Estrogens and Progestins (Ovarian Hormone Therapy) (Systemic)

Before Using This Medicine

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

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

Pregnancy - Estrogens and progestins are not recommended for use during pregnancy or right after giving birth. Becoming pregnant or maintaining a pregnancy is not likely to occur around the time of menopause.

Breast-feeding - Estrogens and progestins pass into the breast milk and can change the content or lower the amount of breast milk. Use of this medicine is not recommended in nursing mothers.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of estrogens and progestins in the elderly with use in other age groups.

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. When you are taking estrogens and progestins, it is especially important that your health care professional know if you are taking any of the following:

• Cyclosporine (e.g., Sandimmune) - Estrogens can prevent cyclosporine's removal from the body; this can lead to kidney or liver problems caused by too much cyclosporine

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

• Blood clotting problems (or history of during previous estrogen therapy) - Estrogens usually are not used until blood clotting problems stop; using estrogens is not a problem for most patients without a history of blood clotting problems due to estrogen use

• Breast cancer or
• Bone cancer or
• Cancer of the uterus or
• Fibroid tumors of the uterus - Estrogens may interfere with the treatment of breast or bone cancer or worsen cancer of the uterus when these conditions are present

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

• Endometriosis or
• High cholesterol or triglycerides (or history of) or
• Pancreatitis (inflammation of pancreas) - Estrogens may worsen these conditions; while estrogens can improve blood cholesterol, they may worsen blood triglycerides for some people