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Using estrogens with or without progestins may increase your chances of getting heart attacksstrokesbreast cancerand blood clotsUsing estrogens with progestins may increase your risk of dementiaYou and your healthcare provider should talk regularly about whether you still need treatment with Estrace.

Other doses of oral conjugated estrogens with medroxyprogesterone acetateand other combinations and dosage forms of estrogens and progestins were not studied in the WHI clinical trials andin the absence of comparable datathese risks should be assumed to be similarBecause of these risksestrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.

Applies to estradiolvaginal creamvaginal insert extended releasevaginal tablet.

Estrogens act through binding to nuclear receptors in estrogen-responsive tissuesTo datetwo estrogen receptors have been identifiedThese vary in proportion from tissue to tissue.

Estrogens increase the risk of gallbladder diseaseDiscontinue estrogen if hypercalcemiasudden partial or complete loss of visionhypertriglyceridemiaor cholestatic jaundice occursPatients dependent on thyroid hormone replacement therapy should have their thyroid function monitored in order to maintain their free thyroid hormone levels in an acceptable rangeEndometriosis may be exacerbated in women treated post-hysterectomy with estrogen-alone therapyThe addition of progestins should be considered in these patients.

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