Estradiol Information, prices and ordering
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In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For estrogens, the following should be considered:
Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to estrogens. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy-Estrogens are not recommended for use during pregnancy or right after giving birth. Becoming pregnant or maintaining a pregnancy is not likely to occur around the time of menopause.
Certain estrogens have been shown to cause serious birth defects in humans and animals. Some daughters of women who took diethylstilbestrol (DES) during pregnancy have developed reproductive (genital) tract problems and, rarely, cancer of the vagina or cervix (opening to the uterus) when they reached childbearing age. Some sons of women who took DES during pregnancy have developed urinary-genital tract problems.
Breast-feeding-Use of this medicine is not recommended in nursing mothers. Estrogens pass into the breast milk and their possible effect on the baby is not known.
Older adults-This medicine has been tested and has not been shown to cause different side effects or problems in older women than it does in younger women.
Other medicines-Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking estrogens, it is especially important that your health care professional know if you are taking any of the following:
Acetaminophen (e.g., Tylenol) (with long-term, high-dose use) or
Amiodarone (e.g., Cordarone) or
Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or
Androgens (male hormones) or
Anti-infectives by mouth or by injection (medicine for infection) or
Antithyroid agents (medicine for overactive thyroid) or
Carbamazepine (e.g., Tegretol) or
Carmustine (e.g., BiCNU) or
Chloroquine (e.g., Aralen) or
Dantrolene (e.g., Dantrium) or
Daunorubicin (e.g., Cerubidine) or
Disulfiram (e.g., Antabuse) or
Divalproex (e.g., Depakote) or
Etretinate (e.g., Tegison) or
Gold salts (medicine for arthritis) or
Hydroxychloroquine (e.g., Plaquenil) or
Isoniazid or
Mercaptopurine (e.g., Purinethol) or
Methotrexate (e.g., Mexate) or
Methyldopa (e.g., Aldomet) or
Naltrexone (e.g., Trexan) (with long-term, high-dose use) or
Oral contraceptives (birth control pills) containing estrogen or
Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or
Phenytoin (e.g., Dilantin) or
Plicamycin (e.g., Mithracin) or
Valproic acid (e.g., Depakene)-Use of these medicines with estrogens may increase the chance of problems occurring that affect the liver
Cyclosporine (e.g., Sandimmune)-Estrogens can prevent cyclosporine's removal from the body; this can lead to cyclosporine causing kidney or liver problems
Protease inhibitors, such as ritonavir (e.g., Norvir)-May decrease the effect of estrogens
Other medical problems-The presence of other medical problems may affect the use of estrogens. Make sure you tell your doctor if you have any other medical problems, especially:
For all patients
Blood clotting problems (or history of during previous estrogen therapy)-Estrogens usually are not used until blood clotting problems stop; using estrogens is not a problem for most patients without a history of blood clotting problems due to estrogen use
Breast cancer or
Bone cancer or
Cancer of the uterus or
Fibroid tumors of the uterus-Estrogens may interfere with the treatment of breast or bone cancer or worsen cancer of the uterus when these conditions are present
Changes in genital or vaginal bleeding of unknown causes-Use of estrogens may delay diagnosis or worsen condition. The reason for the bleeding should be determined before estrogens are used
Endometriosis or
High cholesterol or triglycerides (or history of) or
Gallbladder disease or gallstones (or history of) or
Liver disease (or history of) or
Pancreatitis (inflammation of pancreas)-Estrogens may worsen these conditions. Although estrogens can improve blood cholesterol, they can worsen blood triglycerides for some people
For males treated for breast or prostate cancer
Blood clots or
Heart or circulation disease or
Stroke-Males with these medical problems may be more likely to have clotting problems while taking estrogens; the high doses of estrogens used to treat male breast or prostate cancer have been shown to increase the chances of heart attack, phlebitis (inflamed veins) caused by a blood clot, or blood clots in the lungs
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| how to take this medication |
Estrogens usually come with patient information or directions. Read them carefully before taking this medicine.
Take this medicine only as directed by your doctor. Do not take more of it and do not take or use it for a longer time than your doctor ordered. For patients taking any of the estrogens by mouth, try to take the medicine at the same time each day to reduce the possibility of side effects and to allow it to work better.
For patients taking any of the estrogens by mouth or by injection:
Nausea may occur during the first few weeks after you start taking estrogens. This effect usually disappears with continued use. If the nausea is bothersome, it can usually be prevented or reduced by taking each dose with food or immediately after food.
