Menopause Home > Specific Safety Issues With Estropipate Vaginal Cream
Warnings and precautions to be aware of prior to using estropipate vaginal cream include the following:
- It is important to understand that even though estropipate vaginal cream is applied vaginally, the estrogen hormone in the cream is absorbed into the bloodstream. This means that any of the risks associated with oral estrogen hormone replacement therapy also apply to estropipate vaginal cream. Although the risks are thought to be lower with the cream, since the body is exposed to less of the hormone, the risk is not eliminated.
- Studies have shown that estrogen hormone replacement therapy increases the risk of strokes and blood clots in the legs. Your healthcare provider should make sure you are appropriately treated for any risk factors for heart disease or blood clots before you use estropipate vaginal cream. Risk factors for heart disease include:
- Let your healthcare provider know if you have abnormal vaginal bleeding (such as heavy bleeding or bleeding between periods) while using estropipate vaginal cream, 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. Of course, if you have had a hysterectomy, you are not at risk for uterine cancer. Adding a progestin medication significantly reduces the risk of this type of cancer due to estrogen medications.
- Estrogen drugs (such as estropipate vaginal cream) 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, is recommended.
- Women who take estrogens (such as the one in estropipate vaginal cream) have an increased risk for gallbladder disease.
- Estropipate vaginal cream can cause high triglycerides in some women. Your healthcare provider should monitor you for this problem during treatment.
- If you have an underactive thyroid (hypothyroidism), estropipate vaginal cream 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.
- Estropipate vaginal cream can cause fluid retention. This can cause problems for people with congestive heart failure (CHF) or kidney problems.
- It is not clear whether estrogens (such as the one in estropipate vaginal cream) increase the risk of ovarian cancer. Some studies have shown an increased risk, while others have not.
- The cream can make endometriosis symptoms worse.
- Estropipate vaginal cream can theoretically interact with a number of different medications (see Drug Interactions With Estropipate Vaginal Cream).
- Estropipate vaginal cream should not be used during pregnancy (see Ogen Vaginal Cream and Pregnancy).
- The hormone in estropipate vaginal cream enters the bloodstream and passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to using the drug (see Ogen Vaginal Cream and Breastfeeding).