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Conjugated Estrogens

Conjugated Estrogens


Conjugated estrogens are a medicine that contains a mixture of estrogen hormones. It is used to treat moderate to severe hot flashes, changes in and around the vagina, and other symptoms of menopause or low amounts of estrogen (hypoestrogenism). This medicine is also used to prevent osteoporosis (thinning of the bones) after menopause.

Conjugated estrogens tablet is also used to treat symptoms of breast and prostate cancer that have spread through the body in men and women. It is also used to treat certain conditions in women before menopause if their ovaries do not make enough estrogen naturally.

What Is Conjugated Estrogens Topical?

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Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.

Vaginal conjugated estrogens are a mixture of estrogen hormones used to treat the vaginal symptoms of menopause such as dryness, burning, irritation, and painful sexual intercourse.

Vaginal conjugated estrogens should not be used to prevent heart disease or dementia, because this medication may actually increase your risk of developing these conditions.

Vaginal conjugated estrogens may also be used for purposes not listed in this medication guide.

Vaginal conjugated estrogens can harm an unborn baby or cause birth defects. Do not use if you are pregnant.

  • a history of heart attack, stroke, or blood clot (especially in your lung or your lower body);
  • abnormal vaginal bleeding that a doctor has not checked;
  • liver disease; or
  • any type of breast, uterine, or hormone-dependent cancer.

To make sure you can safely use vaginal conjugated estrogens, tell your doctor if you have any of these other conditions:

  • high blood pressure, heart disease, or circulation problems;
  • a personal or family history of stroke;
  • endometriosis;
  • liver or kidney disease;
  • asthma;
  • epilepsy or other seizure disorder;
  • migraines;
  • diabetes;
  • underactive thyroid;
  • high cholesterol or triglycerides;
  • high or low levels of calcium in your blood;
  • porphyria;
  • systemic lupus erythematosus (SLE); or
  • gallbladder disease.

Long-term treatment with conjugated estrogens may increase your risk of breast cancer, heart attack, or stroke. Talk with your doctor about your individual risks before using vaginal conjugated estrogens long term, especially if you smoke or are overweight. Your doctor should check your progress on a regular basis (every 3 to 6 months) to determine whether you should continue this treatment.

Conjugated estrogens increase your risk of developing endometrial hyperplasia, a condition that may lead to cancer of the uterus. Taking progestins while using vaginal conjugated estrogens may lower this risk. If your uterus has not been removed, your doctor may prescribe a progestin for you to take while you are using vaginal conjugated estrogens.

FDA pregnancy category X. This medication can harm an unborn baby or cause birth defects. Do not use vaginal conjugated estrogens if you are pregnant. Tell your doctor right away if you become pregnant during treatment. Use effective birth control while you are using this medication. You should know that conjugated estrogens vaginal cream can weaken the latex of a condom, diaphragm, or cervical cap. Talk to your doctor about the best contraceptive methods to use.

Conjugated estrogens can pass into breast milk and may harm a nursing baby. This medication may also slow breast milk production. Do not use if you are breast-feeding a baby.

Do not use this medication in anyone under 18 years old without the advice of a doctor.

Drug features

Both drugs come in several forms. Premarin and estradiol are both available as an intramuscular injection or oral tablet. Premarin also comes as an intravenous injection and vaginal cream. Estradiol also comes in these forms:

  • transdermal spray
  • transdermal gel
  • transdermal patch
  • vaginal ring

Several versions of estradiol are transdermal. This means that the medication is absorbed through your skin.

Side effects

Some common side effects of both estradiol and Premarin include:

  • abdominal pain
  • breast changes and pain
  • back pain
  • depression or mood changes
  • dizziness
  • dry mouth
  • headaches
  • high blood pressure
  • increased heart rate
  • insomnia
  • stomach upset
  • vaginal discharge

Conjugated Estrogens Topical Interactions

Do not smoke while using this medication. Smoking can increase your risk of blood clots, stroke, or heart attack caused by vaginal conjugated estrogens.

Tell your doctor about all other medicines you use, especially:

  • a blood thinner such as warfarin (Coumadin, Jantoven);
  • a thyroid medication such as levothyroxine (Synthroid, Levoxyl, Levothroid and others);
  • insulin or diabetes medicine taken by mouth;
  • rifampin (Rifadin, Rifater, Rifamate, Rimactane);
  • ketoconazole (Nizoral) or itraconazole (Sporanox);