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Hot flashes, mood swings, weight gain, or
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Common symptoms of menopause may include:

Weight gain

When hormones shift,
metabolism
slows and fat
stores increase.

Hot flashes

Sudden heat surges caused
by
estrogen drops and
hormonal swings.

Intimacy issues

Low libido or vaginal dryness
often
stem from hormonal
imbalance.

Anxiety

Estrogen changes can
heighten worry,
restlessness,
and panic.

Joint pain

Hormone shifts may increase
inflammation and stiffness
in joints.

Skin changes

Declining estrogen can lead
to
dryness, acne, or loss of
elasticity.

Vaginal dryness

Vaginal dryness

Dryness or irritation making
intimacy
uncomfortable
or painful.

Weight gain

When hormones shift,
metabolism
slows and fat
stores increase.

Hot flashes

Sudden heat surges caused
by
estrogen drops and
hormonal swings.

Intimacy issues

Low libido or vaginal dryness
often
stem from hormonal
imbalance.

Anxiety

Estrogen changes can
heighten worry,
restlessness,
and panic.

Joint pain

Hormone shifts may increase
inflammation and stiffness
in joints.

Skin changes

Declining estrogen can lead
to
dryness, acne, or loss of
elasticity.

Vaginal dryness

Dryness or irritation making
intimacy
uncomfortable
or painful.

Fatigue

Low estrogen and thyroid
issues can
leave you drained
all day.

Night sweats

Hormonal dips can trigger
intense
sweating, discomfort
and poor sleep.

Sleep disruptions

Fluctuating hormones
interfere with
deep, restful
sleep.

Mood swings

Irritability or sadness can rise
with
changing estrogen and
progesterone.

Low energy

When hormones are off,
fatigue shows
up no matter
how much you rest.

Brain fog

Hormonal imbalance may dull
memory, focus, and mental
clarity.

Osteoporosis

Low estrogen levels can
weaken
bones as you age.

Fatigue

Low estrogen and thyroid
issues can
leave you drained
all day.

Night sweats

Hormonal dips can trigger
intense
sweating, discomfort
and poor sleep.

Sleep disruptions

Fluctuating hormones
interfere with
deep, restful
sleep.

Mood swings

Irritability or sadness can rise
with
changing estrogen and
progesterone.

Low energy

When hormones are off,
fatigue shows
up no matter
how much you rest.

Brain fog

Hormonal imbalance may dull
memory, focus, and mental
clarity.

Osteoporosis

Low estrogen levels can
weaken
bones as you age.

LifeMD® HRT Essentials
Program for Women

Experience personalized & affordable
care with
all-inclusive pricing, starting
at just $199/mo*

  • Personalized HRT plan

    Every woman’s menopause journey is unique. Your LifeMD-affiliated provider will create a treatment plan tailored to your unique symptoms, goals, and medical history so you receive care that truly fits your needs. No one-size-fits-all approach.

  • Prescription HRT medications

    Access FDA-approved hormone replacement therapies prescribed by licensed clinicians and delivered straight to your door, with ongoing clinical oversight for safety and effectiveness. See FAQs for more details.*

  • Prescription renewal support

    Stay on track without interruptions. LifeMD seamlessly manages your refills and renewals to save you time and ensure your treatment never lapses.

  • Clinical check-ins

    Regular virtual visits with your LifeMD-affiliated provider confirm your therapy is working, allow for adjustments when needed, and ensure your progress is carefully monitored over time.

  • Optional diagnostic labs

    Whether opting for a local lab or using our convenient and optional at-home lab kits, you and your provider can track hormone levels, thyroid function, and other key biomarkers.

  • Unlimited messaging

    Questions don’t follow a schedule, so LifeMD gives you the flexibility to reach out when it matters most. Message your care team anytime for answers or reassurance.

  • Educational tools & resources

    From exclusive articles to practical guides, you’ll have access to expert-created resources — designed to inform and empower you, so you can feel confident in your care.

