Hormone Therapy For Breast Cancer
Some types of breast cancer are affected by hormones, like estrogen and progesterone. The breast cancer cells have receptors that attach to estrogen and progesterone, which helps them grow. Treatments that stop these hormones from attaching to these receptors are called hormone or endocrine therapy.
Hormone therapy can reach cancer cells almost anywhere in the body and not just in the breast. It’s recommended for women with tumors that are hormone receptor-positive. It does not help women whose tumors don’t have hormone receptors .
Common Side Effects Of Estradiol
Most common side effects of estradiol improve within three months. When taking estradiol, the most common side effects include:
- A skin reaction at the site of patch or cream application
- Vaginal spotting or breakthrough bleeding
- Dysmenorrhea, or painful periods
- Erythema multiformebulls-eye shaped skin lesionsor erythema nodosumpainful and tender bumps beneath the skin
- Ischemic colitis, large intestine injury caused by decreased blood flow
- Intestinal obstruction may occur with the vaginal ring
- Vaginal erosion or ulcer may occur when using the vaginal ring
- Toxic shock syndrome may occur when using the vaginal ring
How Does Hormone Therapy Work
About 2 out of 3 breast cancers are hormone receptor-positive. Their cells have receptors for estrogen and/or progesterone which help the cancer cells grow and spread.
There are several types of hormone therapy for breast cancer. Most types of hormone therapy either lower estrogen levels in the body or stop estrogen from helping breast cancer cells grow.
Estrogen Vs Progesterone: Treating Menopause
Both estrogen and progesterone naturally diminish in the body over time.
Females and intersex people who are going through menopause may experience difficult side effects during menopause, such as hot flashes, vaginal dryness, and mood changes.
However, estrogen-only or estrogen-progesterone therapy can help alleviate some menopause symptoms and also reduce the risks of osteoporosis for people with bone loss.
The risks of taking hormone replacement therapy are similar to those associated with taking birth control pills.
During menopause, taking estrogen without progesterone can increase the risk of endometrial cancer. When your body no longer sheds its endometrial lining , cells can build inside your uterus. Progesterone helps by thinning the lining of the uterus, reducing the risks of cell overgrowth and cancer.
However, if youve had a hysterectomy, its safest to take estrogen alone. It has fewer long-term risks than the combination therapy.
progesterone , or a combination of the two to help regulate their bodies function and appearance.
Both estrogen and progesterone can lead to the development of female secondary sex characteristics, including in transgender women. It can also help to improve their bone health.
When administered as a part of gender affirming hormone therapy, your doctor may also prescribe a medication that blocks the function of testosterone to increase the feminizing effects on the body.
What May Interact With This Medication
Do not take this medication with any of the following:
This medication may also interact with the following:
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
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Estrogen Isnt In All Hormonal Birth Control
Some birth control pills and other things like the shot, hormonal IUD and arm implant only contain progestin, a type of hormone in the progesterone family.
But why does the estrogen in pills raise stroke risk while other hormones dont?
It may have to do with the type of estrogen in almost all birth control pills, Micks says. Its called ethinylestradiol, and its in other forms of hormonal contraception such as the patch and the vaginal ring. Experts think this specific type of estrogen, more than others, increases the risk for blood clots by changing how the liver synthesizes certain proteins that affect clot formation.
Naturally occurring estrogen and other hormones also affect blood clotting, but usually to a lesser extent. Thats why hormonal birth control that only contains progestin is safer for women who have risk factors for stroke.
Estrogen Treatment: Topical Creams Gels And Sprays
- What are they? Estrogen gels , creams , and sprays offer another way of getting estrogen into your system. As with patches, this type of estrogen treatment is absorbed through the skin directly into the bloodstream. The specifics on how to apply these creams vary, although they’re usually used once a day. Estrogel is applied on one arm, from the wrist to the shoulder. Estrasorb is applied to the legs. Evamist is applied to the arm.
- Pros. Because estrogen creams are absorbed through the skin and go directly into the bloodstream, they’re safer than oral estrogen for people who have liver and cholesterol problems.
- Cons. Estrogen gels, creams, and sprays have not been well-studied. While they could be safer than oral estrogen, experts aren’t sure. So assume that they pose the same slight risk of serious conditions, like cancer and stroke.One potential problem with using this type of estrogen treatment is that the gel, cream or spray can rub or wash off before it’s been fully absorbed. Make sure you let the topical dry before you put on clothes. Always apply it after you bathe or shower.
