Are There Any Potential Serious Side Effects Associated with the Use of Estrogen Products ?

Estrogen containing products have been associated with   serious side effects, including:


  • BOXED WARNING: Estrogen-based products have an FDA boxed warning regarding endometrial cancer, cardiovascular events, and dementia.
  • High Blood Pressure: Some patients taking oral estrogen have a spike in their blood pressure.
  • High Triglycerides: Oral estrogen can increase triglycerides in people with high triglycerides.
  • Liver Disease: Patients with liver disease may have trouble handling oral estrogen metabolism. Again, it is good to be aware of this information.
  • Hypothyroidism: Patients on thyroid replacement therapy may require higher doses of medication to treat their hypothyroidism if they take oral estrogen.
  • Retaining Fluid: Estrogen can increase fluid retention and should be used with caution in patients with conditions where this could cause problems, like heart failure and kidney failure.
  • Worsening of Endometriosis: There have been cases of women with endometriosis who have had a hysterectomy but have residual endometrial tissue in their pelvis. Tell your gynecologist that you are using estrogen vaginal cream as a precaution.
  • Oral estrogen therapy has been known to make some of the following conditions worse: Asthma, diabetes, epilepsy, migraines, lupus (SLE), porphyria, or abnormal liver blood vessels called hemangiomas.


Low dose vaginal estradiol is minimally absorbed in comparison to oral estrogen, and studies show that there is a much lower risk of side effects with low dose vaginal estradiol than with oral estrogen, aside from local skin irritation. A recent 18-year study that examined “the associations between vaginal estrogen use and multiple health outcomes including cardiovascular disease (total myocardial infarction, stroke, and pulmonary embolism/deep vein thrombosis), cancer (total invasive, breast, endometrial, ovarian, and colorectal cancer), and hip fracture,” concluded the following:


“Vaginal estrogen use was not associated with a higher risk of cardiovascular disease or cancer. Our findings lend support to the safety of vaginal estrogen use, a highly effective treatment for genitourinary syndrome of menopause.”


These are not all of the potential side effects associated with vaginal estradiol. For additional information regarding the safety of vaginal estradiol, including contraindications and the FDA boxed warning on estrogen-based products, please see important safety information.

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