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Esterified estrogens

Generic Name: esterified estrogens (ess-TER-i-fide ESS-troe-jenz)
Brand Name: Menest

Estrogens have been reported to increase the chance of womb (endometrial) cancer in women who have been through menopause, especially in women who receive estrogen-only hormone therapy. Contact your doctor immediately if you experience any unusual vaginal bleeding. Estrogens may also increase the risk of cancer of the ovary or breast. Estrogen-containing products should not be used to prevent heart disease. Estrogen given with another hormone (progestin) for replacement therapy can infrequently cause heart disease (eg, heart attacks), stroke, serious blood clots in the legs or lungs (pulmonary embolism/deep vein thrombosis), dementia, and cancer of the breast. These risks appear to depend on the length of time esterified estrogens is used and the amount of estrogen per dose. Therefore, esterified estrogens should be used for the shortest possible length of time at the lowest effective dose so that you obtain the benefits and minimize the chance of serious side effects from long-term treatment. Consult your doctor or pharmacist for details.


Esterified estrogens is used for:

Treating certain symptoms of menopause (eg, hot flashes, vaginal itching, burning, or dryness). It is used to treat low levels of estrogen caused by certain conditions (eg, hypogonadism, castration, ovarian failure). It may be used to treat breast or prostate cancer in certain patients. It may also be used for other conditions as determined by your doctor.

Esterified estrogens is a female estrogen hormone. It works by replacing natural estrogens in a woman who can no longer produce enough estrogen. It works for advanced prostate cancer by antagonizing male hormones.

Do NOT use esterified estrogens if:

  • you are allergic to any ingredient in esterified estrogens
  • you are pregnant or suspect you may be pregnant, or you have vaginal bleeding of abnormal or unknown cause
  • you have a history of known or suspected breast cancer (unless your doctor tells you otherwise)
  • you have any other estrogen-dependent cancer
  • you have the blood disease porphyria, or a history of blood clots or liver problems
  • you have had a recent (within the past year) stroke or heart attack

Contact your doctor or health care provider right away if any of these apply to you.

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Before using esterified estrogens:

Some medical conditions may interact with esterified estrogens. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are planning to become pregnant or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have breast lumps or disease, an abnormal mammogram, or a family history of breast cancer or blood clots
  • if you have yellowing of the skin or whites of the eyes during pregnancy or with past estrogen use, or high blood pressure during pregnancy (toxemia)
  • if you have a vaginal infection or womb problems (eg, uterine fibroids/endometriosis, abnormal vaginal bleeding, other uterine problems)
  • if you have abnormal calcium levels in the blood, asthma, cancer, cholesterol or lipid problems, depression, diabetes, epilepsy, excessive weight gain, gallbladder disease, heart disease or other heart problems, high blood pressure, kidney or liver disease, low thyroid hormone levels, lupus, migraine headaches, pancreas disease, seizures, or yellowing of the skin or eyes
  • if you smoke, are overweight, or will be having surgery

Some MEDICINES MAY INTERACT with esterified estrogens. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Anticoagulants (eg, warfarin), corticosteroids (eg, prednisone), succinylcholine, or tacrine because their actions and the risk of their side effects may be increased by esterified estrogens
  • Anticoagulants (eg, warfarin) because their effectiveness may be decreased by esterified estrogens
  • Barbiturates (eg, phenobarbital), carbamazepine, rifampin, hydantoins (eg, phenytoin), or St. John's wort because they may decrease esterified estrogens's effectiveness
  • Azole antifungals (eg, ketoconazole) or macrolide antibiotics (eg, erythromycin) because they may increase the risk of esterified estrogens's side effects

This may not be a complete list of all interactions that may occur. Ask your health care provider if esterified estrogens may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use esterified estrogens:

Use esterified estrogens as directed by your doctor. Check the label on the medicine for exact dosing instructions. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with esterified estrogens. Talk to your pharmacist if you have questions about this information.
  • Take esterified estrogens by mouth with or without food.
  • Eating grapefruit or drinking grapefruit juice may increase the risk of side effects. Check with your doctor before including grapefruit or grapefruit juice in your diet.
  • If you miss a dose of esterified estrogens, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use esterified estrogens.

Important safety information:

  • Esterified estrogens may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use esterified estrogens with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Limit alcoholic beverages.
  • Esterified estrogens may cause dark skin patches on your face (melasma). Exposure to the sun may make these patches darker and you may need to avoid prolonged sun exposure and sunlamps. Consult your doctor regarding the use of sunscreens and protective clothing.
  • Smoking while using esterified estrogens may increase your risk of blood clots (especially in women older than 35 years of age).
  • Contact your health care provider if vaginal bleeding of unknown cause occurs. This could be a sign of a serious condition requiring immediate medical attention.
  • Contact your health care provider if vaginal discomfort occurs or if you suspect you have developed an infection while taking esterified estrogens.
  • Follow your doctor's instructions for examining your breasts, and report any lumps immediately.
  • If you wear contact lenses and you develop problems with them, contact your doctor.
  • If you will be having surgery or will be confined to a chair or bed for a long period of time (eg, a long plane flight), notify your doctor beforehand. Special precautions may need to be taken in these circumstances while you are taking esterified estrogens.
  • Diabetes patients - Esterified estrogens may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Esterified estrogens may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using esterified estrogens.
  • Discuss with your doctor every 3 to 6 months whether treatment with esterified estrogens is still appropriate.
  • Lab tests will be required to monitor therapy. You should have a complete physical examination, including blood pressure measurements, breast and pelvic examinations, and a Pap test, at least once a year. You should also have periodic mammograms as determined by your doctor. Be sure to keep all doctor and lab appointments.
  • Esterified estrogens should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Do not use esterified estrogens if you are pregnant. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Esterified estrogens is found in breast milk. If you are or will be breast-feeding while you use esterified estrogens, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of esterified estrogens:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Abnormal hair growth; breast tenderness; changes in sex drive; cramps; dizziness; flushing; hair loss; headache; lightheadedness; nausea; reduced tolerance to carbohydrates; stomach bloating and upset; swelling; vaginal infection; weight changes.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal vaginal bleeding; breast lumps; calf pain or tenderness; changes in vaginal bleeding (eg, spotting, breakthrough bleeding, prolonged bleeding); changes in vision or speech; chest pain; confusion; coughing of blood; mental/mood changes (eg, depression, memory loss); numbness of an arm or leg; one-sided weakness; pain, swelling, or tenderness in the stomach; problems with contact lenses (eg, changes in fit); severe headache, dizziness, fainting, or vomiting; sudden shortness of breath; swelling of hands or feet; unusual vaginal discharge, itching, or odor; weakness of an arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include excessive vaginal bleeding; severe nausea; vomiting.

Proper storage of esterified estrogens:

Store esterified estrogens at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Keep esterified estrogens out of the reach of children and away from pets.

General information:

  • If you have any questions about esterified estrogens, please talk with your doctor, pharmacist, or other health care provider.
  • Esterified estrogens is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take esterified estrogens or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about esterified estrogens. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to esterified estrogens. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using esterified estrogens.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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