Esterified Estrogens Brand Name– Menest
What is Esterified Estrogens
Esterified estrogens is a mixture of the sodium salts of the sulfate esters of estrogenic substances found in the urine of pregnant mares.
The primary active estrogen in esterified estrogens is sodium estrone sulfate (roughly 80%), the other major component is sodium equilin sulfate (6 to 15%).
Estrone is one-third less active at the cellular level than estradiol, the principal premenopausal human estrogen.
Esterified estrogens may be produced from natural sources or synthesized. There is no evidence that ‘natural’ estrogens are more or less efficacious or safe than ‘synthetic’ estrogens.
Esterified estrogens are used primarily as hormone replacement therapy (HRT) for moderate to severe vasomotor symptoms, atrophic vaginitis, and vulvar atrophy associated with menopause, and for prevention of osteoporosis.
The drug is also used to treat female hypogonadism and other abnormalities of female gonadotropin dysfunction.
Esterified estrogens products were first FDA-approved in 1977.
Indications
- atrophic vaginitis
- hot flashes
- hypogonadism
- menopause
- oophorectomy
- ovarian failure
- palliative treatment of breast cancer
- prostate cancer
For treatment of moderate to severe vasomotor symptoms (hot flashes) of menopause and/or related genitourinary symptoms including atrophic vaginitis, vulvar atrophy (kraurosis vulvae), whether menopause is natural or surgical (e.g., due to oophorectomy)
Side Effects
- abdominal pain
- acne vulgaris
- alopecia
- amenorrhea
- anaphylactoid reactions
- angioedema
- anxiety
- arthralgia
- biliary obstruction
- breakthrough bleeding
- breast cancer
- breast discharge
- breast enlargement
- candidiasis
- cervical dysplasia
- cervicitis
- cholecystitis
- cholelithiasis
- cholestasis
- colitis
- dementia
- depression
- diplopia
- dysmenorrhea
- edema
- elevated hepatic enzymes
- emotional lability
- endometrial cancer
- endometrial hyperplasia
- erythema multiforme
- erythema nodosum
- fatigue
- fluid retention
- galactorrhea
- gingivitis
- gynecomastia
- headache
- hepatitis
- hirsutism
- hypercalcemia
- hyperglycemia
- hypertension
- hypocalcemia
- impaired cognition
- insomnia
- irritability
- jaundice
- leukorrhea
- libido decrease
- libido increase
- maculopapular rash
- mastalgia
- melasma
- menorrhagia
- migraine
- muscle cramps
- myocardial infarction
- nausea
- new primary malignancy
- ovarian cancer
- pancreatitis
- papilledema
- peliosis hepatis
- pelvic pain
- pruritus
- pulmonary embolism
- retinal thrombosis
- stroke
- teratogenesis
- thromboembolism
- thrombosis
- urinary incontinence
- urticaria
- vaginal bleeding
- vaginal discharge
- vaginitis
- visual impairment
- vomiting
- weight gain
Monitoring Parameters
- pap smear
- pelvic exam
Contraindications
- asthma
- breast cancer
- breast-feeding
- cardiac disease
- cerebrovascular disease
- cervical cancer
- children
- contact lenses
- coronary artery disease
- dementia
- depression
- diabetes mellitus
- endometrial cancer
- endometrial hyperplasia
- endometriosis
- gallbladder disease
- geriatric
- hepatic disease
- hepatocellular cancer
- hereditary angioedema
- history of angioedema
- hypercalcemia
- hypercholesterolemia
- hypertension
- hypertriglyceridemia
- hypocalcemia
- hypoparathyroidism
- hypothyroidism
- infants
- migraine
- myocardial infarction
- new primary malignancy
- obesity
- ovarian cancer
- pancreatitis
- porphyria
- pregnancy
- protein C deficiency
- protein S deficiency
- renal disease
- seizure disorder
- stroke
- surgery
- systemic lupus erythematosus (SLE)
- thromboembolic disease
- thromboembolism
- thrombophlebitis
- thyroid disease
- tobacco smoking
- uterine cancer
- uterine leiomyomata
- vaginal bleeding
- vaginal cancer
- visual disturbance
Interactions
- Acarbose
- Acetaminophen; Propoxyphene
- Albiglutide
- Alogliptin; Metformin
- Alpha-glucosidase Inhibitors
- Amiodarone
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amprenavir
- Anastrozole
- Aprepitant, Fosaprepitant
- Atazanavir
- Atazanavir; Cobicistat
- Azelastine; Fluticasone
- Barbiturates
- Beclomethasone
- Betamethasone
- Bexarotene
- Bosentan
- Bromocriptine
- Budesonide
- Budesonide; Formoterol
- Calcium
- Canagliflozin
- Canagliflozin; Metformin
- Carbamazepine
- Cenobamate
- Chenodiol
- Chloramphenicol
- Ciclesonide
- Cimetidine
- Clarithromycin
- Clobazam
- Conivaptan
- Corticosteroids
- Cortisone
- Cosyntropin
- Cyclosporine
- Danazol
- Dantrolene
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Daratumumab; Hyaluronidase
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deflazacort
- Delavirdine
- Dexamethasone
- Diltiazem
- Dipeptidyl Peptidase-4 Inhibitors
- Dulaglutide
- Duloxetine
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Ertugliflozin
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Ethotoin
- Exemestane
- Exenatide
- Felbamate
- Fludrocortisone
- Flunisolide
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Formoterol; Mometasone
- Fosamprenavir
- Fosphenytoin
- Glipizide; Metformin
- Glyburide; Metformin
- grapefruit juice
- Griseofulvin
- Hemin
- Hyaluronidase
- Hyaluronidase, Recombinant; Immune Globulin
- Hydantoins
- Hydralazine
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrocortisone
- Icosapent ethyl
- Imatinib
- Incretin Mimetics
- Indinavir
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Itraconazole
- Ketoconazole
- Lenalidomide
- Letrozole
- Levothyroxine
- Levothyroxine; Liothyronine (Porcine)
- Levothyroxine; Liothyronine (Synthetic)
- Linagliptin; Metformin
- Liothyronine
- Liraglutide
- Lixisenatide
- Lopinavir; Ritonavir
- Lorlatinib
- Meglitinides
- Melatonin
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methylprednisolone
- Metreleptin
- Metyrapone
- Mifepristone
- Miglitol
- Mineral Oil
- Minoxidil
- Modafinil
- Mometasone
- Nefazodone
- Nelfinavir
- Nevirapine
- Nitroprusside
- Ombitasvir; Paritaprevir; Ritonavir
- Ospemifene
- Oxcarbazepine
- Phentermine; Topiramate
- Phenytoin
- Pramlintide
- Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
- Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
- Prednisolone
- Prednisone
- Propoxyphene
- Raloxifene
- Ribociclib; Letrozole
- Rifamycins
- Ritonavir
- Rituximab; Hyaluronidase
- Ropinirole
- Saquinavir
- Semaglutide
- SGLT2 Inhibitors
- Somatropin, rh-GH
- St. John’s Wort, Hypericum perforatum
- Sulfonylureas
- Tacrine
- Tazemetostat
- Testolactone
- Thiazolidinediones
- Thyroid hormones
- Tipranavir
- Topiramate
- Toremifene
- Trandolapril; Verapamil
- Tranexamic Acid
- Trastuzumab; Hyaluronidase
- Triamcinolone
- Tricyclic antidepressants
- Ursodeoxycholic Acid, Ursodiol
- Valproic Acid, Divalproex Sodium
- Verapamil
- Warfarin
- Zafirlukast
