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Natazia Side Effects

Generic name: dienogest / estradiol

Medically reviewed by Last updated on Mar 6, 2024.

Note: This document contains side effect information about dienogest / estradiol. Some dosage forms listed on this page may not apply to the brand name Natazia.

Applies to dienogest / estradiol: oral tablet.


Oral route (Tablet)

Cigarette smoking increases the risk of serious cardiovascular events from combination oral contraceptive (COC) use; this risk increases in women who are over 35 years of age and with number of cigarettes smoked. COCs should not be used by women who are over 35 years of age and smoke.

Serious side effects of Natazia

Along with its needed effects, dienogest / estradiol may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking dienogest / estradiol:

More common


Incidence not known

Other side effects of Natazia

Some side effects of dienogest / estradiol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Incidence not known

For Healthcare Professionals

Applies to dienogest / estradiol: oral tablet.


Common (1% to 10%): Blood pressure changes (including blood pressure increased and blood pressure decreased)

Uncommon (0.1% to 1%): Hypertension, myocardial infarction, palpitations, phlebitis superficialis, vein pain

Rare (less than 0.1%): Hypotension, bleeding varicose vein, venous thromboembolism (VTE), arterial thromboembolism (ATE)

Frequency not reported: Deep vein thrombosis

Postmarketing reports: Venous and arterial thromboembolic events (including pulmonary emboli, deep vein thrombosis, cerebral thrombosis, myocardial infarction, and stroke)[Ref]


Common (1% to 10%): Liver enzymes increased (including alanine aminotransferase increased, aspartate aminotransferase increased, and gamma-glutamyltransferase increased)

Uncommon (0.1% to 1%): Cholecystitis chronic

Rare (less than 0.1%): Focal nodular hyperplasia of the liver, chronic acalculous cholecystitis

Frequency not reported: Acute cholecystitis

Postmarketing reports: Gallbladder disease, hepatitis[Ref]


Common (1% to 10%): Amenorrhea, breast pain/discomfort/tenderness (including nipple disorder and nipple pain), dysmenorrhea, intracyclic bleeding (metrorrhagia), menstrual disorders (menstruation irregular, menorrhagia, vaginal hemorrhage, dysfunctional uterine bleeding, genital hemorrhage, abnormal withdrawal bleeding, uterine hemorrhage), genital discharge

Uncommon (0.1% to 1%): Urinary tract pain, breast discharge, breast enlargement, breast mass, cervical dysplasia, dyspareunia, cervical polyp, cervix erythema, fibrocystic breast disease, ovarian cyst, pelvic pain, premenstrual syndrome, vulvovaginal dryness, smear cervix abnormal, fibrocystic breast disease, uterine spasm, uterine/vaginal bleeding including spotting, vaginal discharge, vulvovaginal dryness

Rare (less than 0.1%): Breast cyst, coital bleeding, galactorrhea, hypomenorrhea, menstruation delayed, ovarian cyst ruptured, vaginal odor, vulvovaginal burning sensation, vulvovaginal discomfort[Ref]


Common (1% to 10%): Nausea or vomiting, abdominal pain (including abdominal distension)

Uncommon (0.1% to 1%): Diarrhea, constipation, dry mouth

Rare (less than 0.1%): Dyspepsia, gastroesophageal reflux disease

Postmarketing reports: Gastrointestinal symptoms[Ref]

Nervous system

Nervous Very common (10% or more): Headache (12.7%)

Common (1% to 10%): Tension headaches

Uncommon (0.1% to 1%): Dizziness, migraine (including migraine with and without aura)

Rare (less than 0.1%): Disturbance in attention, paresthesia, vertigo[Ref]


Common (1% to 10%): Acne

Uncommon (0.1% to 1%): Alopecia, pruritus (including pruritus generalized and rash pruritic), rash (including rash macular), hirsutism, hyperhidrosis, rash

Rare (less than 0.1%): Chloasma, dermatitis, neurodermatitis, pigmentation disorder, seborrhea, skin disorder (including skin tightness)

Postmarketing reports: Chloasma, angioedema, erythema nodosum, erythema multiforme[Ref]


The most common adverse events were irregular uterine bleeding, nausea, breast tenderness, and headache.[Ref]


Rare (less than 0.1%): Lymphadenopathy[Ref]


Rare (less than 0.1%): Allergic skin reaction (including dermatitis allergic and urticaria)

Postmarketing reports: Hypersensitivity[Ref]


Common (1% to 10%): Vulvovaginal mycotic infection (including vaginal candidiasis)

Uncommon (0.1% to 1%): Fungal infection, vaginal infection

Rare (less than 0.1%): Candidiasis, herpes simplex, presumed ocular histoplasmosis syndrome, tinea versicolor, urinary tract infection, vaginitis bacterial, vulvovaginal mycotic infection, pelvic inflammatory disease[Ref]


Uncommon (0.1% to 1%): Increased appetite, fluid retention

Rare (less than 0.1%): Hypertriglyceridemia[Ref]


Uncommon (0.1% to 1%): Muscle spasms, pain in jaw

Rare (less than 0.1%): Back pain[Ref]


Uncommon (0.1% to 1%): Dry eye, eye swelling

Rare (less than 0.1%): Contact lens intolerance[Ref]


Uncommon (0.1% to 1%): Breast cancer in situ, uterine leiomyoma

Rare (less than 0.1%): Benign breast neoplasm[Ref]


Common (1% to 10%): Increased weight, fatigue

Uncommon (0.1% to 1%): Edema, weight decreased, peripheral edema, pyrexia

Rare (less than 0.1%): Hot flush, sensation of heaviness, malaise, chest pain

Postmarketing reports: Vulvovaginal candidiasis[Ref]


Common (1% to 10%): Mood changes (depression, mood swings, depressed mood, mood altered, affect lability, dysthymic disorder, crying), emotional disorder, insomnia, libido decreased

Uncommon (0.1% to 1%): Libido increased, nervousness, restlessness, sleep disorder, stress, irritability, nightmare

Rare (less than 0.1%): Aggression[Ref]


Uncommon (0.1% to 1%): Asthma, dyspnea, epistaxis[Ref]


1. Cerner Multum, Inc. UK Summary of Product Characteristics.

2. Cerner Multum, Inc. Australian Product Information.

3. Product Information. Natazia (dienogest-estradiol). Bayer Pharmaceutical Inc. 2010.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.