Endometrial cancer, which affects the uterine lining, is made more likely by estrogen. The chance of developing endometrial cancer increases with the duration of estrogen use. You should be prescribed a progestin to take along with estrogen if you have not had a hysterectomy (surgical to remove the uterus). Your risk of endometrial cancer may decline as a result, but your risk of certain other medical conditions, such as breast cancer, may rise. Inform your doctor if you have or have ever had cancer as well as if you experience unusual vaginal bleeding prior to starting estrogen therapy. If you experience unusual or unexpected vaginal bleeding while taking estrogen, call your doctor right once. Throughout and after your treatment, your doctor will keep a close eye on you to help prevent the development of endometrial cancer.

Women who combined estrogen and progestins had an increased risk of heart attacks, strokes, blood clots in the legs or lungs, breast cancer, and dementia (loss of cognitive function, including the capacity to think, remember, and understand), according to a big study. These disorders may also be more likely to affect women who take just estrogen. Inform your doctor if you smoke or use tobacco, if you’ve recently suffered a heart attack or stroke, if you currently have or have previously had breast cancer, or if anybody in your family has any of these conditions. Additionally, let your physician know if you currently or ever had any of the following conditions: high blood pressure, high cholesterol or fat levels, diabetes, heart disease, lupus (a disease in which the body attacks its own tissues, causing damage and swelling), breast lumps, or an abnormal mammogram (a breast x-ray used to detect breast cancer).

The major medical disorders mentioned above can present with any of the symptoms below. If you suffer any of the following signs while taking estrogen, contact your doctor right away: Speech difficulties, dizziness, faintness, sudden complete or partial vision loss, double vision, numbness or weakness in one arm or leg, excruciating chest pain or heaviness, coughing up blood, sudden shortness of breath, trouble thinking clearly, remembering, or learning new things, breast lumps or other breast changes, discharge from nipples, or pain, tenderness, or redness in one leg.

You can take precautions to lessen your chance of experiencing a significant health issue while taking estrogen. To prevent heart problems, heart attacks, strokes, or dementia, do not take estrogen by itself or in combination with a progestin. Use as little estrogen as necessary to manage your symptoms, and only take it for the duration required. To determine if you should take a lower dose of estrogen or stop taking the drug, consult your doctor every three to six months.

To help find breast cancer as early as possible, you should check your breasts monthly and get a mammography and breast exam conducted by a doctor once a year. If you have a personal or family history of illness, your doctor will advise you on how to properly inspect your breasts and whether you need to have them checked more frequently than once a year.

If you are undergoing surgery or will be recovering in bed, let your doctor know. In order to reduce your risk of developing blood clots, your doctor may advise you to stop taking estrogen 4-6 weeks before to the procedure or place you on bed rest.

Regularly discuss the advantages and disadvantages of taking estrogen with your doctor.

Women going through menopause (also known as “change of life,” which is the cessation of monthly menstrual cycles) may have hot flushes (also known as “hot flashes,” which are sudden, intense feelings of heat and sweating). Some brands of estrogen are also used to treat or prevent osteoporosis (a condition in which the bones become brittle and weak and break easily) in women who are going through or have gone through menopause, as well as to treat vaginal dryness, itching, or burning. Women should investigate an alternative drug if they solely need it to treat vaginal dryness or to prevent osteoporosis. Some estrogen brands are also used to treat low estrogen symptoms in young women who do not produce enough estrogen on their own. Some estrogen brands are also employed to treat the signs of specific breast and prostate (a male reproductive gland) cancers. The hormones category of drugs includes estrogen. It functions by substituting the body’s natural production of estrogen.

The oral tablet form of estrogen is available. Once a day, it is typically taken with or without food. Sometimes estrogen is taken daily, and other times it is taken on a rotating schedule that alternates between times when estrogen is given every day and times when it is not. In order to treat cancer symptoms, estrogen is typically given three times a day. Every day, take estrogen at about the same time(s). Ask your doctor or pharmacist to explain any instructions on your prescription label that you do not understand, and carefully follow their instructions. Exactly as instructed, take estrogen. Never take it in larger or less amounts or more frequently than directed by your doctor.

In the event that your symptoms are under control, your doctor may start you on a low dose of estrogen and gradually raise it as needed. Discuss the effectiveness of estrogen in your body with your doctor.

Request a copy of the patient’s information from the manufacturer from your pharmacist or physician.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

