Estrogens (Vaginal)

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.

Older adults - This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

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:

• 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

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

• 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

• 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

• 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