  • Access to LifeMD+ Urgent & Primary Care

    As a LifeMD member, additionally gain access to convenient and affordable 24/7 urgent and primary care. Talk to a provider within 1 hour (even on nights and weekends) for a low up-front cost — whether it’s pink eye, a sore throat, or something else that can’t wait.

    Experience convenient, affordable, and comprehensive care designed to meet your immediate and long-term health needs, 100% online.

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Board-Certified Doctors

50 States Served

4.9 Star Patient Reviews

745,000 Patients

100% Online Virtual Care

4.8 Star App Rating

4.9 Star Google Play

Board-Certified Doctors

50 States Served

4.9 Star Patient Reviews

745,000 Patients

100% Online Virtual Care

4.8 Star App Rating

4.9 Star Google Play

Take control of your
symptoms with LifeMD.

Own your body’s changes and love how you feel.

90%

Women on HRT felt reduced symptom frequency & intensity by 90% within 1-2 months

Jan Feb March
National Library of Medicine; The NAMS 2022
Hormone Therapy Position Statement

How LifeMD works

Fast, easy, and convenient care

Complete your
hormone quiz

Share your personal experience through our
private health form.

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Book your virtual
consultation

A provider will evaluate your symptoms to
prescribe medication, if appropriate.

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Treatment shipped
to your home

If prescribed, your included medications
will be
shipped to your home for free.

Rush Shipping

Track symptoms and
optimize care

Stay connected with check-ins, medication
updates, and unlimited provider messaging.

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Don’t ignore the signs. You deserve care that
won’t be dismissed.

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Personalized
prescription options
to fit your needs!

Plans includes multiple treatment options,
so your
medication fits your life, not the
other way around.

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Women's health experts online

Transdermal estradiol may not be for everyone. Some side effects may include skin irritation, breast tenderness, or headaches. Vaginal inserts possible side effects may include local irritation, burning, or discharge; systemic effects are rare. Micronized Progesterone possible side effects may include drowsiness, dizziness, bloating, and mood changes. See Important safety information
Find relief

Women's health experts online

Transdermal estradiol side effects may include skin irritation, breast tenderness, or headaches. Vaginal inserts side effects may include local irritation, burning, or discharge. Micronized Progesterone side effects may include drowsiness, dizziness, bloating, and mood changes. See Important safety information
Personalized
Evidence-based
Expert Care
Convenient
Approachable
Transparent
Accessible
Personalized
Evidence-based
Expert Care
Convenient
Approachable
Transparent
Accessible

Real Results. Real Women.

Take control of your
symptoms with LifeMD.

60%

Clinical trials show estrogen reduces the frequency of hot flashes by 77%.

ScienceDirect
70%

Vasomotor symptoms affect up to 80% of midlife women, but only about 1-in-4 receive treatment.

National Library of Medicine
60%

In trials, estradiol patch reduced the frequency of hot flashes by an average of 75%.

National Library of Medicine
60%

73% of women between 40-65 had not received treatment for their symptoms.

National Library of Medicine
†Based on clinical research and patient-reported outcomes
You don’t have to “tough it out” anymore. Start sleeping well,
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Reviews shown are from verified LifeMD patients across various services.

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Why more women choose LifeMD

Benefits
HRT medication included*
No travel or
waiting rooms
In-person office visits
Includes physical exams
Rx treatment home delivery
Nationally
licensed clinicians
Access to 24/7 urgent care
In-Person / Traditional Clinics

Don’t just accept it.

Expert care for your symptoms

Get expert care for your symptoms

  • Menopause

    Relief from shifting
    hormones

  • Perimenopause

    Guidance through
    early changes

  • Hair & Skin

    Care for aging hair
    and skin

  • Sleep Issues

    Get the sleep & rest
    we deserve

  • Weight Loss

    Support to manage
    your weight

  • Sexual Health

    Feel connected and
    confident

  • Mental Health

    Balance mood and
    mental clarity

Meet the experts

You're not alone.
Your health matters.

