Estrofem (Estradiol Hemihydrate)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Estrofem Used For?
Estrofem is a hormone replacement therapy that helps women with low estrogen levels. It’s designed for short-term use to manage symptoms related to estrogen deficiency.
Primary Uses
Estrofem treats estrogen deficiency in women who have had a hysterectomy (removal of the uterus) or who experience symptoms of low estrogen levels such as hot flushes, night sweats, sleeplessness, dry vagina, urinary problems, headaches, mood swings, lack of concentration, and loss of energy.
How It Works
Estrofem contains estradiol hemihydrate, which replaces the estrogen your body is no longer producing adequately. If you haven’t had a hysterectomy, your doctor may prescribe another medicine called a progestogen to be taken with Estrofem for 10-14 days of your 28-day cycle.
Important: Estrofem is not a contraceptive. If it’s less than 12 months since your last menstrual period or you’re under 50 years old, you may still need additional contraception to prevent pregnancy.
How to Take Estrofem
Estrofem comes in a convenient 28-day calendar dial pack to help you keep track of your daily dose. Take it at the same time each day for best results.
Dosage Instructions
Take one tablet daily, preferably at the same time each day. Swallow each tablet with a glass of water. The calendar dial pack helps you track your doses – set the day reminder, break the plastic tab for your first tablet, then move the dial clockwise one space each day. Once you finish all 28 tablets, start a new pack without interruption.
What If You Miss a Dose?
If you miss your usual dose time, take it when you remember if it’s within 12 hours. If more than 12 hours have passed, skip the missed dose and take your next dose at the regular time. Throw away the missed tablet. If you still have your uterus, you may experience vaginal bleeding or spotting if you forget doses.
Important: Never take a double dose to make up for a missed tablet. This could be harmful.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Breast tenderness, enlargement or pain
- Vaginal bleeding or spotting
- Vaginal thrush (fungal infection)
- Vein inflammation
- Stomach pain, indigestion
- Nausea, vomiting
- Diarrhea, bloating, gas
- Gallbladder problems
- Depression or mood changes
- Changes in sex drive
- Sleep problems
- Headache, migraine
- Dizziness
- Skin rash or itching
- Changes in hair growth
- Leg cramps
- Weight changes
- Swelling from fluid retention
- Visual disturbances
Seek immediate medical attention if you experience:
- Breast lumps, skin dimpling, or nipple changes
- Chest pain spreading to arm or neck
- Difficulty breathing
- Severe calf pain with leg swelling
- Blood clots
- Sudden severe headache or migraine
- Sudden vision problems
- Severe allergic reaction (skin rashes, shortness of breath, swelling of face/lips/tongue)
- Yellow skin or eyes (jaundice)
- Large rise in blood pressure
Important Warnings
Estrofem carries certain risks that need careful consideration. Your doctor will evaluate your medical history before prescribing this medication.
Who Should Not Take Estrofem
Do not use Estrofem if you are pregnant, suspect pregnancy, or are breastfeeding; have or suspect breast cancer, endometrial cancer, or other estrogen-dependent cancers; have unexplained vaginal bleeding; have untreated excessive thickening of the uterus lining; have or have had blood clots in veins or lungs; have blood clotting disorders; have or have had heart attack, stroke, or angina; have liver disease with abnormal blood test results; have porphyria (inherited blood disorder); have kidney disease; or are allergic to estradiol or any ingredients.
Medical Conditions to Discuss
Tell your doctor if you have fibroids, endometriosis, history of endometrial hyperplasia, increased blood clot risk, family history of estrogen-sensitive cancers, high blood pressure, liver disorders, diabetes, gallstones, migraines, lupus, epilepsy, asthma, hearing problems, high triglycerides, fluid retention, thyroid problems, hereditary angioedema, lactose intolerance, or take other medications.
Pregnancy and Breastfeeding
Do not use Estrofem if you are pregnant, suspect you may be pregnant, or are breastfeeding. Contact your doctor immediately if you become pregnant while taking Estrofem.
Cancer Risk: HRT increases the risk of breast cancer, endometrial cancer, and ovarian cancer. The risk depends on duration of use and becomes clear within 3 years. Regular monitoring is essential.
Drug Interactions
Several medications can interfere with how Estrofem works. Always tell your doctor about all medicines you’re taking.
Laboratory Tests: Tell your doctor or laboratory staff that you’re taking Estrofem if you need blood tests, as it can affect some test results.
- Sleep medications including barbiturates
- Epilepsy medicines like phenytoin and carbamazepine
- Antibiotics and anti-infectives like rifampicin, rifabutin, nevirapine, efavirenz
- Anti-infectives such as ritonavir and nelfinavir when used with steroid hormones
- St. John’s Wort (used for depression)
Alcohol & Driving
There are no specific restrictions mentioned for alcohol or driving while taking Estrofem, but caution is advised.
Alcohol
There is no specific information about drinking alcohol while taking Estrofem. Tell your doctor if you drink alcohol.
Driving and Operating Machinery
Be careful before driving or using machines until you know how Estrofem affects you. There is no specific information about driving restrictions.
Storage
Store Estrofem in a cool, dry place away from moisture, heat, and sunlight where the temperature stays below 25°C. Keep the calendar pack in the outer carton to protect from light. Do not store in the bathroom, near a sink, in the car, or on window sills. Do not refrigerate. Keep away from children. Discard after the expiry date or if packaging is damaged.
Overdose Information
If you think you or anyone else has taken too many Estrofem tablets, seek medical attention immediately. Call the Poisons Information Centre at 13 11 26, contact your doctor, or go to the nearest hospital Emergency Department, even if there are no signs of discomfort or poisoning.
Frequently Asked Questions
The source doesn’t specify exact timing, but Estrofem is designed for short-term treatment of estrogen deficiency symptoms. Your doctor will monitor your progress during regular check-ups.
The instructions state to swallow each tablet with a glass of water, but don’t specify whether to take with or without food. Consult your doctor for specific guidance.
Do not stop using Estrofem suddenly. Always follow your doctor’s instructions about stopping treatment, as sudden discontinuation may cause problems.
There is no specific information about alcohol effects with Estrofem. Tell your doctor if you drink alcohol so they can advise you appropriately.
If you miss your usual dose time, take it when you remember if it’s within 12 hours. If more than 12 hours have passed, skip the missed dose and take your next dose at the regular time. Never double dose.
Yes, you should see your doctor for regular check-ups at least once a year. You should also regularly check your breasts and go for breast screening and pap smear tests as recommended.
There is only limited experience treating women older than 65 years with Estrofem. Your doctor will assess whether it’s appropriate for you based on your individual circumstances.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.