Estrogen is a female sex hormone produced by the ovaries. Estrogen is necessary for many processes in the body.

Esterified estrogens are a man-made mixture of estrogens that are used to treat symptoms of menopause such as hot flashes, vaginal dryness, vaginal burning or irritation, or other hormonal changes in the vagina.

This medicine is also used to replace estrogen in women with ovarian failure or other conditions that cause a lack of natural estrogen in the body.

In some cases, esterified estrogens is used to treat symptoms of breast cancer in men and women. Esterified estrogens is also used in men to treat symptoms of advanced prostate cancer. Esterified estrogens treats only the symptoms of cancer but does not treat the cancer itself.

Esterified estrogens may also be used for purposes not listed in this medication guide.

This medicine can harm an unborn baby or cause birth defects. Do not use if you are pregnant, and tell your doctor right away if you become pregnant.

You should not use esterified estrogens if you are allergic to it, if you are pregnant, or if you have:

• unusual vaginal bleeding that a doctor has not checked;
• a bleeding or blood-clotting disorder;
• breast cancer (unless you are taking esterified estrogens to treat breast cancer symptoms);
• a history of hormone-dependent cancer (such as breast, uterine, ovarian, or thyroid cancer); or
• a history of blood clots caused by taking birth control pills or hormone replacement medicine.

Taking this medicine can increase your risk of blood clots, stroke, or heart attack, especially if you have certain other conditions.

To make sure esterified estrogens is safe for you, tell your doctor if you have:

• heart disease (coronary artery disease, chest pain, history of heart attack, stroke, or blood clot);
• gallbladder disease;
• a history of depression;
• liver disease;
• a history of fibrocystic breast disease, lumps, nodules, or an abnormal mammogram;
• a family history of breast cancer;
• diabetes;
• kidney disease;
• epilepsy;
• migraines;
• a history of jaundice caused by pregnancy or birth control pills;
• if you have had your uterus removed (hysterectomy);
• if you are pregnant or plan to become pregnant;
• if you have had a heart attack or stroke; or
• if you have ever had a blood clot (especially in your lung or your lower body).

The hormones in esterified estrogens can pass into breast milk and may harm a nursing baby. This medicine may also slow breast milk production. Do not use if you are breast feeding a baby.

Use Esterified Estrogens (Menest) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using esterified estrogens and call your doctor at once if you have:

• signs of a stroke--sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;
• signs of a blood clot in the lung--chest pain, sudden cough, wheezing, rapid breathing, coughing up blood;
• signs of a blood clot in your leg--pain, swelling, warmth, or redness in one or both legs;
• heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
• liver problems--severe stomach pain, fever, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• high levels of calcium in your blood--nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, confusion, lack of energy, or tired feeling;
• a change in the pattern or severity of migraine headaches;
• swelling in your hands, ankles, or feet;
• a breast lump; or
• severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

• light vaginal bleeding or spotting;
• breast pain or tenderness;
• nausea, vomiting, bloating;
• skin color changes, increased facial hair, thinning scalp hair;
• headache, dizziness, mood changes, decreased sex drive;
• vaginal itching or discharge, very light menstrual periods; or
• problems with contact lenses.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Follow your doctor's instructions about any restrictions on food, beverages, or activity.