Drug Uses

Use Estrandiol to reduce moderate to severe menopausal symptoms, to treat vulval and vaginal atrophy, treat certain cancers in special situations and prevent the thinning of bones.

How Taken

Talk to your local physician or pharmacist. You and your doctor should reevaluate whether or not you still need estrogens at least every six months.

Warnings/Precautions

If you think you may be pregnant, do not use any form of estrogen-containing drug. Using Estrandiol while you are pregnant may cause your unborn child to have birth defects. Estrandiol does not prevent miscarriage.

Missed Dose

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Possible Side Effects

The following side effects have been reported with use of this medicine: nausea and vomiting; breast tenderness or enlargement; enlargement of benign tumors; retention of excess fluid (this may make some conditions worsen, such as asthma, epilepsy, migraine, heart disease, or kidney disease); a spotty darken of the skin, particularly on the face.

Storage

Store at controlled room temperature 15°C to 30°C (59°F to 86°F). Keep this and all drugs out of the reach of children.

Overdose

In case of overdose, call your doctor, hospital or poison control center immediately.

More Information

You are cautioned to discuss very carefully with your doctor or health care provider all the possible risks and benefits of long-term estrogen and progestin treatment as they affect you personally.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.

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Menopause is the transition period in a woman's life when her ovaries stop producing eggs, her body produces less estrogen and progesterone, and menstruation becomes less frequent, eventually stopping altogether.
Causes, incidence, and risk factors
Menopause is a natural event that normally occurs between the ages of 45 and 55.
Once menopause is complete (called postmenopause), you can no longer become pregnant.
The symptoms of menopause are caused by changes in estrogen and progesterone levels. As the ovaries become less functional, they produce less of these hormones and the body responds accordingly. The specific symptoms you experience and how significant (mild, moderate, or severe) varies from woman to woman.
In some women, menstrual flow comes to a sudden halt. More commonly, it tapers off. During this time, your menstrual periods generally become either more closely or more widely spaced. This irregularity may last for 1 to 3 years before menstruation finally ends completely.
A gradual decrease of estrogen generally allows your body to slowly adjust to the hormonal changes. When estrogen drops suddenly, as is seen when the ovaries are removed surgically (called surgical menopause), symptoms can be more severe.
Because hormone levels fall, changes occur in the entire female reproductive system. The vaginal walls become less elastic and thinner. The vagina becomes shorter. Lubricating secretions from the vagina become watery. The outside genital tissue decreases. This is called atrophy of the labia.
Symptoms
The potential symptoms include:
* Hot flashes and skin flushing
* Night sweats
* Insomnia
* Mood swings including irritability, depression, and anxiety
* Irregular menstrual periods
* Spotting of blood in between periods
* Vaginal dryness and painful sexual intercourse
* Decreased sex drive
* Vaginal infections
* Urinary tract infections
In addition, the long-term effects of menopause include:
*
Bone loss and eventual osteoporosis
*
Changes in cholesterol levels and greater risk of heart disease

Signs and tests
Blood and urine tests can be used to measure hormone levels that may indicate when a woman is close to menopause or has already gone through menopause. Examples of these tests include:
* Estradiol
* FSH
* LH
A pelvic exam may indicate changes in the vaginal lining caused by changes in estrogen levels. A bone density test may be performed to screen for low bone density levels seen with osteoporosis.
Treatment
Menopause is a natural process. It does not require treatment unless the symptoms, such as hot flashes or vaginal dryness, are particularly bothersome.
One big decision you may face is whether or not to take hormones to relieve your symptoms. Discuss this thoroughly with your doctor, weighing your risks against any possible benefits. Pay careful attention to the many options currently available to you that do not involve taking hormones.
If you have a uterus and decide to take estrogen, you must also take progesterone to prevent endometrial cancer (cancer of the lining of the uterus). If you do not have a uterus, progesterone is not necessary.
HORMONE REPLACEMENT THERAPY
For years, hormone replacement therapy (HRT) was the main treatment for menopause symptoms. Many physicians believed that HRT was not only good for reducing menopausal symptoms, but also reduced the risk of heart disease and bone fractures from osteoporosis . However, the results of a major study -- called the Women's Health Initiative -- has led physicians to revise their recommendations.
In fact, this important study was stopped early because the health risks outweighed the health benefits. Women taking the hormones did see some benefits. But they greatly increased their risk for breast cancer, heart attacks, strokes, and blood clots.
If your symptoms are severe, you may still want to consider HRT for short-term use (2-4 years) to reduce vaginal dryness, hot flashes, and other symptoms.
To reduce the risks of estrogen replacement therapy and still gain the benefits of the treatment, your doctor may recommend:
* Using estrogen/progesterone regimens that do not contain the form of progesterone used in the study.
* Using a lower dose of estrogen or a different estrogen preparation (for instance, a vaginal cream rather than a pill).
* Having frequent and regular pelvic exams and Pap smears to detect problems as early as possible.
* Having frequent and regular physical exams, including breast exams and mammograms.
ALTERNATIVES TO HRT
The good news is that you can take many steps to reduce your symptoms without taking hormones:
* Dress lightly and in layers
* Avoid caffeine, alcohol, and spicy foods
* Practice slow, deep breathing whenever a hot flash starts to come on (try taking six breaths per minute)
* See an acupuncturist
* Use relaxation techniques like yoga, tai chi, or meditation
* Eat soy foods
* Remain sexually active to preserve elasticity of your vagina
* Perform Kegel exercises daily to strengthen the muscles of your vagina and pelvis
* Use water-based lubricants during sexual intercourse
There are also some medications available to help with mood swings, hot flashes, and other symptoms. These include low doses of antidepressants such as paroxetine (Paxil), venlafaxine (Effexor), bupropion (Wellbutrin), and fluoxetine (Prozac), or clonidine, which is normally used to control high blood pressure.

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