Because the estrogen is absorbed right through the skin, don’t let other people in your family touch these creams or gels. If they do, they could get dosed with estrogen themselves. For the same reason, make sure your hands are clean and dry after applying the medication.
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Comparison Of Hormone Levels In Birth Control Pills
Last updated on By Jing J.
If you have to take birth control pills, what would be the best ones to take? Check out the comparison of hormone levels and side effects of various birth control pills.
Recently some of you asked me about birth control pills: If you have to take birth control pills, what would be the best ones to take, i.e., which birth control pill has the least side effects?
First, I think this is a conversation you ought to have with your healthcare provider since he or she would have the most intimate knowledge regarding your health condition and could recommend the best option for you.
That being said, I think it would be helpful to compare the hormone levels in various birth control pills, so you can be educated and ask the right questions when you discuss your options with your doctor.
What Do I Do If I Missed A Birth Control Pill
The pill works best if you take it every day on schedule, but almost everyone on the pill forgets to take it sometimes. Knowing what to do when you miss a birth control pill is important.
Heres a handy tool to help you figure out what to do if you miss a pill. Youll need to know the brand name of the pill youre on in order to use this tool. You can find the name on your pill pack or by calling your doctor or the drugstore where you got it.
If you cant find out the name of your pill, use a condom anytime you have vaginal sex until you can talk with your nurse or doctor. If youve already had sex in the last 5 days since making a pill mistake, you may want to use emergency contraception.
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What Other Drugs Interact With Estradiol
If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.
Severe Interactions of estradiol include:
Estradiol has serious interactions with at least 32 different drugs.
Estradiol has moderate interactions with at least 185 different drugs.
Estradiol has mild interactions with at least 34 different drugs.
This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.
S For Taking Estrogen
Estrogen can be taken in a number of different ways. People receive estrogen through a pill, injection, patch, or even a topical cream. It’s not just a matter of preference. The route by which people take estrogen affects some of the risks of estrogen treatmentestrogen is absorbed by the body differently depending on how you take it.
Much of the research on the risks of estrogen treatment focus on oral estrogensthose taken by mouth. What research has found is that oral estrogen seems to cause an increased risk of a number of problematic side effects when compared to topical or injected estrogens. This is because of the effects of ingested estrogen on the liver when it passes through that organ during the process of digestion.
This is referred to as the hepatic first pass effect and it is not an issue for estrogen treatment that isn’t taken in pill form. The hepatic first pass effect causes changes in a number of physiological markers that affect cardiovascular health.
These changes may lead to an increase in blood clotting and reduced cardiovascular health. They are not seen as often, if at all, with non-oral estrogens. Therefore, non-oral estrogens may be a safer option.
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Why Is This Medication Prescribed
Combinations of estrogen and progestin are used to treat certain symptoms of menopause. Estrogen and progestin are two female sex hormones. Hormone replacement therapy works by replacing estrogen hormone that is no longer being made by the body. Estrogen reduces feelings of warmth in the upper body and periods of sweating and heat , vaginal symptoms and difficulty with urination, but it does not relieve other symptoms of menopause such as nervousness or depression. Estrogen also prevents thinning of the bones in menopausal women. Progestin is added to estrogen in hormone replacement therapy to reduce the risk of uterine cancer in women who still have their uterus.
What Do I Do If I Want To Get Pregnant
If you decide you want to get pregnant, just stop taking the pill. No matter what kind of birth control pill youre on, its possible to get pregnant right after you stop taking it. It can take a few months for your period to go back to the cycle you had before you started taking the pill, but you can still get pregnant during that time.
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What Does Low Progesterone Mean For A Woman
Females who have low progesterone levels may have irregular periods and struggle to get pregnant. Without this hormone, the body cannot prepare the right environment for the egg and developing fetus. If a woman becomes pregnant but has low progesterone levels, there may be an increased risk of pregnancy loss.
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Selecting The Right Estrogen Replacement Therapy
Menopause is that time in a womans life when the ovaries stop releasing eggs. It is due to the reduced levels of the hormones estrogen and progesterone, which brings with it some unwanted symptoms. The symptoms include hot flashes, night sweats characterized by intense sweating, the sudden feeling of warmth over the face, neck and the chest, vaginal dryness which leads to painful sex. To help menopausal women get some relief from these symptoms, Hormonal Replacement Therapy is recommended. Through this treatment, the hormones estrogen and a synthetic version of progesterone called progestogen is used to replace and replenish the lowered levels of these hormones in the body.