Our board-certified providers specialize in menopause,
HRT, thyroid, and women’s midlife care. You’ll get expert,
evidence-based treatment tailored to your symptoms —
with ongoing care, nutrition support, coaching and real
relief, all from home.

Meet the experts

You're not alone.
Your health matters.

Our board-certified providers specialize in menopause, HRT, thyroid, and women’s midlife care. You’ll get expert, evidence-based treatment tailored to your symptoms with medication, ongoing care, coaching and real relief... all from home.
Patients
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Patients Across All 50 States Trust
LifeMD To Deliver Personalized
Care And Medication.

Impact
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Star

Based On 11.6K Reviews, The
LifeMD Telehealth App Users
Gave 4.9 Out Of 5 Stars.

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Frequently Asked Questions

  • What is the LifeMD Women's Health Program?

    The LifeMD Women’s Health Program is a personalized, evidence-based approach to hormone replacement therapy (HRT) and lifestyle support for women navigating perimenopause or menopause. The program is designed to help relieve symptoms such as hot flashes, night sweats, brain fog, mood changes, reduced libido, and more — while supporting long-term health and well-being.

    A licensed healthcare provider will create a treatment plan tailored to your needs and goals. Your care will include prescription HRT (when appropriate), secure messaging with your LifeMD care team, regular check-ins to assess your progress, and access to tools that support healthy aging — all from the convenience of your phone or computer. Medications included, if clinically appropriate, are one form of estradiol medication (patch, insert, or gel) and micronized progesterone if needed. The cost of an estradiol vaginal ring may vary and is not included with the program fee.

    Whether you're noticing early changes or have already transitioned through menopause, the LifeMD Women’s Health Program offers flexible, expert-led care built around you.

  • What conditions does the program treat?

    The LifeMD Women's Health Program offers specialized treatment to address common symptoms associated with perimenopause and menopause — including hot flashes, night sweats, brain fog, mood changes, weight shifts, sleep disturbances, and decreased libido.

  • What is HRT?

    Hormone replacement therapy (HRT) is a treatment that replaces the hormones — primarily estrogen and progesterone — that decline in a woman's body during perimenopause and menopause. HRT may help relieve common symptoms such as hot flashes, night sweats, mood changes, and/or vaginal dryness.

  • How do I know if HRT is right for me?

    To determine whether hormone therapy (HRT) is appropriate for you, you'll meet with a licensed healthcare provider who will review your symptoms, your overall health profile, and your preferences regarding treatment. If you're experiencing bothersome symptoms such as hot flashes, night sweats, or mood changes — and your provider determines that HRT is clinically appropriate — it may be recommended as part of your treatment plan.

  • What's included in the LifeMD Women's Health Program?

    The program includes provider consultations, a personalized treatment plan, secure messaging, prescription management, and the cost of medication if prescribed.

    Medications included, if clinically appropriate, are one form of estradiol medication (patch, insert, or gel) and micronized progesterone if needed. The cost of an estradiol vaginal ring may vary and is not included with the program fee.

    It also comes with a LifeMD+ membership, which offers 24/7 access to urgent and primary care, prescription renewals, and a marketplace for clinically validated health and wellness products. You'll also gain access to the 6S Lifestyle Program — designed to support graceful, empowered aging.

  • How is my treatment plan personalized?

    Your treatment plan is tailored to you — your symptoms, medical history, goals, and personal preferences. Your LifeMD-affiliated provider takes all of this into account to make sure your care feels both safe and supportive. We don’t believe in one-size-fits-all solutions; your plan is designed with your unique needs in mind.

  • What medications may be prescribed?

