Estrogens (Vaginal)

Brand name(s): Estrace

Before Using This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For vaginal estrogens, the following should be considered:

Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to estrogens or to parabens. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy-Estrogens are not recommended for use during pregnancy, since an estrogen called diethylstilbestrol (DES) that is no longer taken for hormone replacement has caused serious birth defects in humans and animals.

Breast-feeding-Use of this medicine is not recommended in nursing mothers. Estrogens pass into the breast milk and may decrease the amount and quality of breast milk.

Children-Estrogen therapy has been used for the induction of puberty in adolescents with some forms of pubertal delay. Safety and effectiveness have not otherwise been established.

Older adults-Elderly people are especially sensitive to the effects of estrogens. This may increase the chance of side effects during treatment, especially stroke, invasive breast cancer, and memory problems.

Other medicines-Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking or using any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems-The presence of other medical problems may affect the use of estrogens. Make sure you tell your doctor if you have any other medical problems, especially:

• Asthma or
• Epilepsy or
• Heart problems or
• Kidney problems or
• Migraine headaches-Estrogens may worsen these conditions.

• Blood clotting problems-Although worsening of a blood clotting condition is unlikely, some doctors do not prescribe vaginal estrogens for patients with blood clotting problems or a history of these problems

• Certain cancers, including cancers of the breast, bone, or uterus (active or suspected)-Estrogens may interfere with the treatment of breast or bone cancer or worsen cancer of the uterus when these conditions are present

• Diabetes mellitus (sugar diabetes)-Estrogens may alter your body's response to sugar in your diet.

• Endometriosis or
• Fibroid tumors of the uterus-Estrogens may worsen endometriosis or increase the size of fibroid tumors

• Gallbladder problems (gallstones)-Estrogens may increase your chance of getting a gallbladder attack.

• Hepatic hemangioma-Estrogens may worsen this this medical problem.

• Hypercalcemia (too much calcium in your blood)-Estrogens may worsen this this medical problem.

• Hypertriglyceridemia (too much triglycerides in your blood)-Estrogens may increase or chance of getting pancreatitis or other side effects.

• Hypocalcemia (too little calcium in your blood)-Your doctor should treat the low calcium in your blood before starting estrogen therapy.

• Irritation or infection of the vagina-Usually estrogens decrease infections or irritation of the vagina, but sometimes these conditions may become worse

• Liver disease, severe-Estrogens may worsen the condition in some cases; however, many doctors recommend vaginal use of estrogen because it has less effect on the liver than when estrogens are taken by mouth

• Lupus erythematosus, systemic (SLE)-Estrogens may worsen this this medical problem.

• Physical problems within the vagina, such as narrow vagina, vaginal stenosis, or vaginal prolapse-Estradiol vaginal insert may be more likely to slip out of place or cause problems, such as irritation of the vagina

• Porphyria-Estrogens may worsen this medical problem.

• Thyroid problems (underactive thyroid)-Estrogens may alter your body's response to your thyroid medication. Your doctor may alter the amount of thyroid replacement that you take while on estrogen therapy.

• Vision changes, sudden onset including
• Bulging eyes or
• Double vision or
• Migraine headache or
• Vision loss, partial or complete-Estrogens may cause these problems. Tell your doctor if you have had any of these problems.

• Unusual genital or vaginal bleeding of unknown causes-Use of estrogens may delay diagnosis or worsen the condition. The reason for the bleeding should be determined before estrogens are used

Last Revised: 07/19/2004