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Precautions and Warnings With Estradiol Cypionate

Specific Precautions and Warnings With Estradiol Cypionate

Some of the warnings and precautions to be aware of prior to using estradiol cypionate include the following:
  • For women who still have a uterus (who have not had a hysterectomy), taking estradiol cypionate alone (without a progestin) increases the risk of endometrial cancer (cancer of the lining of the uterus). Women who still have a uterus should take estradiol cypionate with a progestin medication.
  • Let your healthcare provider know if you have abnormal vaginal bleeding (such as very heavy bleeding or bleeding between periods) while taking estradiol cypionate, as this may be a sign of precancerous or cancerous changes in the uterus. Your healthcare provider can perform the necessary tests to rule out cancer.
  • Estrogen drugs (such as estradiol cypionate) used with or without a progestin may increase the risk of breast cancer. Proper screening and monitoring (as determined by your healthcare provider), such as yearly mammograms and monthly breast self-exams, are recommended.
  • Estrogens (such as estradiol cypionate) should never be used to prevent heart disease (see Hormone Replacement Therapy and Heart Health for more information), as they are not effective for this use.
  • Studies have shown that estrogen hormone replacement therapy (such as estradiol cypionate) increases the risk of strokes and blood clots in the legs.
  • Before you take estradiol cypionate, your healthcare provider should make sure that you are appropriately treated for any risk factors for blood clots or heart disease (such as high blood pressure, high cholesterol, diabetes, obesity, or smoking). When possible, estradiol cypionate should be stopped four to six weeks before many surgeries, in order to help prevent blood clots.
  • Estrogen drugs (such as estradiol cypionate) used with or without a progestin seem to increase the risk of dementia. In no case should estradiol cypionate be used to prevent or treat dementia (it is not effective for this use).
  • Estradiol cypionate may worsen epilepsy, porphyria, asthma, diabetes, migraine headaches, lupus, and hepatic hemangiomas.
  • Women who take estrogen (such as estradiol cypionate) have an increased risk for gallbladder disease.
  • Let your healthcare provider know right away if you notice any vision changes. This can signal a blood clot in the retina, a possible side effect of estradiol cypionate.
  • Estradiol cypionate can cause high blood pressure (hypertension) or high triglycerides in some women. Your healthcare provider should monitor you for these problems.
  • If you have had jaundice (yellowing of the whites of the eyes or skin) due to estrogens or pregnancy in the past, it is possible that estradiol cypionate will cause similar problems to recur. If this happens, your healthcare provider will probably advise you to stop taking estradiol cypionate.
  • If you have an underactive thyroid (hypothyroidism), estradiol cypionate may increase your body's requirement for thyroid hormones. Your healthcare provider should monitor you and adjust the dose of your thyroid medications as necessary.
  • Estradiol cypionate can cause fluid retention. This can cause problems for people with congestive heart failure (CHF) or kidney problems.
  • Estradiol cypionate should be used with caution in people who have low calcium levels in the blood (known medically as hypocalcemia).
  • It is not clear if estradiol cypionate increases the risk of ovarian cancer. Some studies have shown an increased risk, while others have not.
  • Estradiol cypionate can make endometriosis symptoms worse.
  • Estradiol cypionate can interact with a number of different medications (see Drug Interactions With Estradiol Cypionate for more information).
  • Estradiol cypionate should not be used during pregnancy (see Depo-Estradiol and Pregnancy).
  • Estradiol cypionate does pass through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see Depo-Estradiol and Breastfeeding).
  • Estradiol cypionate contains chlorobutanol, an inactive ingredient that can be habit forming.
Last reviewed by: Kristi Monson, PharmD
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