    Medications that may be considered are estradiol, micronized progesterone, and thyroid replacement if necessary. The hormones prescribed through LifeMD are bioidentical, meaning they have the same chemical and molecular structure as the hormones naturally produced by your body. Customized programs may include different strengths, routes and dosing schedules for medications. Your provider will work with you to determine the most appropriate option(s) based on your symptoms, preferences, and medical history.

  • Do I need a video visit to receive treatment?

    Yes. All patients begin with a video consultation to establish care and determine whether treatment with HRT is appropriate. This visit is an important first step — it helps your provider understand your needs and ensures your care starts off on the right foot. After treatment begins, check-ins may happen through video or secure messaging, depending on your progress and your clinical needs.

  • What should I expect during my first appointment?

    During your first video appointment, your LifeMD-affiliated provider will take time to understand your symptoms, medical history, and personal health goals. This initial visit helps build a complete picture of your health and lays the foundation for a treatment plan that’s tailored to you.

  • What happens after I start treatment?

    After you begin treatment, you’ll stay connected with your provider through regular check-ins in the LifeMD patient portal. These updates will help your provider track your progress, address any concerns, and make adjustments to your treatment plan as needed.

  • Who will manage my care at LifeMD?

    You’ll work with a licensed healthcare provider who will design your treatment plan and adjust it as needed based on your symptoms, progress, and goals.

  • How often will my plan be reviewed?

    Your treatment plan will be reviewed through regular check-ins and periodic 20-minute video consultations. These touchpoints give your provider the opportunity to track how you're feeling, understand how well your treatment is working, and make adjustments if needed. You'll share updates on your symptoms, any side effects, and overall progress — helping ensure your care stays aligned with your needs and that you feel supported along the way.

  • Will I be able to message my provider?

    Yes. You'll have secure messaging access through your LifeMD patient portal, so you can stay connected with your provider between visits. Whether you have a quick question or need to share an update, your care team is just a message away.

  • What if I have questions between appointments?

    You can securely message your provider anytime through the LifeMD patient portal with questions or concerns.

  • How do refills work?

    Your LifeMD-affiliated provider will send refill reminders and request check-ins to assess your progress before renewing medications. Most medications are provided in 90-day supplies and are typically renewed based on your provider’s review of your symptoms, side effects, and overall response to treatment.

  • Will my dosage change over time?

    It might. Your provider will monitor your symptoms, response to treatment, and any available lab results as required. If adjustments are needed to maintain effectiveness or minimize side effects, your dosage may be adjusted accordingly.

  • Is everything handled online?

    Yes. With LifeMD, your entire experience — from video visits and secure messaging to prescription management and ongoing care — happens through our easy-to-use online platform. It’s designed to give you convenient, private, and flexible access to expert care.

  • How much does the program cost?

    Plans start at $199 per month when three months are paid upfront. The program includes provider consultations, a personalized treatment plan, secure messaging, prescription management, and the cost of medication if prescribed.

    Medications included, if clinically appropriate, are one form of estradiol medication (patch, insert, or gel) and micronized progesterone if needed. The cost of an estradiol vaginal ring may vary and is not included with the program fee.

    It also comes with a LifeMD+ membership, which offers 24/7 access to urgent and primary care, prescription renewals, and a marketplace for clinically validated health and wellness products. You'll also gain access to the 6S Lifestyle Program — designed to support graceful, empowered aging.

  • Does LifeMD offer both hormonal and non-hormonal treatments?

    Yes. LifeMD believes in individualized care, so certain plans may include more tools and others fewer, depending on your needs. The hormones prescribed through LifeMD are bioidentical, meaning they have the same chemical and molecular structure as the hormones naturally produced by your body. We also believe in holistic care driven by lifestyle — recommendations to optimize sleep, nutrition, exercise, and more.

  • Does LifeMD offer bioidentical hormones?

    Yes. The hormones prescribed through LifeMD are bioidentical, meaning they have the same chemical and molecular structure as the hormones naturally produced by your body. We offer a variety of options including FDA-approved bioidentical hormone preparations. Your provider will work with you to determine the most appropriate option based on your symptoms, preferences, and medical history.