For patients using the transdermal (skin patch) form of estradiol:
Wash and dry your hands thoroughly before and after handling the patch.
Apply the patch to a clean, dry, nonoily skin area of your lower abdomen, hips below the waist, or buttocks that has little or no hair and is free of cuts or irritation. The manufacturer of the 0.025-mg patch recommends that its patch be applied to the buttocks only. Furthermore, each new patch should be applied to a new site of application. For instance, if the old patch is taken off the left buttock, then apply the new patch to the right buttock.
Do not apply to the breasts. Also, do not apply to the waistline or anywhere else where tight clothes may rub the patch loose.
Press the patch firmly in place with the palm of your hand for about 10 seconds. Make sure there is good contact, especially around the edges.
If a patch becomes loose or falls off, you may reapply it or discard it and apply a new patch.
Each dose is best applied to a different area of skin on your lower abdomen, hips below the waist, or buttocks so that at least 1 week goes by before the same area is used again. This will help prevent skin irritation.
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| side effects |
Women rarely have severe side effects from taking estrogens to replace estrogen. Discuss these possible effects with your doctor:
The prolonged use of estrogens has been reported to increase the risk of endometrial cancer (cancer of the lining of the uterus) in women after menopause. This risk seems to increase as the dose and the length of use increase. When estrogens are used in low doses for less than 1 year, there is less risk. The risk is also reduced if a progestin (another female hormone) is added to, or replaces part of, your estrogen dose. If the uterus has been removed by surgery (total hysterectomy), there is no risk of endometrial cancer.
It is not yet known whether the use of estrogens increases the risk of breast cancer in women. Although some large studies show an increased risk, most studies and information gathered to date do not support this idea. Breast cancer has been reported in men taking estrogens.
The following side effects may be caused by blood clots, which could lead to stroke, heart attack, or death. These side effects occur rarely, and, when they do occur, they occur in men treated for cancer using high doses of estrogens. Get emergency help immediately if any of the following side effects occur:
Rare-for males being treated for breast or prostate cancer only
Headache (sudden or severe); loss of coordination (sudden); loss of vision or change of vision (sudden); pains in chest, groin, or leg, especially in calf of leg; shortness of breath (sudden and unexplained) ; slurring of speech (sudden); weakness or numbness in arm or leg
Also, check with your doctor as soon as possible if any of the following side effects occur:
More common
Breast pain (in females and males); increased breast size (in females and males); swelling of feet and lower legs; weight gain (rapid)
Less common or rare
Changes in vaginal bleeding (spotting, breakthrough bleeding, prolonged or heavier bleeding, or complete stoppage of bleeding); lumps in, or discharge from, breast (in females and males); pains in stomach, side, or abdomen; yellow eyes or skin
Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
More common
Bloating of stomach; cramps of lower stomach; loss of appetite; nausea; skin irritation or redness where skin patch was worn
Less common
Diarrhea (mild); dizziness (mild); headaches (mild); migraine headaches ; problems in wearing contact lenses; unusual decrease in sexual desire (in males); unusual increase in sexual desire (in females); vomiting (usually with high doses)
Also, many women who are taking estrogens with a progestin (another female hormone) will start having monthly vaginal bleeding, similar to menstrual periods, again. This effect will continue for as long as the medicine is taken. However, monthly bleeding will not occur in women who have had the uterus removed by surgery (total hysterectomy).
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.
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| precautions |
It is very important that your doctor check your progress at regular visits to make sure this medicine does not cause unwanted effects . These visits will usually be every year, but some doctors require them more often.
In some patients using estrogens, tenderness, swelling, or bleeding of the gums may occur. Brushing and flossing your teeth carefully and regularly and massaging your gums may help prevent this. See your dentist regularly to have your teeth cleaned. Check with your medical doctor or dentist if you have any questions about how to take care of your teeth and gums, or if you notice any tenderness, swelling, or bleeding of your gums.
It is not yet known whether the use of estrogens increases the risk of breast cancer in women. Therefore, it is very important that you regularly check your breasts for any unusual lumps or discharge. Report any problems to your doctor. You should also have a mammogram (x-ray pictures of the breasts) done if your doctor recommends it. Because breast cancer has occurred in men taking estrogens, regular breast self-exams and exams by your doctor for any unusual lumps or discharge should be done.
If your menstrual periods have stopped, they may start again. This effect will continue for as long as the medicine is taken. However, if taking the continuous treatment (0.625 mg conjugated estrogens and 2.5 mg medroxyprogesterone once a day), monthly bleeding usually stops within 10 months.
