Conjugated estrogens Side Effects

Not all side effects for conjugated estrogens may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to conjugated estrogens: oral tablet

In addition to its needed effects, some unwanted effects may be caused by conjugated estrogens. In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking conjugated estrogens:

More common
  • Heavy non-menstrual vaginal bleeding
Less common
  • Body aches or pain
  • chills
  • cough
  • difficulty with breathing
  • ear congestion
  • fever
  • headache
  • loss of voice
  • nasal congestion
  • runny nose
  • sneezing
  • sore throat
  • unusual tiredness or weakness
Incidence not known
  • Abdominal or stomach pain and tenderness
  • acid or sour stomach
  • anxiety
  • backache
  • belching
  • bloody stools
  • blurred vision
  • breast tenderness, enlargement, pain, or discharge
  • change in vaginal discharge
  • change in vision
  • changes in skin color
  • chest pain or discomfort
  • clay-colored stools
  • clear or bloody discharge from the nipple
  • confusion
  • constipation
  • dark urine
  • diarrhea
  • difficulty with speaking
  • dimpling of the breast skin
  • dizziness or lightheadedness
  • double vision
  • fainting
  • fast heartbeat
  • full or bloated feeling or pressure in the stomach
  • headache, severe and throbbing
  • heartburn
  • hives
  • hoarseness
  • inability to move the arms, legs, or facial muscles
  • inability to speak
  • indigestion
  • inverted nipple
  • irritation
  • itching
  • joint pain, stiffness, or swelling
  • loss of appetite
  • lump in the breast or under the arm
  • migraine headache
  • nausea
  • pain or discomfort in the arms, jaw, back, or neck
  • pain or feeling of pressure in the pelvis
  • pain, redness, or swelling in the arm or leg
  • pain, tenderness, or swelling of the foot or leg
  • painful or tender cysts in the breasts
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • persistent crusting or scaling of the nipple
  • poor insight and judgment
  • problems with memory or speech
  • rash
  • rectal bleeding
  • redness of the skin
  • redness or swelling of the breast
  • shortness of breath
  • slow speech
  • sore on the skin of the breast that does not heal
  • stomach discomfort or upset
  • sudden shortness of breath or troubled breathing
  • sweating
  • swelling of the abdominal or stomach area
  • swelling of the eyelids, face, lips, hands, or feet
  • tightness in the chest
  • trouble recognizing objects
  • trouble thinking and planning
  • trouble walking
  • troubled breathing or swallowing
  • unpleasant breath odor
  • vaginal bleeding
  • vomiting
  • vomiting of blood
  • wheezing
  • yellow eyes or skin

Some of the side effects that can occur with conjugated estrogens may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common
  • Back pain
  • excess air or gas in the stomach or intestines
  • itching of the vagina or genital area
  • lack or loss of strength
  • pain during sexual intercourse
  • passing gas
  • thick, white vaginal discharge with no odor or with a mild odor
Less common
  • Increased clear or white vaginal discharge
  • leg cramps
Incidence not known
  • Blistering, peeling, or loosening of the skin
  • cramps
  • decreased interest in sexual intercourse
  • diarrhea
  • difficulty with moving
  • heavy bleeding
  • hives or welts
  • inability to have or keep an erection
  • increased hair growth, especially on the face
  • increased in sexual ability, desire, drive, or performance
  • increased interest in sexual intercourse
  • irritability
  • itching of the vagina or outside genitals
  • joint or muscle pain
  • loss in sexual ability, desire, drive, or performance
  • loss of scalp hair
  • mental depression
  • mood changes
  • muscle stiffness
  • pain
  • pain during sexual intercourse
  • pain in the ankles or knees
  • painful, red lumps under the skin, mostly on the legs
  • patchy brown or dark brown discoloration of the skin
  • rash
  • red, irritated eyes
  • sores, ulcers, or white spots in the mouth or on the lips
  • swelling of the breasts or breast soreness in both females and males
  • thick, white curd-like vaginal discharge without odor or with mild odor
  • unexpected or excess milk flow from the breasts
  • weight changes

