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Generic name: Esterified estrogens and Methyltestosterone
Brand names: Estratest

Why is Esterified estrogens and Methyltestosterone prescribed?

Estratest tablets quell the flushing, sweating, "hot flashes," and vaginal irritation that trouble three-quarters of all women when they reach menopause. Estratest works by replacing some of the estrogen that is lost when the reproductive system shuts down. Although it relieves the physical symptoms of menopause, it won't help emotional symptoms such as depression if the physical symptoms are absent. It combines supplemental estrogen with a synthetic form of the male hormone testosterone, and is prescribed when estrogen alone fails to relieve menopausal symptoms.

Most important fact about Esterified estrogens and Methyltestosterone

Estrogen replacement therapy increases the risk of endometrial cancer (cancer in the lining of the uterus). It is also important to note that estrogen replacement therapy will not prevent heart disease, in fact it is possible that it could increase your risk for heart attack and stroke.

The higher the dose and the longer the treatment, the greater the risks. It's wise, therefore, to limit yourself to the smallest dose that provides relief, and to stop the treatment as soon as you can. It's also essential to have regular checkups and to report any unusual vaginal bleeding to your doctor immediately.

How should you take Esterified estrogens and Methyltestosterone?

Take Estratest cyclically--a dose a day for 3 weeks, then no tablets for 1 week.

--If you miss a dose...

Take it as soon as you remember. However, if it almost time for your next dose, skip the one you missed and return to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe to continue using Estratest.

• More common side effects may include:
  Abdominal cramps, acne, allergic reactions, anxiety, bladder problems, bloating, breast discharge, breast swelling and tenderness, brown patches on the face, cervical changes, clotting disorders, deepening of the voice, depression, dizziness, enlarged clitoris, enlarged fibroids, gallbladder disease, hair loss on scalp, hair growth on face, headache, high blood sugar, high cholesterol, intolerance to contact lenses, liver disorders, menstrual problems, migraine, nausea, sex drive changes, skin eruptions, swelling, tingling, twitching, vaginal yeast infection, vision changes, vomiting, weight changes, yellowing of skin and eyes

Why should Esterified estrogens and Methyltestosterone not be prescribed?

You should avoid Estratest if you are breast feeding or have any of the following conditions:

• Breast cancer or any other type of cancer that's stimulated by estrogen (except in certain special circumstances).
• Known or suspected pregnancy.
• Unexplained vaginal bleeding.
• A clotting disorder such as phlebitis, or clotting problems during previous estrogen therapy.
• Severe liver damage.

Special warnings about Esterified estrogens and Methyltestosterone

Long-term estrogen replacement therapy definitely increases the risk of endometrial cancer and may increase the risk of breast cancer as well. If you have a family history of breast cancer, or if you have breast nodules or abnormal mammograms, be sure to have frequent breast exams.

Estrogen replacement drugs have been associated with an increased risk of heart disease, such as heart attack and stroke, as well as blood clots in the brain, heart, or lungs. You are at a higher risk for heart disease if you have high blood pressure, diabetes, if you smoke cigarettes, have high cholesterol, or are overweight. If you are having surgery you will need to discontinue estrogen therapy at least 4 to 6 weeks prior to the procedure because the risk for blood clots becomes higher due to the time you may be immobilized. Because estrogen replacement poses a slight theoretical danger of clotting disorders, and testosterone has been known to cause fluid retention and heart failure in people with heart, liver, or kidney disease. Take Estratest with caution if you have any of these conditions or have ever suffered a stroke. Also let the doctor know if you have asthma, epilepsy, migraines, or bone disease.

Estrogen replacement also increases the risk of gallbladder disease. Women who take birth control pills, which have the same effect, suffer an increase in gallbladder problems after 2 years of use.

Both estrogen and testosterone can cause liver problems, including benign tumors, cancers, and hepatitis. Be sure to report any pain, tenderness, or swelling in the abdomen to your doctor immediately. If you develop signs of liver disease such as yellowing of the skin and eyes, stop taking Estratest and see your doctor at once.

Estrogen can cause an increase in blood pressure, so the doctor will monitor it closely. Estrogen also can raise blood sugar levels. If you have diabetes, use Estratest cautiously.

Estrogen therapy occasionally causes symptoms of hormonal overload, such as breast tenderness and excessive uterine bleeding. Estrogen can also foster an increase in the size of uterine fibroids (benign tumors) and may increase the risk of mental depression.

High doses of the testosterone in Estratest can cause a woman's voice to deepen and can promote the growth of facial hair. To prevent a permanent change, the hormone must be discontinued. Inform your doctor immediately if you develop hoarseness, acne, or hair on the face. Also report any nausea, vomiting, changes in skin color, or swelling in the ankles.

Possible food and drug interactions when taking Esterified estrogens and Methyltestosterone

If Estratest is taken with certain other drugs, their effects may be altered. It is especially important to check with your doctor before combining Estratest with the following:

Blood thinners such as Coumadin
Insulin

Special information if you are pregnant or breastfeeding

Estrogen and testosterone both can cause birth defects, and estrogen taken during pregnancy increases the child's risk of certain vaginal and cervical cancers later in life. Do not take Estratest if there's any chance that you're pregnant, and avoid it when nursing a baby.

Recommended dosage

WOMEN IN MENOPAUSE

Estratest is available in full- and half-strength tablets (Estratest H.S.). The tablets are taken cyclically (3 weeks on and 1 week off). The usual daily dosage is 1 tablet of Estratest or 1 to 2 tablets of Estratest H.S.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose of Estratest, seek medical attention immediately.

• Symptoms of overdose may include:
  Nausea, vaginal bleeding