Also, vaginal bleeding between your regular menstrual periods may occur during the first 3 months of use. Do not stop taking your medicine. Check with your doctor if bleeding continues for an unusually long time, if your period has not started within 45 days of your last period, or if you think you are pregnant.
Tell the doctor in charge that you are taking this medicine before having any laboratory test because some results may be affected.
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| other uses |
Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, estrogen is used in certain patients with the following medical conditions:
Osteoporosis caused by lack of estrogen before menopause
Atherosclerotic disease (hardening of the arteries)
Turner's syndrome (a genetic disorder)
Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.
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| missed dosage |
For patients taking any of the estrogens by mouth: If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
For patients using the transdermal (skin patch) form of estradiol: If you forget to apply a new patch when you are supposed to, apply it as soon as possible. However, if it is almost time for the next patch, skip the missed one and go back to your regular schedule. Always remove the old patch before applying a new one. Do not apply more than one patch at a time.
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| storage |
To store this medicine:
Keep out of the reach of children.
Store away from heat and direct light.
Do not store in the bathroom medicine cabinet because the heat or moisture may cause the medicine to break down.
Keep the injection form of this medicine from freezing.
Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.
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| overdose |
The dose of these medicines will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.
The number of tablets that you take or the amount of injection you use depends on the strength of the medicine. Also, the number of doses you take or use each day or patches you apply each week, the time allowed between doses, and the length of time you take or use the medicine depend on the medical problem for which you are taking, using, or applying estrogen.
For conjugated estrogens
For oral dosage form (tablets):
For treating breast cancer in women after menopause and in men:
Adults-10 milligrams (mg) three times a day for at least three months.
For treating a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis), or symptoms of menopause:
Adults-0.3 to 1.25 mg a day. Your doctor may want you to take the medicine each day or only on certain days of the month.
To prevent loss of bone (osteoporosis):
Adults-0.625 mg a day. Your doctor may want you to take the medicine each day or only on certain days of the month.
For treating ovary problems (female hypogonadism or for starting puberty):
Adults and teenagers-2.5 to 7.5 mg a day. This dose is divided up and taken in smaller doses. Your doctor may want you to take the medicine only on certain days of the month.
For treating ovary problems (failure or removal of both ovaries):
Adults-1.25 mg a day. Your doctor may want you to take the medicine each day or only on certain days of the month.
For treating prostate cancer:
Adults-1.25 to 2.5 mg three times a day.
For injection dosage form:
For controlling abnormal bleeding of the uterus:
Adults-25 mg injected into a muscle or vein. This may be repeated in six to twelve hours if needed.
For diethylstilbestrol
For oral dosage form (tablets):
For treating prostate cancer:
Adults-At first, 1 to 3 milligrams (mg) a day. Later, your doctor may decrease your dose to 1 mg a day.
For diethylstilbestrol diphosphate
For oral dosage form (tablets):
For treating prostate cancer:
Adults-50 to 200 milligrams (mg) three times a day.
For injection dosage form:
For treating prostate cancer:
Adults-At first, 500 mg is mixed in solution with sodium chloride or dextrose injection and injected slowly into a vein. Your doctor may increase your dose to 1 gram a day for five or more straight days as needed. Then, your doctor may lower your dose to between 250 and 500 mg one or two times a week.
For esterified estrogens
For oral dosage form (tablets):
For treating breast cancer in women after menopause and in men:
Adults-10 milligrams (mg) three times a day for at least three months.
For treating a genital skin condition (vulvar atrophy) or inflammation of the vagina (atrophic vaginitis), or to prevent loss of bone (osteoporosis):
Adults-0.3 to 1.25 mg a day. Your doctor may want you to take the medicine each day or only on certain days of the month.
For treating ovary problems (failure or removal of both ovaries):
Adults-1.25 mg a day. Your doctor may want you to take the medicine each day or only on certain days of the month.
For treating ovary problems (female hypogonadism):
Adults-2.5 to 7.5 mg a day. This dose may be divided up and taken in smaller doses. Your doctor may want you to take the medicine each day or only on certain days of the month.
For treating symptoms of menopause:
Adults-0.625 to 1.25 mg a day. Your doctor may want you to take the medicine each day or only on certain days of the month.
For treating prostate cancer:
Adults-1.25 to 2.5 mg three times a day.
For estradiol
For oral dosage form (tablets):
For treating breast cancer in women after menopause and in men:
Adults-10 milligrams (mg) three times a day for at least three months.
