Female hypogonadism, Breast Cancer

Prolonged and continous use predisposes to endometrial hyperplasia and malinancy.
Thrombosis, hypertension, liver tumors. Ca breast.

Nausea, vomiting, disturbance of menstrual
cycle,fluid  retension, discomfort in breast,

weight gain, increased appetite, increased tendency for vaginal candidiasis,
mental depression, alteration in libido,
rashes, alopecia, hirsutism,gynaecomastia and impotence.

Uterine,liver & mammary carcinoma,thromboembolic disorders. Pregnancy, undiagnosed
vaginal bleeding.

Special precautions:
H/O cholestatic jaundice,impaired liver function CVS disease.
 

Female hypogonadism, Breast Cancer

Dosage:
Usual dosage range is  0.02 to 1.5mg/day. The effective dose may be as low as  0.02mg
every other day.
 

1. Patient information is available with products

2. Diabetic patients- Notify physician if any of the following occur. Pain in the groin or calves of the leg,   sharp chest pain,or sudden shortness of breath, abnormal vaginal bleeding, missed menstrual     period or suspected pregnancy lumps in the breast, sudden severe headache, dizziness or fainting,   vision or speech disturbance,weakness  or numbness in the arm or leg, severe abdominal pain,  yellowing of the skin or eyes, severe depression

3. May cause photosensitivity (sensitivity to sunlight). Avoid prolonged exposure to the sun and other   ultraviolet light.
   Use sunscreens and wear protective clothing until tolerance is determined

Pharmacology:

Although six different natural estrogens have been isolated from the human female, only three are  present insignificant quantities - Estradiol, estrone, and estriol. The most potent secretory product of  the ovary, estradiol is rapidly  oxidised to estrone. Hydration of estrone produces the much weaker   estriol.  The estrogenic potency of estradiol is 12 times
  estrones and 80 times estriols

Pharmacokinetics:

Absorptrion of most natural estrogens and their derivatives from the GI tract is complete. The limited  oral effectiveness of natural estrogens and their esters is due to their metabolism. About 80% of  estradiol is bound to sex hormone binding globulin, most of the rest is loosely bound to albumin and about 2% is unbound. Estrone is highly bound to protein as it circulates in the blood primarily as a conjugate with sulfate.