Estrogen replacement therapy is one such way of administering this treatment, and here only the hormone estrogen is used in the form of pills, vaginal suppositories, rings, gels, creams, and sprays.
When it comes to choosing the right estrogen replacement therapy a lot of things need to be considered carefully. A patient with a family history of problems related to blood clots, liver disease, the stroke should be very careful in choosing an option that is right for them. For someone that has not had their uterus and ovaries removed surgically taking estrogen-only hormonal replacement therapy can lead to the risk of developing endometrial cancer.
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Effects In Breastfed Infants
A mother who had severe postpartum depression with 2 previous infants was prescribed a transdermal estradiol patch that released 50 mcg daily beginning on day 1 postpartum to prevent recurrence of depression. At 11 days of age, the infant was jaundiced and had gained only 60 grams since birth. With more frequent nursing, weight gain improved, but remained inadequate until day 28 when the estradiol was discontinued. The infant then experienced above average weight gain through day 66 postpartum. The delayed and reduced weight gain was possibly caused by estradiol.
Six nursing mothers received transdermal estradiol as part of a study comparing estradiol to sertraline and placebo for postpartum depression. The mothers received estradiol dosages between 50 and 200 mcg daily at the time of serum level analysis at 4 and 8 weeks of therapy. Four of the 6 infants were exclusively breastfed and the other two were more than 50% breastfed. There was no difference in infant length, weight, and head circumference nor in the average daily gains in any of these parameters between treatments.
Estradiol Side Effects And How To Avoid Them
Estradiol is the strongest of three forms of estrogen naturally produced by the female body. These also include estrone and estriol , which are hormones that bind to the bodys estrogen receptors. Both estradiol and estriol can be used as hormone replacement therapy in postmenopausal women, but estradiol is far more commonly used. Estriol is only available in compounded drugs that are not FDA approved.
Estradiol is a generic prescription medication used as hormone therapy to treat symptoms of menopause such as night sweats, skin flushing, hot flashes, and vaginal dryness, inflammation, and thinning. These effects are caused by decreased estrogen levels in the body and taking estradiol helps increase the hormone and help with symptoms.
Estradiol is also an ingredient in certain low-dose birth control pills that are prescribed to some women during perimenopause. Estradiol may be prescribed to prevent osteoporosis and to treat menopausal migraine and postpartum depression. It is sometimes used in palliative care for certain breast and prostate cancers.
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How Estrogen Levels Impact Migraines
The explanation for why drops and fluctuations in estrogen cause migraines is not completely clear, but there are several possible mechanisms.
Estrogen has a known impact on the action of serotonin, a neurotransmitter that modulates pain and mood. Estrogen also affects blood vessels and blood pressure, and blood vessel alterations are known to play a role in migraines as well.
It is likely that both of these factors, and possibly others, could mediate the estrogen-migraine connection.
What Other Information Should I Know
Keep all appointments with your doctor and the laboratory. You should have a complete physical exam, including blood pressure measurements, breast and pelvic exams, and a Pap test at least yearly. Follow your doctor’s directions for examining your breasts report any lumps immediately.
If you are taking hormone replacement therapy to treat symptoms of menopause, your doctor will check every 3 to 6 months to see if you still need this medication. If you are taking this medication to prevent thinning of the bones , you will take it for a longer period of time.
Before you have any laboratory tests, tell the laboratory personnel that you take hormone replacement therapy, because this medication may interfere with some laboratory tests.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
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What Are The Dosages Of Estradiol
Dosages of Estradiol:
Dosage Considerations Should be Given as Follows:
- Pediatric: Safety and efficacy not established
- Estrace: 1-2 mg orally once daily for 3 weeks, followed by 1 week off
- Valerate: 10-20 mg intramuscularly every 4 weeks
- EstroGel: 1.25 g/day 3 weeks on, 1 week off
- Alora, Climara Vivelle-Dot, Estraderm: Use transdermally and follow product-specific directions
- Prevention of osteoporosis: 0.5 mg orally once daily for 3 weeks, followed by 1 week off
- Metastatic breast cancer: 10 mg orally every 8 hours for 3 months
- Prostate cancer: 1-2 mg orally every 8 hours for 3 months or more
- Oral : 1-2 mg orally once/day titrate to use minimal effective dose
- Transdermal : Use transdermally and follow product-specific directions
- Valerate: 10-20 mg intramuscularly every 4 weeks
- Cypionate: 1.5-2 mg intramuscularly every 4 weeks
- Vaginal discomfort, vaginal erosion, vaginal ulceration, adherence of the vaginal ring to the vaginal wall
This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.