  • Am I too old to start HRT?

    There’s no specific age requirement for starting HRT. In general, the risks are lower when therapy is started within 10 years of menopause or before age 60. However, HRT can still be appropriate after this window when individual risk factors and overall health are taken into account.

  • Is HRT appropriate prior to menopause or during perimenopause?

    For some women, HRT can be started during perimenopause to help ease symptoms of hormone changes. Your LifeMD-affiliated provider will guide you on whether it’s the right fit for you.

  • Will HRT affect my weight?

    HRT is not typically associated with weight gain. In some cases, it may even help reduce fat mass and preserve lean muscle. While hormonal balance can influence where fat is stored, it’s rarely the primary driver of weight changes. Occasionally, patients may experience shifts in water balance when starting HRT, which can briefly affect the scale — but this usually stabilizes over time.

  • How long can I stay on HRT?

    There’s no fixed time limit. Many women can safely stay on HRT for decades when it’s personalized, properly monitored, and adjusted as needed. The key is using the appropriate type, dose, and delivery method for your needs — with periodic reevaluation of benefits and risks.

  • What are common side effects, and when should I worry?

    Common side effects of HRT can include breast tenderness, bloating, or mild mood changes — especially when starting treatment or upon adjusting your dose. These usually improve with time. If any symptoms persist, worsen, or don't feel typical for you, reach out to your care team through the LifeMD patient portal.

  • How often do I need to have labs done?

    Most patients don’t require labs to begin HRT. However, your provider may recommend — or you can request — lab testing every 2 to 3 months early on, and then twice a year once your levels are stable. Frequency of labs may vary depending on your symptoms, goals, and type of HRT you've been prescribed.

Own your body’s
changes and love
how
you feel again.

Feel better with hormone therapy and lifestyle
guidance made just for you, backed by real science
and designed around what your body needs.

Women's health experts online

Important Safety Information

Last Updated: September 24, 2025
  1. Estradiol (All Forms)
  2. Micronized Progesterone (Oral)
 

Warning
All products:

  • Do not use this drug to prevent heart disease or dementia. A study of women taking an oral estrogen with a progestin showed a raised chance of heart attack, stroke, blood clot, breast cancer, and dementia. The chance of stroke, blood clot, and dementia was also raised when the estrogen was taken alone. Not all products and doses were studied. It is not known if the same effects may happen with this drug.
  • The chance of endometrial cancer may be raised with the use of estrogen alone in patients with a uterus. Use of a progestin along with estrogen may lower the risk. Call your doctor right away if you have unexplained or long-lasting vaginal bleeding.
  • Use this drug for the shortest time needed at the lowest useful dose. Your doctor will talk with you on a regular basis to see if you need to keep taking this drug. Skin gel and spray:
  • Do not let another person or a pet touch this drug or the treated part of your skin. If they do, wash their skin with soap and water. If you notice any signs that others may have been in contact with the treated area by accident, call the doctor. This may include signs of unusual sexual development like breast changes in children.


