Note: This document contains side effect information about esterified estrogens. Some of the dosage forms listed on this page may not apply to the brand name Menest.
Applies to esterified estrogens: oral tablet
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.
Applies to esterified estrogens: oral tablet
The more commonly reported adverse effects have included headache, breast pain, stomach/abdominal cramps, bloating, hair loss, nausea and vomiting.
Frequency not reported: Nausea, vomiting, abdominal cramps, bloating, gallbladder disease, pancreatitis
Frequency not reported: Ovarian cancer, endometrial hyperplasia, endometrial cancer, breast cancer, increase in abnormal mammograms, hepatocellular carcinomas
The increased risk of breast cancer due to use of estrogens is controversial. Several studies have suggested that long-term estrogen therapy may be associated with a slightly increased risk of breast cancer. Meta analysis of 51 studies (epidemiological data) supports a modest risk increase associated with long-term hormone replacement therapy (HRT).
Follow-up to the Nurses' Health Study of 1992 concluded, however, that there is an increased risk of breast cancer in women taking estrogen replacement therapy and that the risk is not reduced by concurrent use of progestins. (In that study, greater risk was associated with advanced age and prolonged duration of hormonal therapy.)
The Women's Health Initiative (WHI) which enrolled predominantly healthy postmenopausal women (n=27,000) to assess the risks and benefits of using conjugated estrogens 0.625 mg/day alone or with medroxyprogesterone acetate 2.5 mg/day compared to placebo has shown an absolute excess risk of 8 more invasive breast cancers per 10,000 women-years in the group treated with CE/MPA. Observational studies have also reported an increased risk of breast cancer in women using estrogen/progestin, with a smaller increased risk for estrogen alone.
The risk of endometrial cancer among unopposed estrogen users is about 2 to 12- fold greater than in non-users. Most studies have shown no significant increased risk with use for less than 1 year, but an increased risk of 15 to 24-fold with use for 5 to 10 years or more, persisting for at least 8 to 15 years after estrogen therapy is discontinued.
Frequency not reported: Deep and superficial venous thrombosis, pulmonary embolism, thrombophlebitis, myocardial infarction, stroke, increase in blood pressure
In the Women's Health Initiative study (WHI), an increase myocardial infarctions and strokes was observed in women receiving conjugated estrogens compared to placebo; a substudy of the WHI in which women were receiving conjugated estrogen plus progestin, showed an increased risk of coronary heart disease (CHD) events (defined as nonfatal myocardial infarction and CHD death) compared to placebo (37 vs 30 per 10,000 women-years). This increase was observed in year one and persisted. In a clinical trial of secondary prevention of cardiovascular disease (Heart and Estrogen/Progestin Replacement study; HERS) in postmenopausal women with documented heart disease (n = 2,763, average age 66.7 years) use of conjugated estrogens with progestin demonstrated no cardiovascular benefit.
A substudy of the WHI showed a 2-fold greater rate of venous thromboembolism (VTE), including deep venous thrombosis and pulmonary embolism, in women receiving conjugated estrogen with medroxyprogesterone compared to women receiving placebo. The rate of VTE was 34 per 10,000 women-years compared to 16 per 10,000 women-years in the placebo group. This increase risk was observed during the first year and persisted.
Frequency not reported: Increase or decrease in weight, reduced carbohydrate tolerance, aggravation of porphyria, edema, hypocalcemia, increased triglycerides
Frequency not reported: Changes in vaginal bleeding pattern, abnormal withdrawal bleeding or flow, breakthrough bleeding, spotting, dysmenorrhea, increase in size of uterine leiomyomata, vaginitis, including vaginal candidiasis, change in amount of cervical secretion, changes in cervical ectropion, endometrial hyperplasia, premenstrual like syndrome, amenorrhea during and after treatment; cystitis like syndrome
There are more reports of hepatic tumors occurring in women taking long-term oral contraceptives, but there are some reports in women taking isolated estrogen therapy.
Frequency not reported: Benign hepatic adenomas, hepatic hemangiomas
Frequency not reported: Urticaria, angioedema, anaphylactoid/anaphylactic reactions
Frequency not reported: Migraine, dizziness, headache, exacerbation of epilepsy, dementia, chorea
Frequency not reported: Mental depression, nervousness, mood disturbances, irritability
Frequency not reported: Retinal vascular thrombosis, steepening of corneal curvature, intolerance to contact lenses
Frequency not reported: Chloasma or melasma (may persist when drug is discontinued), scalp hair loss, hirsutism, erythema nodosum, hemorrhagic eruptions, erythema multiforme, rash, pruritus
Frequency not reported: Increased levels of thyroxin-binding globulin, breast tenderness, enlargement, pain, nipple discharge, galactorrhea, fibrocystic breast changes
Frequency not reported: Arthralgias, leg cramps
Frequency not reported: Exacerbation of asthma
Medically reviewed by BestRx Medical Team Last updated on 1/1/2020.
Source: Drugs.com Menest