What is the most important information I should know about Estrace?

• Estrace increases the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, another hormone drug, with Estrace lowers the risk of developing this condition. Therefore, if your uterus has not been removed, your doctor may prescribe a progestin for you to take together with the estrogen. Visit your doctor regularly and report any unusual vaginal bleeding right away.
• Treatment with Estrace long-term may increase the risk of stroke. Because of this risk, you should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking Estrace long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.
• The Women's Health Initiative (WHI) study reported increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50-79 years of age) during 5 years of treatment with oral conjugated estrogens combined with medroxyprogesterone acetate.
• The Women's Health Initiative Memory Study (WHIMS) found that postmenopausal women 65 years of age or older who were treated with oral conjugated estrogens plus medroxyprogesterone acetate had an increased risk of developing dementia. It is unknown whether this finding applies to younger postmenopausal women or to women using estrogen only therapy.
• Have yearly physical exams and examine your breasts for lumps on a monthly basis while taking Estrace.
• Do not take Estrace if you are pregnant.

What is Estrace?

• Estrace is a form of estrogen. Estrogen is a female sex hormone necessary for many processes in the body.
• Estrace is used to treat symptoms of menopause such as hot flashes and dryness, burning, and irritation in the vaginal area; deficiency in ovary function (including underdevelopment of female sexual characteristics and some types of infertility); Turner's syndrome; some types of breast cancer in men and in postmenopausal women; degeneration of the vagina and urethra; and prostate cancer. In addition, Estrace is used to prevent osteoporosis.
• Estrace may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking Estrace?

• Do not take Estrace without first talking to your doctor if you have
  • a circulation, bleeding, or blood-clotting disorder;
  • undiagnosed, abnormal vaginal bleeding; or
  • any type of breast, uterine, or hormone-dependent cancer.
• Taking Estrace may not be recommended in some cases if you have any of the conditions listed above.
• Before taking Estrace, tell your doctor if you have
  • high blood pressure, angina, or heart disease;
  • a history of stroke or heart attack;
  • high levels of cholesterol or triglycerides in the blood;
  • liver disease;
  • kidney disease;
  • asthma;
  • epilepsy;
  • migraines;
  • diabetes;
  • depression;
  • gallbladder disease;
  • uterine fibroids; or
  • had a hysterectomy (uterus removed).
• You may not be able to take Estrace, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• The Women's Health Initiative (WHI) study reported increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50-79 years of age) during 5 years of treatment with oral conjugated estrogens combined with medroxyprogesterone acetate.
• The Women's Health Initiative Memory Study (WHIMS) found that postmenopausal women 65 years of age or older who were treated with oral conjugated estrogens plus medroxyprogesterone acetate had an increased risk of developing dementia. It is unknown whether this finding applies to younger postmenopausal women or to women using estrogen only therapy.
• Treatment with Estrace long-term may increase the risk of stroke. Because of this risk, you should contact your doctor or healthcare provider to discuss your individual risks and benefits before taking Estrace long-term. You should also talk to your doctor or healthcare provider on a regular basis (for example, every 3-6 months) about whether you should continue this treatment.
• Estrace is in the FDA pregnancy category X. This means that Estrace is known to cause birth defects in an unborn baby. Do not take this medication if you are pregnant or could become pregnant during treatment.
• Estrace may decrease milk flow and have other effects on milk composition. Do not use this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take Estrace?

• Take this medication exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
• Estrace may be administered by mouth, injection, or inserted into the vagina. Your healthcare provider may administer injections of Estrace or will provide you with detailed instructions on how