Esterified Estrogens and Methyltestosterone (Oral)

Overview

Although estrogen regulates a woman's menstrual cycle throughout her childbearing years, it also plays a crucial role during the menopause. Whilst estrogen levels may fluctuate during the perimenopause, they tend to drop to a very low level once the menopause has started. It's this change in hormone level which causes a number of menopausal symptoms, such as night sweats, headaches, palpitations, hot flashes, breast tenderness, vaginal dryness and/or fatigue.

Often, menopausal patients are treated with estrogen alone and this can be successful in relieving their symptoms. However, estrogen is not the only hormone which fluctuates during the menopause. Although testosterone is a typically male hormone, women do have lower levels of the hormone in their systems. Whilst women do continue to produce testosterone during and after the menopause, they generally produce less than half the amount they did during their childbearing years.

Although it's natural for the level of hormones to fluctuate and drop both prior to and during the menopause, the associated symptoms can be extremely debilitating. By adding hormones to the patient's body, physicians can help to relieve these symptoms and can drastically improve the patient's quality of life.

It is necessary, however, to monitor the patient's hormone levels throughout treatment. Whilst Esterified estrogens and Methyltestosterone tablets will increase the levels of hormones in the patient's system, they should not be increased to too high a level. Instead, physicians must increase the patient's hormone levels enough to relieve their symptoms, whilst keeping their hormone level low enough for the menopause to continue. This ensures that the patient's body transitions through the menopause and that the patient isn't plagued by on-going symptoms.

If treatment with estrogen has been ineffective, patients may obtain relief from their symptoms if they are treated with a combination of Esterified estrogens and Methyltestosterone. Whilst Esterified estrogens help with a wide range of symptoms, such as breast pain, low libido, palpitations, headaches and vaginal dryness, Methyltestosterone is known to be particularly useful in treating bone loss, hot flashes, low libido and fatigue. When used as a combination medication, Esterified estrogens and Methyltestosterone can, therefore, relieve numerous symptoms associated with the menopause.

Conditions Treated

  • Menopause

Type Of Medicine

  • Hormone therapy

Side Effects

When taking any medicine, patients may experience some side effects. Whilst some are fairly common and relatively mild, others can be troublesome and severe. Depending on the nature of the side effects, patients may need to seek medical help when they're taking Esterified estrogens and Methyltestosterone. As this medication is a form of hormone therapy, it's not uncommon for patients to experience some adverse effects. Often, these are more pronounced when patients begin taking Esterified estrogens and Methyltestosterone but are reduced over time.

If patients experience any of the following side effects when taking Esterified estrogens and Methyltestosterone, they should notice them diminish over time:

  • Blemishes on skin
  • Loss of hair
  • Blotchy, brown spots on exposed skin
  • Loss of sexual desire, ability, performance or drive
  • Decreased interest in sexual intercourse
  • Irritability
  • Depression
  • Leg cramps
  • Headache, throbbing and severe
  • Inability to become or stay aroused
  • Pimples
  • Increased hair growth, especially on the face
  • Decrease or increase in weight
  • Increased in sexual ability, desire, drive or performance
  • Redness of the skin
  • Increased interest in sexual intercourse
  • Mental depression
  • Twitching or uncontrolled movements of the lips, tongue, arms, legs or face
  • Inflammation or swelling of the mouth

Although the above symptoms tend to be more noticeable when patients first start taking Esterified estrogens and Methyltestosterone, they may disappear once the patient's system gets used to the medication. Due to this, patients may not need to seek medical help, if their side effects are relatively mild. If side effects persist, however, or if they are severe, patients should contact their physician for advice.

When patients are taking Esterified estrogens and Methyltestosterone, there are a number of adverse effects which could occur. If the patient experiences any of the following, they should seek medical help:

  • Irregular, missed or absent menstrual periods
  • Decreased breast size
  • Oily skin or acne
  • Enlarged clitoris
  • Deepening of the voice
  • Hoarseness
  • Menstrual changes
  • Unnatural hair loss or growth
  • Stopping of menstrual bleeding
  • Continuing nausea
  • Dark-colored urine
  • Cough
  • Difficulty swallowing
  • Fast heartbeat
  • Dizziness
  • Hives
  • Fever
  • Loss of appetite
  • Itching
  • Light-colored stools
  • Swelling or puffiness around the eyes, face, lips, eyelids or tongue
  • Red-colored or purple spots inside the mouth or nose or on the body
  • Rash on the skin
  • Chest tightness
  • Shortness of breath
  • Unusual weakness or tiredness
  • Sore throat
  • Vomiting
  • Stomach or abdominal pain, cramps or bloating
  • Anxiety
  • Wheezing
  • Bleeding from nose or gums
  • Chest discomfort or pain
  • Confusion
  • Loosening, peeling or blistering of the skin
  • Constipation
  • Bloating
  • Clay-colored stools
  • Cloudy or bloody urine
  • Change in vaginal discharge
  • Itching, burning, numbness, prickling, tingling, crawling or 'œpins and needles' feelings
  • Changes in skin color, tenderness or pain
  • Darkening of urine
  • Chills
  • Bloody or clear discharge from nipple
  • Decreased amount of urine
  • Convulsions
  • Painful, difficult or burning urination
  • Diarrhea
  • Trouble speaking
  • Difficulty breathing
  • Fever
  • Difficulty with moving
  • Fainting
  • Difficulty with speaking
  • Eye pain
  • Dimpling of the breast skin
  • Lightheadedness or dizziness
  • Double vision
  • Fluid-filled skin blisters
  • Headache
  • Frequent urge to urinate
  • Inability to move arms, facial muscles or legs
  • Heavy bleeding
  • Inability to speak
  • Nausea
  • Indigestion
  • Muscle stiffness or pain
  • Inverted nipple
  • Muscle cramps in arms, hands, legs, feet or face
  • Irregular heartbeats
  • Mood or mental changes
  • Itching of the genital area or vagina
  • Lump under the arm or in the breast
  • Muscle or joint pain
  • Light-colored stools
  • Large, hive-like swelling on the eyelids, face, tongue, lips, throat, legs, feet, hands or sex organs
  • Rattling, noisy breathing
  • Loss of appetite
  • Tingling and numbness around the mouth, feet or fingertips
  • Pains in the abdomen, side or stomach, may radiate to the back
  • Feeling or pressure or pain in the pelvis
  • Pain
  • Red, painful lumps under the skin, mostly on the legs
  • Pain during sexual intercourse
  • Discomfort or pain in the jaw, arms, neck or back
  • Pain in the knees or ankles
  • Skin thinness
  • Pelvic pain
  • Swelling
  • Persistent scaling or crusting of the nipple
  • Sweating
  • Purple or pinpoint red spots on the skin
  • Sudden troubled breathing or shortness of breath
  • Poor judgement or insight
  • Irritated, red eyes
  • Problems with memory or speech
  • Swelling or redness of the breast
  • Stomach pain
  • Ringing in the ears
  • White spots, ulcers or sores on the lips or in the mouth
  • Sensitivity to the sun
  • Slow speech
  • Shortness of breath
  • Sore on the skin of the breast which does not heal
  • Swelling of the hands, fingers, lower legs and/or feet
  • Sore throat
  • Tenderness of the breast tissue
  • Vaginal bleeding
  • White, thick curd-like vaginal discharge, either without odor or with mild odor
  • Changes to vision
  • Tiredness
  • Vomiting of blood
  • Tremor
  • Weakness
  • Trouble recognizing objects
  • Yellowing of the eyes and/or skin
  • Trouble planning and thinking
  • Weight gain
  • Difficulty walking
  • Troubled breathing at rest
  • Unpleasant breath odor
  • Excess or unexpected milk flow from breasts

Whilst many of these side effects are rare, they do warrant medical attention. In some cases, they may indicate that the medication is not suited to the patient or that their dose is too high or too low. If patients notice their voice deepening or excess hair growth, for example, the dose of Methyltestosterone may be too high for their needs. By obtaining medical advice, patients can ensure that the medication isn't causing any harmful effects and that their dose is appropriate.

Dosage

Available in different strengths, patients may be prescribed Esterified estrogens and Methyltestosterone at a strength of 0.625mg-1.25mg or 1.25mg-2.5mg. Prior to prescribing medication, physicians will carry out blood tests to confirm the patient's existing hormone levels.

Although these test results will help the physician to determine what dose of Esterified estrogens and Methyltestosterone is appropriate, the patient's clinical presentation, age and weight will also be taken into account when the medication is prescribed.

