There are no restrictions on food, beverages, or activity while taking conjugated estrogens unless your doctor directs otherwise. Estrogens should not be given to pregnant women due to the risk of harm to the fetus. Estrogens are secreted in breast milk and cause unpredictable effects in the infant. They should not be taken by women who are breast-feeding.

Safety information

The most common side effects of conjugated estrogens are headache, nausea, back pain, joint pain and vaginal bleeding. Patients may also experience vaginal spotting, loss of periods or excessively prolonged periods, breast pain, breast enlargement and an increase or decrease in sexual drive. Effects of estrogen on the skin include rash, and melasma (tan or brown patches) that may develop on the forehead, cheeks, or temples and may persist even after estrogens are stopped. In the eyes, conjugated estrogens may cause an increase in the curvature of the cornea, and patients with contact lenses may develop intolerance to their lenses.

There is an increased risk of cholesterol gallstones among men and women taking estrogens. Estrogens can inhibit the flow of bile from the liver (cholestasis) and uncommonly cause jaundice.

• Conjugated estrogens increase 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 conjugated estrogens 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 conjugated estrogens may increase the risk of heart attack, stroke, breast cancer, and blood clots in the lungs or legs. Because of these risks, conjugated estrogens should be prescribed at the lowest effective dose, for the shortest amount of time necessary.
• If you experience any of the following serious side effects, stop taking conjugated estrogens and seek emergency medical attention:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  • shortness or breath or pain in the chest;
  • a painful, red, or swollen leg;
  • abnormal vaginal bleeding;
  • pain, swelling, or tenderness in the abdomen;
  • severe headache or vomiting, dizziness, faintness or changes in vision or speech;
  • yellowing of the skin or eyes; or
  • a lump in a breast.
• Other, less serious side effects may be more likely to occur. Continue to take conjugated estrogens and talk to your doctor if you experience
  • decreased appetite, nausea, or vomiting;
  • swollen or tender breasts;
  • acne or skin color changes;
  • decreased sex drive;
  • migraine headaches or dizziness;
  • water retention (swollen hands, feet, or ankles);
  • problems with wearing contact lenses;
  • depression; or
  • changes in menstrual cycle or breakthrough bleeding.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.