Category:

• Hormonal

Description:

• Estrogen and Androgen combination hormone replacement

• Estratest: 1.25mg esterified estrogens, 2.5mg methyltestosterone

• Estratest H.S.: 0.625mg esterified estrogens, 1.25mg methyltestosterone

Indications:

• Menopausal vasomotor symptoms (hot flashes, etc.)

• Postpartum breast engorgement

Contraindications:

• Known or suspected breast cancer (except those being treated for metastatic disease)

• Known or suspected estrogen-dependent neoplasia

• Known or suspected pregnancy

• Undiagnosed abnormal genital bleeding

• Current or history of thrombophlebitis, thrombosis, thromboembolic disorders (except when used in breast or prostatic cancer treatment).

Precautions:

• Pregnancy category X

• Use with caution in nursing mothers and patients with hypertension, diabetes, asthma, epilepsy, migraine, cardiac or renal dysfunction, history of depression, pre-existing uterine leiomyotoma, history of jaundice during pregnancy, impaired liver function, metabolic bone disorders and in young women (and men).

• Take with food to avoid GI side effects.

• May decrease glucose intolerance in diabetic patients.

• Discontinue therapy and contact health care provider if pregnancy is suspected.

• Rule out breast cancer prior to initiating treatment.

• May cause irreversible androgenic effects (hirsutism, decreased breast size, deepening of voice, clitoral hypertrophy)

Adverse Reactions (Side Effects):

• Rash, acne, alopecia, nausea

• Abnormal menstrual bleeding, changes in cervical secretions

• Edema, weight change

• Depression, insomnia, somnolence

• Androgenic: acne, oily kin/hair, weight gain, mild hirsutism, decreased breast size, deepening of voice, clitoral hypertrophy, testicular hypotrophy

• Hypoestrogenic: flushing, sweating, vaginitis, nervousness, emotional disorders

• Hepatic dysfunction

• CNS: dizziness, headache, sleep disorders, fatigue

• Muscle cramps, joint pain and swelling

Dosage:

• Administered orally

• Menopausal vasomotor symptoms: 1 tablet per day

• Postpartum breast engorgement: 1 tablet per day for 5 days

For more information on the use of conjugated estrogens and methyltestosterone, read:

• Menopause, in Operational Obstetrics & Gyencology

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001