Generally, the lowest effective dose of Esterified estrogens and Methyltestosterone should be used and physicians should encourage the patient to discontinue treatment as quickly as possible. In most cases, however, one 1.25mg-2.5mg tablet per day will be effective in controlling the symptoms of menopause. Alternatively, patients may be given a starting dose of 0.625mg-1.25mg once per day and advised to take two tablets if symptoms still persist.

Often, patients are advised to take Esterified estrogens and Methyltestosterone cyclically. This means that patients may be instructed to take the medication daily for a period of three weeks, before having one week without any Esterified estrogens and Methyltestosterone at all. The patient would then take the medication for another three weeks before having another week off.

Although this treatment regimen is standard for women with menopausal symptoms, every patient is different and will be given specific treatment instructions by their physician. It is essential that patients adhere to these instructions as they will be tailored towards the patient's specific needs.

If patients miss a dose of Esterified estrogens and Methyltestosterone, they should take it as soon as it's possible to do so. However, if their next dose if almost due, patients should avoid this missed dose completely and simply carry on with their medicine schedule as normal. Patients shouldn't attempt to take a double dose of Esterified estrogens and Methyltestosterone, even if they have missed a previous dose.

Patients should not suddenly stop taking Esterified estrogens and Methyltestosterone or change their dose unless they are advised to do so by a healthcare professional. Often, when physicians advise patients to stop taking Esterified estrogens and Methyltestosterone, they will instruct them to gradually lower their dose and taper off the medication, rather than stopping it completely. If patients want to stop taking Esterified estrogens and Methyltestosterone or are not obtaining relief from the treatment, they should discuss this with their physician.

Potential drug interactions:

Due to the risk of interactions occurring, Esterified estrogens and Methyltestosterone is not usually prescribed in conjunction with the following medications:

  • Anisindione
  • Phenprocoumon
  • Bupropion
  • Donepezil
  • Dicumarol

Although the above medicines may interact with Esterified estrogens and Methyltestosterone, physicians may feel it's appropriate to prescribe both treatments in some circumstances. If so, they may alter the patient's dose or instruct them to take the medicine at different times as this could help to prevent interactions occurring.

Whilst the following medications can be taken alongside Esterified estrogens and Methyltestosterone, they may increase the risk of side effects occurring:

  • Clarithromycin
  • Warfarin
  • Ginseng
  • Tipranavir
  • Ketoconazole
  • Licorice
  • Levothyroxine

Patients should be aware that Esterified estrogens and Methyltestosterone could interact with other substances as well. These may include over-the-counter medicines, vitamins, supplements and even certain food and drink. Due to this, patients should avoid the following products when taking Esterified estrogens and Methyltestosterone:

  • Grapefruit, grapefruit juice, grapefruit derivatives

In addition to this, patients should tell their doctor if they are using any other medicines, supplements or vitamins before taking Esterified estrogens and Methyltestosterone. Patients will also need to seek medical advice before using any of these supplements once they have begun taking Esterified estrogens and Methyltestosterone.

Warnings

Physicians will need to obtain a thorough medical history from the patient before prescribing Esterified estrogens and Methyltestosterone. Existing medical conditions may be contra-indicators for treatment with Esterified estrogens and Methyltestosterone, even if they are not active at the present time. These may include:

  • Systemic lupus erythematosus
  • Porphyria
  • Abnormal vaginal bleeding
  • Migraine headaches
  • Blood clotting problems, including deep vein thrombosis, pulmonary embolism etc.
  • Underactive thyroid (Hypothyroidism)
  • Breast cancer
  • Liver disease
  • Heart attack
  • Stroke
  • Cancer
  • Asthma
  • Diabetes
  • Fluid retention (edema)
  • Depression
  • Vision or eye problems
  • Epilepsy
  • Endometriosis
  • High calcium in the blood (Hypercalcemia)
  • Low calcium in the blood (Hypocalcemia)
  • Hepatitis
  • Gallbladder disease
  • Clot in the veins (venous thromboembolism)
  • Blood vessel or heart disease
  • High fat or triglycerides in the blood (Hypertriglyceridemia)
  • High blood pressure (Hypertension)
  • High cholesterol in the blood (Hypercholesterolemia)

Furthermore, the patient's age should be taken into account before Esterified estrogens and Methyltestosterone is prescribed. Often, older patients have age-related heart, kidney and/or liver problems and this can increase the time it takes for the body to process medication. Due to this, Esterified estrogens and Methyltestosterone may not be expelled from the body as quickly and a lower than average dose may be needed.