What is this drug used for?
  • It is used to prevent soft, brittle bones (osteoporosis) after menopause.
  • It is used to prevent or lower the signs of the change of life (menopause).
  • It is used to add estrogen to the body when the ovaries have been taken out or do not work the right way.
  • Rarely, it is used to treat breast or prostate cancers.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?
All products:
  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have had any of these health problems: Bleeding disorder, blood clots, a higher risk of having a blood clot, breast cancer, liver problems or liver tumor, heart attack, stroke, or a tumor where estrogen makes it grow.
  • If you have unexplained vaginal bleeding.
  • If you are pregnant or may be pregnant. Do not take this drug if you are pregnant.
Vaginal ring:
  • If you have any of these health problems: Some vaginal problems like narrow vagina or vaginal infection, uterus not in the normal spot, or other health problems that may raise the chance of vaginal irritation, vaginal ulcers, or make it more likely for the vaginal ring to come out. Ask your doctor if you are not sure.
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?
All products:
  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists. This drug may need to be stopped before certain types of surgery as your doctor has told you. If this drug is stopped, your doctor will tell you when to start taking this drug again after your surgery or procedure.
  • Talk with your doctor if you will need to be still for long periods of time like long trips, bedrest after surgery, or illness. Not moving for long periods may raise your chance of blood clots.
  • If you are allergic to tartrazine (FD&C Yellow No. 5), talk with your doctor. Some products have tartrazine.
  • If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
  • High blood pressure has happened with drugs like this one. Have your blood pressure checked as you have been told by your doctor.
  • Have your blood work and bone density checked as you have been told by your doctor.
  • Be sure to have regular breast exams and gynecology check-ups. You will also need to do breast self-exams as you have been told.
  • The risk of certain side effects like heart attack, stroke, breast cancer, ovarian cancer, and others may not be the same for everyone. Factors like how long an estrogen is taken, if it is taken with or without a progestin, and other factors may affect the risk for certain side effects. Talk with your doctor about the benefits and risks of using this drug.
  • High triglyceride levels have happened with this drug. Tell your doctor if you have ever had high triglyceride levels.
  • This drug may cause dark patches of skin on your face. Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
  • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
  • Do not smoke. Smoking raises the chance of heart disease. Talk with your doctor.
  • Limit your drinking of alcohol.
  • If you drink grapefruit juice or eat grapefruit often, talk with your doctor.
  • This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.
  • If you are 65 or older, use this drug with care. You could have more side effects.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.
Soft, brittle bones (osteoporosis):
  • This drug works best when used with calcium/vitamin D and weight-bearing workouts like walking or PT (physical therapy).
  • Follow the diet and exercise plan that your doctor told you about.
All skin products:
  • Talk with your doctor before you use other drugs or products on your skin. This includes soaps.
Skin gel:
  • Do not use sunscreen before using gel or soon after using gel.
  • Do not use sunscreen on gel part for 7 days in a row.

What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
All products:
  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Signs of gallbladder problems like pain in the upper right belly area, right shoulder area, or between the shoulder blades; yellow skin or eyes; fever with chills; bloating; or very upset stomach or throwing up.
  • Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up.
  • Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
  • Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight.
  • Eyesight changes or loss, bulging eyes, or change in how contact lenses feel.
  • A lump in the breast, breast pain or soreness, or nipple discharge.
  • Vaginal itching or discharge.
  • Vaginal bleeding that is not normal.
  • Depression or other mood changes.
  • Memory problems or loss.
  • Fever.
  • Not able to pass urine or change in how much urine is passed.
  • Pain when passing urine.
  • This drug may cause you to swell or keep uid in your body. Tell your doctor if you have swelling, weight gain, or trouble breathing.
  • Call your doctor right away if you have signs of a blood clot like chest pain or pressure; coughing up blood; shortness of breath; swelling, warmth, numbness, change of color, or pain in a leg or arm; or trouble speaking or swallowing.
  • High calcium levels have happened with drugs like this one in some people with cancer. Call your doctor right away if you have signs of high calcium levels like weakness, confusion, feeling tired, headache, upset stomach or throwing up, constipation, or bone pain.
Vaginal ring:
  • Toxic shock syndrome (TSS) has happened in a few patients using vaginal rings. TSS is rare, but can be deadly. Tell your doctor right away if you have diarrhea, dizziness or light-headedness, passing out, fever, muscle pain, upset stomach, throwing up, or a sunburn-like rash.

