Applies to conjugated estrogens topical: vaginal cream.

Serious side effects

Along with its needed effects, conjugated estrogens topical may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking conjugated estrogens topical:

More common

• Breast pain
• change in vaginal discharge
• cough or hoarseness
• fever or chills
• increased clear or white vaginal discharge
• itching of the vagina or genital area
• lower back or side pain
• pain during sexual intercourse
• pain or feeling of pressure in the pelvis
• painful or difficult urination
• thick, white vaginal discharge with no odor or with a mild odor
• vaginal bleeding

Less common

• Feeling faint, dizzy, or lightheaded
• feeling of warmth or heat
• flushing or redness of the skin, especially on the face and neck
• headache
• sweating

Incidence not known

• Abdominal or stomach bloating
• abnormal uterine bleeding or spotting
• acne
• anxiety
• bloody or cloudy urine
• breast tenderness, enlargement, pain, or discharge
• chest pain or discomfort
• decreased vision or other changes in vision
• difficulty with swallowing
• enlargement of the penis or testes
• fast heartbeat
• frequent urge to urinate
• growth of pubic hair
• hives
• itching
• itching of the vagina or outside genitals
• nausea
• pain during sexual intercourse
• pain or discomfort in the arms, jaw, back, or neck
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• rapid increase in height
• shortness of breath
• stomach pain
• sudden shortness of breath or troubled breathing
• sweating
• tightness in the chest
• unusual tiredness or weakness
• vomiting
• wheezing

Other side effects

Some side effects of conjugated estrogens topical may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Abdominal or stomach pain
• back pain
• diarrhea
• headache
• lack or loss of strength

Less common

• Body aches or pain
• congestion
• increased dryness or soreness of the throat
• runny nose
• tender, swollen glands in the neck
• trouble with swallowing
• voice changes

Incidence not known

• Abdominal or stomach cramps
• changes in weight
• decreased or increased interest in sexual intercourse
• depression
• difficulty with moving
• headache, severe and throbbing
• heavy bleeding
• inability to have or keep an erection
• increased hair growth, especially on the face
• irritability
• itching of the vagina or genitals
• leg cramps
• loss of scalp hair
• loss or increase in sexual ability, desire, drive, or performance
• mood changes
• muscle pain or stiffness
• nervousness
• pain
• pain in the joints
• patchy brown or dark brown discoloration of the skin
• poor insight and judgment
• problems with memory or speech
• swelling of the breasts or breast soreness in both females and males
• trouble recognizing objects
• trouble thinking and planning
• weakness

For Healthcare Professionals

Applies to conjugated estrogens topical: vaginal cream with applicator.

Genitourinary

Common (1% to 10%): Breast pain, leukorrhea, dysuria, vaginal hemorrhage, vaginal moniliasis, vaginitis, vulvovaginal disorder

Uncommon (0.1% to 1%): Breast enlargement, urinary urgency

Postmarketing reports: Abnormal uterine bleeding or spotting, dysmenorrhea or pelvic pain, increase in size of uterine leiomyomata, change in cervical secretion, cystitis-like syndrome, application site reactions of vulvovaginal discomfort (including burning, irritation, and genital pruritus), endometrial hyperplasia, endometrial cancer, precocious puberty, breast tenderness, breast discharge, fibrocystic breast changes, breast cancer, gynecomastia in males^[Ref]

Cardiovascular

Common (1% to 10%): Vasodilation

Postmarketing reports: Deep vein thrombosis, myocardial infarction, increase in blood pressure^[Ref]

Nervous system

Common (1% to 10%): Headache

Uncommon (0.1% to 1%): Dizziness

Postmarketing reports: Stroke, migraine, dementia^[Ref]

Gastrointestinal

Postmarketing reports: Nausea, vomiting, abdominal cramps, bloating^[Ref]

Dermatologic

Common (1% to 10%): Acne, pruritus

Postmarketing reports: Chloasma that may persist when drug is discontinued, loss of scalp hair, hirsutism, rash^[Ref]

Other

Common (1% to 10%): Moniliasis, pain

Postmarketing reports: Increase or decrease in weight, edema^[Ref]

Psychiatric

Postmarketing reports: Mental depression, mood disturbances, nervousness, irritability, changes in libido^[Ref]

Respiratory

Postmarketing reports: Pulmonary embolism, exacerbation of asthma^[Ref]

Musculoskeletal

Common (1% to 10%): Muscle cramp

Postmarketing reports: Arthralgias, leg cramps^[Ref]

Hypersensitivity

Postmarketing reports: Hypersensitivity^[Ref]

Hepatic

Postmarketing reports: Increased incidence of gallbladder disease^[Ref]

Metabolic

Postmarketing reports: Glucose intolerance, increased triglycerides^[Ref]

Ocular

Postmarketing reports: Retinal vascular thrombosis, intolerance to contact lenses^[Ref]