In rare cases, taking Esterified estrogens and Methyltestosterone can cause serious side effects, such as a stroke or heart attack. The risk of these complications is increased if the patient smokes cigarettes or is overweight, has high cholesterol, high blood pressure and/or diabetes. Patients should discuss these risks with their physician before taking Esterified estrogens and Methyltestosterone and during treatment.

When patients take large doses of estrogen over a significant period of time, the risk of them developing certain types of cancer may increase. Patients should be aware of this risk before beginning treatment and should contact their physician immediately if they experience vaginal bleeding whilst taking Esterified estrogens and Methyltestosterone.

Esterified estrogens and Methyltestosterone may increase the risk of developing breast cancer. Whilst taking this medication, patients should perform regular checks to determine whether there are any lumps in their breast tissue or any discharge from the nipple. In addition to this, patients should have regular check-ups with a healthcare practitioner. Patients will also undergo an annual x-ray to check whether any changes to the breast tissue have taken place. Patients should discuss the increased risk of breast cancer before taking Esterified estrogens and Methyltestosterone, particularly if they have a family history of breast cancer.

If patients experience any vision changes whilst taking this medication, they should inform their physician immediately. This may include blurred vision, difficulty reading normally or other changes to the patient's sight. The patient may be referred to an ophthalmologist to ensure that no harmful effects are causing damage to their eyes.

Esterified estrogens and Methyltestosterone may increase the risk of developing dementia in women over the age of 65 years. Patients should be made aware of this risk before taking this medication and should seek help from their physician if they become concerned about developing dementia whilst taking Esterified estrogens and Methyltestosterone.

Taking increased doses of Methyltestosterone for a significant period of time may increase the patient's risk of liver problems, such as hepatitis and/or liver cancer. Patients will need to discuss this risk with their physician before they begin treatment.

If patients are due to undergo any medical testing whilst taking this medication, they should inform the relevant healthcare practitioner that they are taking Esterified estrogens and Methyltestosterone. Similarly, if patients are due to undergo any surgical procedures, they should notify their doctor beforehand. In some cases, patients may be advised to stop taking Esterified estrogens and Methyltestosterone in the weeks before surgery or if they are facing a period of recovery and/or inactivity.

Whilst taking Esterified estrogens and Methyltestosterone, patients should have regular check-ups with their physician. Although these should take place at least once every six or 12 months, patients may require more frequent monitoring in some cases.

It is uncommon for postmenopausal women to become pregnant but patients should be aware that taking Esterified estrogens and Methyltestosterone whilst pregnant could cause harm to an unborn fetus. If patients become pregnant whilst taking this medicine, they should contact their physician immediately.

Patients should not take Esterified estrogens and Methyltestosterone whilst breastfeeding as there is a chance that the medication could be passed on to the infant and cause harm.

Before taking Esterified estrogens and Methyltestosterone, patients should inform their physician if they have any allergies. If patients experience an allergic reaction whilst taking this medication, they should seek urgent medical help, particularly if they exhibit any of the following symptoms:

  • Wheezing
  • Itching
  • Hives
  • Difficulty breathing
  • Difficulty swallowing
  • Hoarseness
  • Swelling of the tongue, lips, throat, hands, mouth and/or face

Storage

When storing Esterified estrogens and Methyltestosterone at home, patients should follow the manufacturer's guidelines and their physician's instructions. In most cases, however, Esterified estrogens and Methyltestosterone should be kept at room temperature and away from moisture, heat and direct light. In addition to this, medication should be kept out of reach of children and/or pets.

If patients are advised to stop taking Esterified estrogens and Methyltestosterone, they should contact their physician's office or pharmacist so that they can dispose of the medication responsibly.

Summary

When patients are going through the menopause, they can suffer a wide range of symptoms. Whilst some symptoms may be fairly mild, others can be extremely debilitating, and even incapacitating in some cases. By adding hormones to their system, however, the symptoms associated with the menopause can be significantly reduced.

Although hormone therapy can carry some risks, physicians will carry out a thorough assessment before prescribing Esterified estrogens and Methyltestosterone. Once the patient's clinical presentation and familial medical history has been assessed, doctors can determine whether the treatment is appropriate for the individual. If so, it's likely that Esterified estrogens and Methyltestosterone will alleviate the patient's symptoms and enable them to function effectively while going through the menopause.