What are some other side effects of this drug?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
All products:
  • Dizziness or headache.
  • Hair loss.
  • Upset stomach or throwing up.
  • Constipation.
  • Stomach pain or cramps.
  • Bloating.
  • Enlarged breasts.
  • Tender breasts.
  • Vaginal bleeding or spotting.
  • Painful periods.
  • Signs of a common cold.
  • Nose or throat irritation.
  • Weight gain or loss.
  • Joint pain.
  • Leg cramps.
  • Change in sex interest.
Injection, patch, and vaginal ring:
  • Irritation where this drug was used.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.

How is this drug best taken?
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
Skin patch:
  • Do not take this drug by mouth. Use on your skin only. Keep out of your mouth, nose, and eyes (may burn).
  • Use this drug at the same time of day.
  • Wash hands before and after use.
  • Put patch on clean, dry, healthy skin on the lower belly or upper buttocks. Move the site with each new patch.
  • Do not put a patch on the same site for at least 7 days.
  • Do not use on skin that has any problems.
  • Do not put on the breast.
  • Do not put on skin where you have just used creams, oils, lotions, powder, or other skin products. The patch may not stick as well.
  • Put patch on a site without hair.
  • Do not put the patch on the waistline.
  • Do not put the patch on a site where sitting will make it come off.
  • Do not cut or divide patches. Do not use patches that are damaged.
  • If the patch falls off, put it back on. If you cannot put the patch back on, put on a new one in a different area.
  • Wear only one patch at a time.
  • After you take off a skin patch, be sure to fold the sticky sides of the patch to each other. Throw away used patches where children and pets cannot get to them.
Vaginal ring:
  • Put into the vagina and leave in place for 90 days.
  • To use, wash your hands and take ring from the pouch.
  • Be sure your hands are dry before you touch this drug.
  • Press sides of ring at the same time between thumb and index finger and put folded ring into the vagina.
  • Perfect placement is not needed for the ring to work. The ring will not hurt.
  • To take out, hook the index finger around the rim or hold rim between index finger and middle finger and pull out.
  • Do not throw the vaginal ring in the toilet.
  • Wash hands after use.

What do I do if I miss a dose?
Injection and vaginal ring:
  • Call your doctor to nd out what to do.
Skin patch:
  • Put on a missed patch as soon as you think about it after taking off the old one. Skin gel and spray:
  • Use a missed dose as soon as you think about it.
  • If it is less than 12 hours until the next dose, skip the missed dose and go back to your normal time.
  • Do not use 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?
All other products:
  • Store at room temperature in a dry place. Do not store in a bathroom.
Skin gel:
  • Protect from heat or open ame.
  • If you are using a pump, throw away any part not used after labeled number of doses are used.
    • Skin patch:
  • Store in a protective pouch until ready for use.
All products:
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not push down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts
  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else's drugs.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
 

Warning
Capsules and injection:

  • Do not use this drug with an estrogen to prevent heart disease or dementia. A study of women taking an estrogen with a progestin showed a raised chance of heart attack, stroke, breast cancer, a blood clot, and dementia.
  • Use this drug for the shortest time needed at the lowest useful dose. Your doctor will talk with you on a regular basis to see if you need to keep taking this drug.


What is this drug used for?
  • It is used to lower the chance of endometrial changes after menopause in people who are getting estrogen therapy.
  • It is used to treat uterine bleeding due to hormonal imbalance.
  • It is used to treat people who do not have a monthly period cycle.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?
All products:
  • If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
  • If you have a peanut allergy and are taking the capsules. The capsules have peanut oil in them.
  • If you have had any of these health problems: Bleeding disorder; blood clots or risk of having a blood clot; breast cancer or other cancer; liver disease; heart attack; stroke; or tumor where estrogen or progesterone make it grow.
  • If you have unexplained vaginal bleeding.
  • If you are pregnant or may be pregnant. Injection and all vaginal products:
  • If you have had a recent miscarriage.
All vaginal products:
  • If you are using any other vaginal products. This includes drugs to treat fungal infections, vaginal lubricants, diaphragms, and condoms.

