Know the basics
What is estrogens used for?
Estrogens is used for the following conditions:
- Moderate to severe vasomotor symptoms associated with menopause;
- Vulvular and vaginal atrophy;
- Female hypogonadism;
- Female castration or primary ovarian failure;
- Palliative treatment of prostatic carcinoma;
- Prophylaxis of osteoporosis in postmenopausal women;
- Abnormal uterine bleeding;
How should I take estrogens?
Estrogen comes as a tablet to take by mouth. It is usually taken with or without food once a day. Estrogen is sometimes taken every day and sometimes taken according to a rotating schedule that alternates a period of time when estrogen is taken every day with a period of time when estrogen is not taken. When estrogen is used to relieve the symptoms of cancer, it is usually taken three times a day. Take estrogen at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take estrogen exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor may start you on a low dose of estrogens and gradually increase your dose if your symptoms are still bothersome, or decrease your dose if your symptoms are well-controlled. Talk to your doctor about how well estrogen works for you.
Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
How do I store estrogens?
Estrogens is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store estrogens in the bathroom or the freezer. There may be different brands of estrogens that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.
You should not flush estrogens down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.
Know the precautions & warnings
What should I know before using estrogens?
Before taking estrogen,
- Tell your doctor and pharmacist if you are allergic to any brand of oral estrogen, any other estrogen products, any other medications, or any of the ingredients in estrogen tablets. If you will be taking estrace®brand tablets, tell your doctor and pharmacist if you are allergic to aspirin or tartrazine (a food color additive). Ask your pharmacist or check the manufacturer’s patient information for a list of the inactive ingredients in the brand of estrogen tablets you plan to take.
- Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: amiodarone (cordarone, pacerone); certain antifungals such as itraconazole (sporanox) and ketoconazole (nizoral); aprepitant (emend); carbamazepine (carbatrol, epitol, tegretol); cimetidine (tagamet); clarithromycin (biaxin); cyclosporine (neoral, sandimmune); dexamethasone (decadron, dexpak); diltiazem (cardizem, dilacor, tiazac, others); erythromycin (e.e.s, erythrocin);fluoxetine (prozac, sarafem); fluvoxamine (luvox); griseofulvin (fulvicin, grifulvin, gris-peg); lovastatin (altocor, mevacor); medications for human immunodeficiency virus (hiv) or acquired immunodeficiency syndrome (aids) such as atazanavir (reyataz), delavirdine (rescriptor), efavirenz (sustiva), indinavir (crixivan), lopinavir (in kaletra), nelfinavir (viracept), nevirapine (viramune), ritonavir (norvir, in kaletra), and saquinavir (fortovase, invirase); medications for thyroid disease; nefazodone; phenobarbital; phenytoin (dilantin, phenytek); rifabutin (mycobutin); rifampin (rifadin, rimactane, in rifamate); sertraline (zoloft); troleandomycin (tao); verapamil (calan, covera, isoptin, verelan); and zafirlukast (accolate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- Tell your doctor what herbal products you are taking, especially st. John’s wort.
- Tell your doctor if you have or have ever had yellowing of the skin or eyes during pregnancy or during your treatment with an estrogen product, endometriosis (a condition in which the type of tissue that lines the uterus [womb] grows in other areas of the body), uterine fibroids (growths in the uterus that are not cancer), asthma, migraine headaches, seizures, porphyria (condition in which abnormal substances build up in the blood and cause problems with the skin or nervous system), very high or very low levels of calcium in your blood, or thyroid, liver, kidney, gallbladder, or pancreatic disease.
- Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking estrogen, call your doctor immediately.
- Talk to your doctor about the risks and benefits of taking estrogen if you are 65 years of age or older. Older women should not usually take oral estrogen unless they are also taking other hormones. Oral estrogen taken without other hormones is not as safe or effective as other medications that can be used to treat the same condition.
- If you are taking estrogen to prevent osteoporosis, talk to your doctor about other ways to prevent the disease such as exercising and taking vitamin d and/or calcium supplements.
Is it safe to take estrogens during pregnancy or breast-feeding?
There are no adequate studies in women for determining risk when using estrogens during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking estrogens. Estrogens is pregnancy risk category X according to the US Food and Drug Administration (FDA).
FDA pregnancy risk category reference below:
- A=No risk,
- B=No risk in some studies,
- C=There may be some risk,
- D=Positive evidence of risk,
Know the side effects
What are the side effects of estrogens?
Side effects include: Abnormal bleeding; Vomiting, nausea; Tender breasts; Weight gain; Fluid retention; Headache; Depression;
Males: Gynaecomastia, impotence.
Potentially Fatal: Unopposed replacement therapy in postmenopausal women associated with increased risk of endometrial and breast cancer.
Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.
Know the interactions
What drugs may interact with estrogens?
Estrogens may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, non-prescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval, especially: rifampicin, barbiturates increase rate of metabolism.
Does food or alcohol interact with estrogens?
Estrogens may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.
What health conditions may interact with estrogens?
Estrogens may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially: Asthma; Epilepsy; Migraine; heart or kidney dysfunction; ; CV disease; ; cerebrovascular disorders; ; diabetes, ; hypercalcaemia;; gall bladder disease; ; porphyria.
Understand the dosage
The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using estrogens.
What is the dose of estrogens for an adult?
Moderate to severe vasomotor symptoms associated with menopause:
- adult:45 mg/day; may increase up to 1.25 mg/day; attempt to discontinue estrogens at 3-6-mth intervals.
Vulvular and vaginal atrophy:
- adult:3 mg/day.
- adult:3-0.625 mg/day given cyclically, may titrate dose in 6-12-mth intervals; add progestin treatment to maintain bone mineral density once skeletal maturity is achieved.
Female castration or primary ovarian failure:
- adult:25 mg/day given cyclically; adjust according to patient response. For maintenance, adjust to the lowest effective dose.
Palliative treatment of prostatic carcinoma
- adult:25-2.5 mg 3 times/day.
Prophylaxis of osteoporosis in postmenopausal women
- adult:Initial: 0.3 mg/day, cyclically or daily, depending on patient’s condition. Adjust dose based on bone mineral density and clinical response. Lowest effective dose should be used.
Abnormal uterine bleeding
- Adult:25 mg via IV/IM admin, may repeat in 6-12 hr if needed. Treatment should be followed by a low-dose oral contraceptive.
What is the dose of estrogens for a child?
The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.
How is estrogens available?
Estrogens is available in the following dosage forms and strengths:
- Tablet: 1 mg, 2 mg;
- Tablet: 0.3 mg, 0.625 mg, 1.25 mg;
- Gel: 0.1%/1gm, 0.06%/5gm;
- Patch: 0.025 mg, 0.05 mg, 0.1 mg, 1.5 mg;
What should I do in case of an emergency or overdose?
In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.
What should I do if I miss a dose?
If you miss a dose of estrogens, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Estrogen (Oral Route, Parenteral Route, Topical Application Route, Transdermal Route). http://www.mayoclinic.org/drugs-supplements/estrogen-oral-route-parenteral-route-topical-application-route-transdermal-route/description/drg-20069495. Accessed June 25, 2016
Estrogens. https://www.drugs.com/drug-class/estrogens.html. Accessed June 25, 2016.
Review Date: May 30, 2016 | Last Modified: January 4, 2017