Estrogens, Esterified(ess’ troe jenz)
Menest
PREGNANCY CATEGORY X
Drug Classes
Estrogen
Hormone
Therapeutic Actions
Estrogens are endogenous hormones important in the development of the female reproductive system and secondary sex characteristics. They cause capillary dilatation, fluid retention, protein anabolism, and thin cervical mucus; conserve calcium and phosphorus and encourage bone formation; inhibit ovulation and prevent postpartum breast discomfort. They are responsible for the proliferation of the endometrium; absence or decline of estrogen produces signs and symptoms of
menopause on the uterus, vagina, breasts, cervix. Palliation with androgen-dependent prostatic carcinoma is attributable to competition for androgen receptor sites, decreasing the influence of androgens.
menopause on the uterus, vagina, breasts, cervix. Palliation with androgen-dependent prostatic carcinoma is attributable to competition for androgen receptor sites, decreasing the influence of androgens.
Indications
Palliation of moderate to severe vasomotor symptoms, atrophic vaginitis, or kraurosis vulvae associated with menopause
Treatment of female hypogonadism; female castration; primary ovarian failure
Palliation of inoperable prostatic cancer
Palliation of inoperable, metastatic breast cancer in men, postmenopausal women
Contraindications and Cautions
Contraindicated with allergy to estrogens, breast cancer (with exceptions), estrogen-dependent neoplasm, undiagnosed abnormal genital bleeding, active or past thrombophlebitis or thromboembolic disorders from previous estrogen use, pregnancy (serious fetal defects; women of childbearing age should be advised of the risks and birth control measures suggested).
Use cautiously with metabolic bone disease, renal or hepatic insufficiency, heart failure, lactation.
Available Forms
Tablets—0.3, 0.625, 1.25, 2.5 mg
Dosages
Administer PO only.
Adults
Moderate to severe vasomotor symptoms, atrophic vaginitis, kraurosis vulvae associated with menopause: 0.3–1.25 mg/day PO for atrophic vaginitis and kraurosis vulvae. 1.25 mg/day PO for vasomotor symptoms. Adjust to lowest effective dose. Cyclic therapy (3 wk of daily estrogen followed by 1 wk of rest from drug therapy) is recommended. If patient has not menstruated in 2 mo, start at any time. If patient is still menstruating, start therapy on day 5 of bleeding.
Female hypogonadism: 2.5–7.5 mg/day PO in divided doses for 20 days on/10 days off. If bleeding does not occur by the end of that period, repeat the same dosage schedule. If bleeding does occur before the end of the 10-day rest, begin a 20-day estrogen–progestin cyclic regimen with progestin given orally during the last 5 days of estrogen therapy. If bleeding occurs before this cycle is finished, restart course on day 5 of bleeding.
Female castration, primary ovarian failure: 1.25 mg/day PO cyclically. Adjust dosage by patient response to lowest effective dose.
Prostatic cancer (inoperable): 1.25–2.5 mg tid PO. In long-term therapy, judge effectiveness by symptomatic response and serum phosphatase determinations.
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