For Healthcare Professionals

Applies to conjugated estrogens: injectable powder for injection, oral tablet, vaginal cream

Oncologic

Oncologic side effects have included increased risks of endometrial carcinoma, ovarian cancer, and breast cancer.[Ref]

Cardiovascular

Cardiovascular side effects have included deep and superficial venous thrombosis, pulmonary embolism, thrombophlebitis, increase in blood pressure, and myocardial infarction.[Ref]

The manufacturer recommends close observation if conjugated estrogens must be used in patients who may be particularly sensitive to fluid retention because of underlying asthma, epilepsy, migraine, heart disease, and renal dysfunction.[Ref]

Genitourinary

Genitourinary side effects have included breakthrough bleeding, spotting, changes in vaginal bleeding pattern, abnormal withdrawal bleeding or flow, dysmenorrhea, increase the size of preexisting uterine leiomyomata, vaginitis, including vaginal candidiasis, change in cervical erosion and in degree of cervical secretion, cystitis-like syndrome, application site reactions of vulvovaginal discomfort including burning and irritation, genital pruritus, ovarian cancer, endometrial hyperplasia, and precocious puberty.[Ref]

Metabolic

Metabolic side effects have included increased serum triglyceride levels and reduced carbohydrate tolerance. Aggravation of porphyria has been reported.[Ref]

General

General side effects have included reports of fluid retention and increase or decrease in weight.[Ref]

Gastrointestinal

Gastrointestinal side effects have included nausea, vomiting, abdominal cramps, bloating, cholestatic jaundice, pancreatitis, ischemic colitis, and increased incidence of gallbladder disease.[Ref]

Cases of oral pigmentation and ischemic colitis have been reported rarely.[Ref]

Hematologic

Hematologic side effects have included hypercoagulability. Several cases of the hemolytic uremic syndrome have also been associated with conjugated estrogen therapy.[Ref]

Hepatic

Hepatic side effects have included enlargement of hepatic hemangiomas and rare cases of focal nodular hyperplasia, liver cell adenomas, hepatic hemangiomas and well-differentiated hepatocellular carcinomas.[Ref]

Hepatic side effects have also included many reports of hepatic tumors in women taking long-term oral contraceptives. However, some tumors have been reported in women taking isolated estrogen therapy.[Ref]

Nervous system

Nervous system side effects have included headache, migraine, dizziness, stroke, chorea, nervousness, exacerbation of epilepsy, dementia, and mental depression. Possible growth potentiation of benign meningioma has been reported.[Ref]

Other

Other side effects have included breast tenderness, pain, enlargement, secretion, and fibrocystic breast changes.[Ref]

Psychiatric

Psychiatric side effects have included case reports of rapid mood cycling in patients with severe depression.[Ref]

Respiratory

Respiratory side effects have included pulmonary embolism, exacerbation of asthma, and rare cases of exacerbations of pulmonary lymphangioleiomyomatosis. In addition, combinations of high-dose conjugated estrogens and progestin have been reported to increase ventilation and increase the hypoxic ventilatory response.[Ref]

Dermatologic

Dermatologic side effects have included chloasma or melasma, which did not always resolve following discontinuation of estrogen therapy, scalp hair loss, hirsutism, rash, erythema multiforme, erythema nodosum, and hemorrhagic eruptions.[Ref]

Hypersensitivity

Hypersensitivity side effects have included anaphylactoid/anaphylaxis reactions including urticaria and angioedema.[Ref]

Endocrine

Endocrine side effects have included reports of increased levels of thyroxin-binding globulin, leading to an increase in total thyroid serum levels and a decrease in resin uptake of T3. Free thyroid hormone levels remained unchanged. Other endocrine effects have included decreased fasting plasma glucose.[Ref]

Ocular

Ocular side effects have included retinal vascular thrombosis and intolerance to contact lenses.[Ref]

Local

Local side effects have included phlebitis at the injection site and injection site pain and edema.[Ref]

References

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