Before taking estrogen,

• If you have an allergy to any brand of oral estrogen, any other estrogen products, any other medications, or any of the substances in estrogen tablets, let your doctor and pharmacist know right once. Inform your doctor and pharmacist if you have any aspirin or tartrazine (a food coloring additive) allergies before beginning to take Estrace® brand tablets. For a list of the inactive components in the brand of estrogen tablets you intend to use, speak with your pharmacist or consult the manufacturer’s patient information.
• Inform your doctor and pharmacist about any prescription and over-the-counter drugs, vitamins, and dietary supplements you are currently taking or intend to take. Incorporate any of the following: certain antifungals, including itraconazole (Sporanox) and ketoconazole (Nizoral), amiodarone (Cordarone, Pacerone); cimetidine (Tagamet), aprepitant (Emend), carbamazepine (Carbatrol, Epitol, Tegretol), clarithromycin (Biaxin); diltiazem (Cardizem, Dilacor, Tiazac, others); dexamethasone (Decadron, Dexpak); cyclosporine (Neoral, Sandimmune); lovastatin (Altocor, Mevacor), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), griseofulvin (Fulvicin, Grifulvin, Gris-PEG), and erythromycin (E.E.S., Erythrocin); drugs like atazanavir (Reyataz), delavirdine (Rescriptor), and efavirenz (Sustiva) are used to treat HIV infection or the acquired immunodeficiency syndrome (AIDS), ritonavir (Norvir, in Kaletra), lopinavir (in Kaletra), nelfinavir (Viracept), nevirapine (Viramune), and saquinavir (Fortovase, Invirase); thyroid medicine; nefazodone; phenobarbital, phenytoin (Dilantin, Phenytek), rifampin (Rifadin, Rimactane, in Rifamate), rifabutin (Mycobutin), and phenytoin; zafirlukast (Accolate), verapamil (Calan, Covera, Isoptin, Verelan), troleandomycin (TAO), and sertraline (Zoloft). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
• Please let your doctor know if you are taking any herbal supplements, especially St. John’s wort.
• Inform your doctor if you have endometriosis (a disorder in which the tissue that lines the uterus [womb] develops in other places of the body), yellowing of the skin or eyes, pregnancy, or therapy with an estrogen product, asthma, migraine headaches, seizures, porphyria (a disorder in which abnormal substances accumulate in the blood and cause issues with the skin or nervous system), uterine fibroids (uterine growths that are not cancer), extremely high or extremely low blood calcium levels, thyroid, liver, kidney, gallbladder, or pancreatic disease.
• Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. When taking estrogen, call your doctor right away if you become pregnant.
• If you are 65 years of age or older, discuss with your doctor the advantages and disadvantages of taking estrogen. Unless they are also taking other hormones, older women should generally avoid taking oral estrogen. In comparison to other treatments for the same condition, oral estrogen taken alone is not as safe or effective.
• Talk to your doctor about alternate methods of preventing the condition, such as exercising and taking calcium and/or vitamin D supplements, if you are taking estrogen to prevent osteoporosis.

If you plan to consume grapefruits or grapefruit juice while taking this medication, consult your doctor.

If you are taking estrogen to prevent osteoporosis, ask your doctor how you might increase your intake of calcium and vitamin D.

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

Estrogen might have negative effects. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Achy or sensitive breasts
• Uneasy stomach
• Vomiting
• Heartburn
• Constipation
• Diarrhea
• Gas
• Loss or increase of weight
• Leg twitches
• Nervousness
• Depression
• Dizziness
• Tingling or burning in the legs or arms
• Tense muscles
• Hair fall
• Excessive hair growth
• Sporadic darkening of the face’s skin
• Wearing contact lenses is challenging
• Vaginal enlargement, redness, stinging, itching, or irritation
• Vaginal oozing
• Alterations in sexual drive
• Cold signs

Some adverse effects can be very harmful. Call your doctor right away if you have any of these signs or any of those in the IMPORTANT WARNING section:

• Enlarged eyes
• Infection-related symptoms such as a sore throat, fever, chills, and cough
• Stomach discomfort, soreness, or pain
• Reduced appetite
• Weakness
• Eyes or skin that have a yellow tint
• Joints hurt
• Moves that are challenging to manage
• Blisters or a rash
• Hives
• Itching
• Swelling of the lower legs, lower arms, hands, feet, ankles, tongue, or throat
• Hoarseness
• Breathing or swallowing challenges

Estrogen may raise your risk of getting ovarian cancer or gallbladder disease, both of which may require surgical intervention to address. The dangers of using estrogen should be discussed with your doctor.

In children who take heavy amounts of estrogen for a long time, growth may stall or cease early. The timing and rate of a child’s sexual development may also be impacted by estrogen. The doctor treating your child for estrogen use will keep a close eye on him or her. The hazards of giving your child this medication should be discussed with your child’s doctor.

There are potential adverse effects of estrogen. If you experience any strange issues while taking this medicine, contact your doctor right away.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online at http://www.fda.gov/Safety/MedWatch or by phone at 1-800-332-1088 if you have a serious side event.

Keep this medication tightly closed in the original container and out of the reach of children. Keep it at room temperature and out of the bathroom and other places with excessive heat and moisture.

As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.http://www.upandaway.org

To make sure that pets, kids, and other people cannot take leftover pharmaceuticals, they should be disposed of in a specific manner. You shouldn’t flush this medication down the toilet, though. The best option to get rid of your medication is instead through a medication take-back program. To find out about take-back initiatives in your neighborhood, speak with your pharmacist or get in touch with your city’s waste/recycling department. If you do not have access to a take-back program, you can find more information at the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p).

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Additionally, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose symptoms could include:

• Uneasy stomach
• Vomiting
• Uterine bleeding

Keep all of your doctor’s appointments.

Inform the lab staff and your doctor that you are taking estrogen prior to any laboratory test.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.