart failure or reduced function of their kidneys who are taking estrogens should be carefully observed for retention of water and its complications.
Blood clots in the legs (deep vein thrombosis or DVT) or lungs (pulmonary embolism) occasionally occur in women taking conjugated estrogens. This potentially serious complication of estrogen therapy is dose-related, that is, it occurs more commonly with higher doses. Therefore, the lowest effective doses that relieve symptoms should be used. Cigarette smokers are at a higher risk for blood clots. Therefore, patients requiring estrogen therapy should quit smoking.
Estrogens can promote a build-up of the lining of the uterus (endometrial hyperplasia) and increase the risk of endometrial cancer. (Women who have undergone surgical removal of the uterus – hysterectomy - are not susceptible to endometrial hyperplasia.) The addition of a progestin to estrogen therapy prevents the development of endometrial cancer.
The Women's Health Initiative found that postmenopausal women (50 to 79 years old) taking conjugated estrogens, 0.625 mg daily, in combination with medroxyprogesterone (Provera, Depo-Provera, Depo-Sub Q Provera 104), 2.5 mg daily, for five years, had an increased risk of heart attacks, stroke, breast cancer, and blood clots, while postmenopausal women taking conjugated estrogens without progesterone experienced only increased strokes but not increased blood clots, heart disease, or breast cancer.
What drugs interact with conjugated estrogens?
Medications like St. John's Wort, phenobarbital, carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol), and rifampin (Rifadin) can accelerate the breakdown of conjugated estrogens, leading to low levels of absorbed drug and reduced effectiveness. Grapefruit juice and medications like erythromycin, clarithromycin (Biaxin, Biaxin XL), ketoconazole (Nizoral, Extina, Xolegel, Kuric), and ritonavir can slow down the breakdown of conjugated estrogens in the liver, leading to increased levels of estrogens and increased estrogen side effects.
What formulations of conjugated estrogens are available?
Conjugated estrogens are available as oral tablets and topical cream.
What about taking conjugated estrogens during pregnancy or while breastfeeding?
Conjugated estrogens are not recommended during pregnancy because it may cause birth defects in the unborn. Use of conjugated estrogens is not recommended in nursing mothers because conjugated estrogens enter breast milk and may have harmful effects on the newborn. Conjugated estrogens can also affect the quality and quantity of breast milk.
Conjugated Estrogens (Cenestin, Enjuvia, Estrace, and Others) is a class of drug that comprises mixtures of man-made natural estrogens to be prescribed as a source of replacement for the natural female hormone. Side effects, drug interactions, dosage, storage, and risks should be reviewed prior to taking conjugated estrogens.
Multimedia: Slideshows, Images & Quizzes
Menopause Quiz: Symptoms & Signs
The Menopause Quiz challenges your knowledge about the time in a woman’s life when menstruation ceases. Menopause can bring many...
Menopause & Perimenopause: Symptoms, Signs
What is menopause? What are the signs of menopause? What age does menopause start? Learn about menopause and perimenopause...
Women’s Health: 13 Hormone Imbalance Symptoms and Signs
Hormone imbalance involves changes in estrogen, progesterone, and other hormone levels. Hormonal imbalance may cause symptoms...
Related Disease Conditions
Migraine headaches are severe headaches that are sensitive to light, sounds, and smells. Some people who suffer from...
Raynaud's phenomenon is characterized by a pale-blue-red sequence of color changes of the digits, most commonly after exposure to...
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the "change of life." Menopause...
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and...
Natural Remedies for Hot Flashes
Hot flashes are experienced by many women, especially at night. However, not all women undergoing menopause experience hot...
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's...
Premature Menopause (Symptoms, Causes, and Treatments)
Premature menopause is when menopause occurs in a woman before the age of 40. Causes of premature menopause include premature...
Sex and Menopause (What to Expect)
Menopause is often associated with a change in sexual functioning. Loss of estrogen, bladder control issues, anxiety, stress,...
Perimenopause (Symptoms, Signs, Remedies, and Treatments)
Perimenopause is the time in a woman's life when she is approaching menopause. During this time a woman starts to develop...
Night Sweats (Causes, Remedies, and Treatments in Women and Men)
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. The causes of night sweats in most...
Hot Flashes (Causes, Symptoms & Medication Treatment in Men and Women)
Hot flashes (or flushing) is the most common symptom experienced by a woman prior to and during the early stages of menopause,...
Vulvodynia (Vaginal Pain)
Vulvodynia or vaginal pain, genital pain is a condition in which women have chronic vulvar pain with no known cause. There are...
Vaginal dryness and vaginal atrophy occurs in women during perimenopause, menopause, and postmenopause. With vaginal atrophy, the...