What are some things I need to know or do while I take this drug?
All products:
  • Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists. This drug may need to be stopped before certain types of surgery as your doctor has told you. If this drug is stopped, your doctor will tell you when to start taking this drug again after your surgery or Procedure.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
  • If you have an allergy to any type of nuts or seeds, talk with your doctor.
  • If you have high blood sugar (diabetes), talk with your doctor. This drug may raise blood sugar.
  • Be sure to have regular breast exams and gynecology check-ups. You will also need to do breast self-exams as you have been told.
  • This drug may affect certain lab tests. Tell all of your health care providers and lab workers that you take this drug.
  • Blood clots have happened with this drug. These clots have included heart attack, stroke, and clots in the leg, lung, or eye. Sometimes blood clots can be deadly. Tell your doctor if you have ever had a blood clot. Talk with your doctor.
  • Talk with your doctor if you will need to be still for long periods of time like long trips, bedrest after surgery, or illness. Not moving for long periods may raise your chance of blood clots.
  • If you are 65 or older, use this drug with care. You could have more side effects
  • This drug is not a method of birth control and will not prevent pregnancy. If you have questions, talk with the doctor.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.
  • Ovarian hyperstimulation syndrome (OHSS) is a severe side effect that may happen in some people who use this drug. Call your doctor right away if you have severe stomach pain or bloating; very upset stomach, throwing up, or diarrhea; a big weight gain; shortness of breath; or change in how much urine is passed.
Capsules and injection:
  • Certain side effects like heart attack, stroke, breast cancer, and others have been seen in some people taking a certain estrogen with a progestin. The risk may not be the same for everyone. Factors like how long the treatment is, if an estrogen is taken with or without a progestin, and other factors may affect the risk for certain side effects. Talk with your doctor about the benefits and risks of using this drug.

What are some side effects that I need to call my doctor about right away?
All products:
  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of liver problems like dark urine, tiredness, decreased appetite, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Shortness of breath, a big weight gain, or swelling in the arms or legs.
  • Trouble walking.
  • Severe dizziness or passing out.
  • Eyesight changes or loss, bulging eyes, or change in how contact lenses feel.
  • A lump in the breast, breast pain or soreness, or nipple discharge.
  • Vaginal itching or discharge.
  • Vaginal bleeding that is not normal.
  • Pain when passing urine.
  • Passing urine more often.
  • Depression or other mood changes.
  • Memory problems or loss.
  • This drug may cause you to swell or keep fluid in your body. Tell your doctor if you have swelling, weight gain, or trouble breathing.
  • Signs of a blood clot like chest, arm, back, neck, or jaw pain or pressure; coughing up blood; numbness or weakness on 1 side of your body; trouble speaking or thinking; change in balance; change in eyesight; shortness of breath; or swelling, warmth, or pain in the leg or arm.
Vaginal insert and ring:
  • Pelvic pain.
Vaginal ring:
  • Toxic shock syndrome (TSS) has happened in a few patients using vaginal rings. TSS is rare, but can be deadly. Tell your doctor right away if you have diarrhea, dizziness or light-headedness, passing out, fever, muscle pain, upset stomach, throwing up, or a sunburn-like rash.

What are some other side effects of this drug?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
All products:
  • Feeling dizzy, sleepy, tired, or weak.
  • Headache.
  • Constipation, diarrhea, throwing up, or upset stomach.
  • Stomach pain or cramps.
  • Bloating.
  • Enlarged breasts.
  • Tender breasts.
  • Muscle pain.
  • Weight gain.
  • Vaginal bleeding or spotting.
  • Lowered interest in sex.
Injection and all vaginal products:
  • Irritation where this drug was used.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.

How is this drug best taken?
Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.
Capsules:
  • Take at bedtime if taking once a day.
  • Take with or without food. Take with food if it causes an upset stomach.
  • Take with a full glass of water.
  • If you have trouble swallowing, talk with your doctor.