For treating a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis), ovary problems (female hypogonadism or failure or removal of both ovaries), or symptoms of menopause:
Adults-0.5 to 2 mg a day. Your doctor may want you to take the medicine each day or only on certain days of the month.
For treating prostate cancer:
Adults-1 to 2 mg three times a day.
To prevent loss of bone (osteoporosis):
Adults-0.5 mg a day. Your doctor may want you to take the medicine each day or only on certain days of the month.
For transdermal dosage form (skin patches):
For treating a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis), symptoms of menopause, ovary problems (female hypogonadism or failure or removal of both ovaries), or to prevent loss of bone (osteoporosis):
For the Climara or FemPatch patches
Adults-0.025 to 0.1 milligram (mg) (one patch) applied to the skin and worn for one week. Then, remove that patch and apply a new one. A new patch should be applied once a week for three weeks. During the fourth week, you may or may not wear a patch. Your health care professional will tell you what you should do for this fourth week. After the fourth week, you will repeat the cycle.
For the Alora, Estraderm, or Vivelle patches
Adults-0.025 to 0.1 mg (one patch) applied to the skin and worn for one half of a week. Then, remove that patch and apply and wear a new patch for the rest of the week. A new patch should be applied two times a week for three weeks. During the fourth week, you may or may not apply new patches. Your health care professional will tell you what you should do for this fourth week. After the fourth week, you will repeat the cycle.
For estradiol cypionate
For injection dosage form:
For treating ovary problems (female hypogonadism):
Adults-1.5 to 2 milligrams (mg) injected into a muscle once a month.
For treating symptoms of menopause:
Adults-1 to 5 mg injected into a muscle every three to four weeks.
For estradiol valerate
For injection dosage form:
For treating a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis), symptoms of menopause, or ovary problems (female hypogonadism or failure or removal of both ovaries):
Adults-10 to 20 milligrams (mg) injected into a muscle every four weeks as needed.
For treating prostate cancer:
Adults-30 mg injected into a muscle every one or two weeks.
For estrone
For injection dosage form:
For controlling abnormal bleeding of the uterus:
Adults-2 to 5 milligrams (mg) a day, injected into a muscle for several days.
For treating a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis), or symptoms of menopause:
Adults-0.1 to 0.5 mg injected into a muscle two or three times a week. Your doctor may want you to receive the medicine each week or only during certain weeks of the month.
For treating ovary problems (female hypogonadism or failure or removal of both ovaries):
Adults-0.1 to 1 mg a week. This is injected into a muscle as a single dose or divided into more than one dose. Your doctor may want you to receive the medicine each week or only during certain weeks of the month.
For treating prostate cancer:
Adults-2 to 4 mg injected into a muscle two or three times a week.
For estropipate
For oral dosage form (tablets):
For treating a genital skin condition (vulvar atrophy), inflammation of the vagina (atrophic vaginitis), or symptoms of menopause:
Adults-0.75 to 6 milligrams (mg) a day. Your doctor may want you to take the medicine each day or only on certain days of the month.
For treating ovary problems (female hypogonadism or failure or removal of both ovaries):
Adults-1.5 to 9 mg a day. Your doctor may want you to take the medicine each day or only on certain days of the month.
To prevent loss of bone (osteoporosis):
Adults-0.75 mg a day. Your doctor may want you to take the medicine each day for twenty-five days of a thirty-one-day cycle.
For ethinyl estradiol
For oral dosage form (tablets):
For treating breast cancer in women after menopause and in men:
Adults-1 milligram (mg) three times a day.
For treating ovary problems (female hypogonadism or failure or removal of both ovaries):
Adults-0.05 mg one to three times a day for three to six months. Your doctor may want you to take the medicine each day or only on certain days of the month.
For treating prostate cancer:
Adults-0.15 to 3 mg a day.
For treating symptoms of menopause:
Adults-0.02 to 0.05 mg a day. Your doctor may want you to take the medicine each day or only on certain days of the month.
For ethinyl estradiol and norethindrone
For oral dosage form (tablets):
For treating symptoms of menopause:
Adults-1 tablet (5 mcg ethinyl estradiol and 1 mg of norethindrone) each day
To prevent loss of bone (osteoporosis):
Adults-1 tablet (5 mcg ethinyl estradiol and 1 mg of norethindrone) each day
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| contraindications |
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For estrogens, the following should be considered:
Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to estrogens. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy-Estrogens are not recommended for use during pregnancy or right after giving birth. Becoming pregnant or maintaining a pregnancy is not likely to occur around the time of menopause.