Treatment & Diagnosis
Medications & Supplements
- estrogens conjugated, Premarin
- conjugated equine estrogens and medroxyprogesterone acetate, Prempro, Premphase
- esterified estrogens, Estratab (discontinued); Menest
- esterified estrogens and methyltestosterone, Estratest, Estratest HS
- estrogens conjugated synthetic, Cenestin
- conjugated estrogens vaginal cream, Premarin Vaginal Cream
- methyltestosterone w/ estrogen - oral, Estratest
- estrogens cream - vaginal
Prevention & Wellness
Daily Health News
Subscribe to MedicineNet's General Health Newsletter
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
REFERENCE: FDA Prescribing Information.
Top estrogens-oral Related Articles
Alternative Treatments for Hot FlashesHot flashes are experienced by many women, especially at night. However, not all women undergoing menopause experience hot flashes. What causes hot flashes? A hot flash is a feeling of warmth that spreads over the body. Treatment for hot flashes include hormone replacement therapy and alternative prescription medications such as:
- SSRIs (Effexor, Paxil, Prozac),
- clonidine (Catapres),
- megestrol (Megace),
- and gabapentin (Neurontin).
BreastfeedingIt's important to know whether you will breastfeed or bottle-feed your baby prior to delivery, as the breasts' ability to produce milk diminishes soon after childbirth without the stimulation of breastfeeding. Breast milk is easily digested by babies and contains infection-fighting antibodies and cholesterol, which promotes brain growth. Formula-fed babies actually need to eat somewhat less often since formula is less readily digested by the baby than human milk. This article explores the advantages and disadvantages of both forms of feeding.
CancerCancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Hormonal Methods of Birth ControlThere are several different hormonal methods of birth control. The differences among them involve: the amount of hormone, the type of hormone, and the way the hormone enters a woman's body. The hormones can be estrogen and/or progesterone. The hormones can be taken by mouth, implanted into body tissue, absorbed from a patch on the skin, injected under the skin, or placed in the vagina. Common types of hormonal birth control include: "The Pill" (oral contraceptives), injection (Depo-Provera, Lunelle), the patch (Ortho-Evra), and the vaginal ring (Nuvaring).
13 Hormone Imbalance Symptoms and SignsHormone imbalance involves changes in estrogen, progesterone, and other hormone levels. Hormonal imbalance may cause symptoms like weight gain, hot flashes, fatigue, and acne. Hormonal changes happen in menopause and at other times. Women with hormone imbalances can seek treatment from medications like triptan and SSRIs.
MenopauseMenopause 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 QuizThe Menopause Quiz challenges your knowledge about the time in a woman’s life when menstruation ceases. Menopause can bring many physical, mental and sexual challenges to maturing women, but they don’t have to be limiting. Take the Menopause Quiz to learn the causes, symptoms and treatments of what’s known as “the change of life.”
Menopause SlideshowWhat is menopause? What are the signs of menopause? What age does menopause start? Learn about menopause and perimenopause symptoms. Find the latest treatments for menopause.
Menopause and SexMenopause 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.
Migraine headaches are severe headaches that are sensitive to light, sounds, and smells. Some people who suffer from migraines also have severe head pain. People also have symptoms of nausea and vomiting. Common migraine triggers may include:
- Certain foods
- Changes in barometric pressure
- Other phenomenon
They are diagnosed by a doctor if the headache pattern fits established migraine headache criteria. Over-the-counter (OTC) and prescription medications are sometime used to treat acute migraines. To prevent or reduce the frequency and severity of them doctors recommend supplements and prescription medications, for example:
- Blood pressure drugs
- Anti-seizure drugs
Lifestyle modification helps in migraine management. Many people who suffer from migraines get relief from their condition by keeping a headache diary, identifying and avoiding triggers, and taking appropriate medication.
Premature Menopause (Medical Procedural Causes)Premature menopause is when menopause occurs in a woman before the age of 40. Causes of premature menopause include premature ovarian failure, treatments for cancer and other conditions, surgical removal of the ovaries, or chronic diseases of the pituitary or thyroid gland, or psychiatric disorders. Treatment is directed at menopausal symptoms.
Raynaud's PhenomenonRaynaud's phenomenon is characterized by a pale-blue-red sequence of color changes of the digits, most commonly after exposure to cold. Occurring as a result of spasm of blood vessels, the cause is unknown. Symptoms of Raynaud's phenomenon depend on the severity, frequency, and duration of the blood vessel spasm. Treatments include protection of the digits, medications, and avoiding emotional stresses, smoking, cold temperature, and tools that vibrate the hands.
Sexual Health OverviewSexual 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.