Class Name(s):

• 68:16.04 Estrogens

Pronunciation:

• (ess' troe jen)

Brand Name(s):

• Amnestrogen^® (esterified estrogens)¶
• Cenestin^® (conjugated synthetic A estrogens)
• Enjuvia^® (conjugated synthetic B estrogens)¶
• Estrace^® Tablets (estradiol)¶
• Estratab^® (esterified estrogens)¶
• Evex^® (esterified estrogens)¶
• Femogen^® (esterified estrogens)¶
• Menest^® (esterified estrogens)¶
• Ogen 5^® Tablets (estropipate)
• Ortho-est^® (estropipate)¶
• Premarin^® Tablets (conjugated estrogens)
• Essian^® (as a combination product containing Esterified Estrogens, Methyltestosterone)
• Femtest^® (as a combination product containing Esterified Estrogens, Methyltestosterone)
• Menrium^® (as a combination product containing Chlordiazepoxide, Esterified Estrogens)¶
• Milprem^® (as a combination product containing Conjugated Estrogens, Meprobamate)¶
• PMB^® (as a combination product containing Conjugated Estrogens, Meprobamate)¶
• Premarin^® with Methyltestosterone (as a combination product containing Conjugated Estrogens, Methyltestosterone); also available generically

Other Name(s):

• conjugated estrogens
• esterified estrogens
• estradiol
• estropipate

IMPORTANT WARNING:

Estrogen increases the risk that you will develop endometrial cancer (cancer of the lining of the uterus [womb]). The longer you take estrogen, the greater the risk that you will develop endometrial cancer. If you have not had a hysterectomy (surgery to remove the uterus), you should be given another medication called a progestin to take with estrogen. This may decrease your risk of developing endometrial cancer, but may increase your risk of developing certain other health problems, including breast cancer. Before you begin taking estrogen, tell your doctor if you have or have ever had cancer and if you have unusual vaginal bleeding. Call your doctor immediately if you have abnormal or unusual vaginal bleeding during your treatment with estrogen. Your doctor will watch you closely to help ensure you do not develop endometrial cancer during or after your treatment.

Talk to your doctor regularly about the risks and benefits of taking estrogen.

WHY is this medicine prescribed?

Estrogen may be used for the following:

• to treat hot flushes ('hot flashes'; sudden strong feelings of heat and sweating) in women who are experiencing menopause ('change of life', the end of monthly menstrual periods)
• to treat vaginal dryness, itching, or burning
• to prevent osteoporosis (a condition in which the bones become thin and weak and break easily) in women who are experiencing or have experienced menopause
• to relieve symptoms of low estrogen in young women who do not produce enough estrogen naturally
• to relieve the symptoms of certain types of breast and prostate (a male reproductive gland) cancer

Estrogen is in a class of medications called hormones. It works by replacing estrogen that is normally produced by the body.

HOW should this medicine be used?

Estrogen comes as a tablet to take by mouth. Take with or without food once a day. It is sometimes taken every day and sometimes taken according to a rotating schedule that alternates a period of time when estrogen is taken every day with a period of time when estrogen is not taken. When used to relieve the symptoms of cancer, it is taken three times a day. Take estrogen at around the same time(s) every day.

Take estrogen exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of estrogen and gradually increase your dose if your symptoms are still bothersome, or decrease your dose if your symptoms are well-controlled. Talk to your doctor about how well estrogen works for you.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Are there OTHER USES for this medication?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before taking estrogen,

• tell your doctor or pharmacist if you are allergic to this medication, any part of this medication, or any other medications, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take while taking estrogen. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• the following herbal product may interact with estrogen: St. John's wort. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking estrogen. Do not start any of these medications while taking estrogen without discussing with your healthcare provider.
• tell your doctor if you have or have ever had yellowing of the skin or eyes during pregnancy or during your treatment with an estrogen product, endometriosis (a condition in which the type of tissue that lines the uterus [womb] grows in other areas of the body), uterine fibroids (growths in the uterus that are not cancer), asthma, migraine headaches, seizures, porphyria (condition in which abnormal substances build up in the blood and cause problems with the skin or nervous system), very high or very low levels of calcium in your blood, history of heart attack or stroke or blood clots in extremities or lungs, cancer, high blood pressure, elevated triglycerides, hereditary angioedema (rare genetic disorder that causes recurrent severe swelling in various parts of the body), bleeding disorders, or thyroid, liver, kidney, gallbladder, or pancreatic disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking estrogen, call your doctor immediately. Estrogen may harm the fetus.
• talk to your doctor about the risks and benefits of taking estrogen if you are 65 years of age or older. Older women should not usually take oral estrogen unless they are also taking other hormones. Oral estrogen taken without other hormones is not as safe or effective as other medications that can be used to treat the same condition.
• if you are taking estrogen to prevent osteoporosis, talk to your doctor about other ways to prevent the disease such as exercising and taking vitamin D and/or calcium supplements.

What SPECIAL DIETARY instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

Talk to your doctor about ways to increase the amount of calcium and vitamin D in your diet, especially if you are taking estrogen to prevent osteoporosis.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Estrogen may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• breast pain or tenderness
• belly pain, upset stomach, gas, vomiting
• weight gain or loss
• leg cramps
• dizziness
• burning or tingling in the arms or legs
• swelling, redness, burning, itching, or irritation of the vagina
• vaginal discharge
• change in sexual desire

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• sudden swelling or pain in arms or legs
• chest pain, shortness of breath, coughing up blood
• face drooping, speech difficulty, severe headache, arm weakness, vision changes, dizziness, confusion, numbness, difficulty walking
• chest pain, arm pain, sweating, heartburn or indigestion
• breast lumps
• bulging eyes or double vision, migraine, sudden loss of vision
• loss of appetite, belly pain, yellowing of the skin or eyes
• hives, skin rash itching, difficulty breathing or swallowing, or swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• abdominal pain or tenderness, pain after eating, heartburn or indigestion, gas
• swelling of arms or legs
• tiredness, weight gain, changes in mood, dizziness, hair loss, constipation

Estrogen may increase your risk of developing cancer of the ovaries or gallbladder disease that may need to be treated with surgery. Talk to your doctor about the risks of taking estrogen.

Estrogen may cause growth to slow or stop early in children who take large doses for a long time. Estrogen may also affect the timing and speed of sexual development in children. Your child's doctor will monitor him or her carefully during his or her treatment with estrogen. Talk to your child's doctor about the risks of giving this medication to your child.

Estrogen may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at http://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• upset stomach
• vomiting
• vaginal bleeding

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location - one that is up and away and out of their sight and reach. http://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website http://goo.gl/c4Rm4p for more information.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking estrogen.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

^¶ This branded product is no longer on the market. Generic alternatives may be available.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™ Copyright, 2026. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: May 15, 2026.