Category:

• Hormonal  

Description:

• Estrogen hormone

Indications:

• Menopausal vasomotor symptoms (hot flashes, etc.)

• Atrophic vaginitis and kraurosis vulvae

• Female hypogonadism

• Female castration and primary ovarian failure

• Breast cancer (palliation only)

• Prostatic carcinoma

• Osteoporosis prophylaxis

• Postpartum breast engorgement

• Abnormal uterine bleeding due to hormonal imbalance

Contraindications:

• Known or suspected breast cancer (except those being treated for metastatic disease)

• Known or suspected estrogen-dependent neoplasia

• Known or suspected pregnancy

• Undiagnosed abnormal genital bleeding

• Current or history of thrombophlebitis, thrombosis, thromboembolic disorders (except when used in breast or prostatic cancer treatment).

Precautions:

• Pregnancy category X

• Use with caution in nursing mothers and patients with hypertension, diabetes, asthma, epilepsy, migraine, cardiac or renal dysfunction, history of depression, pre-existing uterine leiomyotoma, history of jaundice during pregnancy, impaired liver function, metabolic bone disorders and in young women (and men).

• Take with food to avoid GI side effects.

• May decrease glucose intolerance in diabetic patients.

• Discontinue therapy and contact health care provider if pregnancy is suspected.

Adverse Reactions (Side Effects):

• Rash, acne, alopecia, hirsutism

• Abnormal menstrual bleeding, changes in cervical secretions

• Edema, weight change

• Depression, insomnia, somnolence

• Nausea

Dosage:

• Administered orally, vaginally and IV injection

• Menopausal vasomotor symptoms: 1.25mg per day

• Atrophic vaginitis and kraurosis vulvae: 0.3-1.25mg orally, intravaginally and topically per day depending on tissue response

• Female hypogonadism: 2.5-7.5mg per day in divided doses for 20 days, then rest for ten days, then repeat schedule until bleeding occurs

• Female castration and primary ovarian failure: 1.25mg per day cyclically, adjusted to lowest dose for individual

• Breast cancer (palliation only): 10mg tid for at least three months

• Prostatic carcinoma: 1.25-2.5mg tid

• Osteoporosis prophylaxis: 1.25mg per day, cyclically

• Postpartum breast engorgement: 3.75mg q4h for 5 doses or 1.25mg q4h for 5 days

• Abnormal uterine bleeding due to hormonal imbalance: 25mg IM or IV injection, repeat in 6-12 hours if needed

For more information on the use of conjugated estrogens, read:

• Menopause, in Operational Obstetrics & Gyencology