Specific EstroGel Warnings and Precautions
Some of the warnings and precautions to be aware of prior to using EstroGel
include the following:
- Studies have shown that estrogen hormone replacement therapy (such as EstroGel) increases the risk of strokes and blood clots in the legs.
- Before you take EstroGel, your healthcare provider should make sure that you are appropriately treated for any risk factors for blood clots or heart disease (such as high blood pressure, high cholesterol, diabetes, obesity, or smoking). When possible, EstroGel should be stopped four to six weeks before many surgeries, in order to help prevent blood clots.
- Estrogens (such as EstroGel) should never be used to prevent heart disease (see Hormone Replacement Therapy and Heart Health for more information), as they are not effective for this use.
- Let your healthcare provider know if you have abnormal vaginal bleeding (such as very heavy bleeding or bleeding between periods) while taking EstroGel, as this may be a sign of precancerous or cancerous changes in the uterus. Your healthcare provider can perform the necessary tests to rule out cancer.
- For women who still have a uterus (who have not had a hysterectomy), taking EstroGel by itself (without a progestin) increases the risk of endometrial cancer (cancer of the lining of the uterus). Women who still have a uterus should take EstroGel with a progestin medication.
- Estrogen drugs (such as EstroGel) used with or without a progestin may increase the risk of breast cancer. Proper screening and monitoring (as determined by your healthcare provider), such as yearly mammograms and monthly self breast exams, are recommended.
- Estrogen drugs (such as EstroGel) used with or without a progestin seem to increase the risk of dementia. In no case should EstroGel be used to prevent or treat dementia -- it is not effective for this use.
- EstroGel may worsen epilepsy, porphyria, asthma, diabetes, migraine headaches, lupus, and hepatic hemangiomas.
- Women who take estrogen (such as EstroGel) have an increased risk for gallbladder disease.
- Let your healthcare provider know right away if you notice any vision changes. This can signal a blood clot in the retina, a possible side effect of EstroGel.
- EstroGel can cause high blood pressure (hypertension) or high triglycerides in some women. Your healthcare provider should monitor you for these problems.
- If you have had jaundice (yellowing of the whites of the eyes or skin) due to estrogens or pregnancy in the past, it is possible that EstroGel will cause similar problems to recur. If this happens, your healthcare provider will probably advise you to stop taking EstroGel.
- If you have an underactive thyroid (hypothyroidism), EstroGel may increase your body's requirement for thyroid hormones. Your healthcare provider should monitor you and adjust the dose of your thyroid medications as necessary.
- EstroGel can cause fluid retention. This can cause problems for people with congestive heart failure (CHF) or kidney problems.
- EstroGel should be used with caution in people who have low calcium levels in the blood (known medically as hypocalcemia).
- It is not clear if EstroGel increases the risk of ovarian cancer. Some studies have shown an increased risk, while others have not.
- EstroGel can make endometriosis symptoms worse.
- EstroGel can interact with a number of different medications (see EstroGel Drug Interactions for more information).
- EstroGel should not be used during pregnancy (see EstroGel and Pregnancy).
- EstroGel does pass through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see EstroGel and Breastfeeding).