Ensuring Safe Treatment With Evamist

Specific Precautions and Warnings for Evamist

Some of the warnings and precautions to be aware of prior to using Evamist include the following:
  • Let your healthcare provider know if you have abnormal vaginal bleeding (such as very heavy bleeding or bleeding between periods) while taking Evamist, 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 Evamist 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 consider taking Evamist with a progestin medication.
  • Studies have shown that estrogen hormone replacement therapy (such as Evamist) increases the risk of strokes and blood clots in the legs.
  • Before you take Evamist, 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, Evamist should be stopped four to six weeks before many surgeries, in order to help prevent blood clots.
  • Estrogens (such as Evamist) 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.
  • Estrogen drugs (such as Evamist) 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 breast self-exams, are recommended.
  • Estrogen drugs (such as Evamist) used with or without a progestin seem to increase the risk of dementia. In no case should Evamist be used to prevent or treat dementia (it is not effective for this use).
  • Evamist may worsen epilepsy, porphyria, asthma, diabetes, migraine headaches, lupus, and hepatic hemangiomas.
  • Women who take estrogen (such as Evamist) 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 Evamist.
  • Evamist 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 Evamist will cause similar problems to recur. If this happens, your healthcare provider will probably advise you to stop taking Evamist.


  • Do not let the skin where Evamist has been applied come into contact with children or pets. The drug could be transferred to the child and pet, potentially causing problems. If contact cannot be avoided, you should wear long sleeves to prevent direct contact. 
If contact occurs, the child may experience signs of premature puberty and breast development (in girls) or breast enlargement (in boys). Pets may experience breast enlargement or genital swelling. 
  • If you have an underactive thyroid (hypothyroidism), Evamist 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.
  • Evamist can cause fluid retention. This can cause problems for people with congestive heart failure (CHF) or kidney problems.
  • Evamist should be used with caution in people who have low calcium levels in the blood (known medically as hypocalcemia).
  • It is not clear if Evamist increases the risk of ovarian cancer. Some studies have shown an increased risk, while others have not.
  • Evamist can make endometriosis symptoms worse.
  • Evamist can interact with a number of different medications (see Evamist Drug Interactions for more information).
  • Evamist should not be used during pregnancy (see Evamist and Pregnancy).
  • Evamist 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 Evamist and Breastfeeding).
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