Certain estrogens have been shown to cause serious birth defects in humans and animals. Some daughters of women who took diethylstilbestrol (DES) during pregnancy have developed reproductive (genital) tract problems and, rarely, cancer of the vagina or cervix (opening to the uterus) when they reached childbearing age. Some sons of women who took DES during pregnancy have developed urinary-genital tract problems.
Breast-feeding-Use of this medicine is not recommended in nursing mothers. Estrogens pass into the breast milk and their possible effect on the baby is not known.
Older adults-This medicine has been tested and has not been shown to cause different side effects or problems in older women than it does in younger women.
Other medicines-Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking estrogens, it is especially important that your health care professional know if you are taking any of the following:
Acetaminophen (e.g., Tylenol) (with long-term, high-dose use) or
Amiodarone (e.g., Cordarone) or
Anabolic steroids (nandrolone [e.g., Anabolin], oxandrolone [e.g., Anavar], oxymetholone [e.g., Anadrol], stanozolol [e.g., Winstrol]) or
Androgens (male hormones) or
Anti-infectives by mouth or by injection (medicine for infection) or
Antithyroid agents (medicine for overactive thyroid) or
Carbamazepine (e.g., Tegretol) or
Carmustine (e.g., BiCNU) or
Chloroquine (e.g., Aralen) or
Dantrolene (e.g., Dantrium) or
Daunorubicin (e.g., Cerubidine) or
Disulfiram (e.g., Antabuse) or
Divalproex (e.g., Depakote) or
Etretinate (e.g., Tegison) or
Gold salts (medicine for arthritis) or
Hydroxychloroquine (e.g., Plaquenil) or
Isoniazid or
Mercaptopurine (e.g., Purinethol) or
Methotrexate (e.g., Mexate) or
Methyldopa (e.g., Aldomet) or
Naltrexone (e.g., Trexan) (with long-term, high-dose use) or
Oral contraceptives (birth control pills) containing estrogen or
Phenothiazines (acetophenazine [e.g., Tindal], chlorpromazine [e.g., Thorazine], fluphenazine [e.g., Prolixin], mesoridazine [e.g., Serentil], perphenazine [e.g., Trilafon], prochlorperazine [e.g., Compazine], promazine [e.g., Sparine], promethazine [e.g., Phenergan], thioridazine [e.g., Mellaril], trifluoperazine [e.g., Stelazine], triflupromazine [e.g., Vesprin], trimeprazine [e.g., Temaril]) or
Phenytoin (e.g., Dilantin) or
Plicamycin (e.g., Mithracin) or
Valproic acid (e.g., Depakene)-Use of these medicines with estrogens may increase the chance of problems occurring that affect the liver
Cyclosporine (e.g., Sandimmune)-Estrogens can prevent cyclosporine's removal from the body; this can lead to cyclosporine causing kidney or liver problems
Protease inhibitors, such as ritonavir (e.g., Norvir)-May decrease the effect of estrogens
Other medical problems-The presence of other medical problems may affect the use of estrogens. Make sure you tell your doctor if you have any other medical problems, especially:
For all patients
Blood clotting problems (or history of during previous estrogen therapy)-Estrogens usually are not used until blood clotting problems stop; using estrogens is not a problem for most patients without a history of blood clotting problems due to estrogen use
Breast cancer or
Bone cancer or
Cancer of the uterus or
Fibroid tumors of the uterus-Estrogens may interfere with the treatment of breast or bone cancer or worsen cancer of the uterus when these conditions are present
Changes in genital or vaginal bleeding of unknown causes-Use of estrogens may delay diagnosis or worsen condition. The reason for the bleeding should be determined before estrogens are used
Endometriosis or
High cholesterol or triglycerides (or history of) or
Gallbladder disease or gallstones (or history of) or
Liver disease (or history of) or
Pancreatitis (inflammation of pancreas)-Estrogens may worsen these conditions. Although estrogens can improve blood cholesterol, they can worsen blood triglycerides for some people
For males treated for breast or prostate cancer
Blood clots or
Heart or circulation disease or
Stroke-Males with these medical problems may be more likely to have clotting problems while taking estrogens; the high doses of estrogens used to treat male breast or prostate cancer have been shown to increase the chances of heart attack, phlebitis (inflamed veins) caused by a blood clot, or blood clots in the lungs
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