Hormone Therapy (HT)

Estrogen side effects

Side effects that can occur with all forms of estrogen but are more frequent with oral estrogen include:

• Irregular vaginal bleeding.
• Headaches.
• Nausea.
• Vaginal discharge.
• Fluid retention.
• Weight gain.
• Breast tenderness.
• Spotting or darkening of the skin, particularly on the face.
• Reference Gallstones Opens New Window. Women who use estrogen therapy (ET) are more likely to have gallstones that cause symptoms than women who do not use ET. (High estrogen levels are linked to gallbladder disease.)
• In rare cases, an increased growth of preexisting Reference uterine fibroids Opens New Window or a worsening of Reference endometriosis Opens New Window.

In addition, the estrogen patch (transdermal estrogen) may cause skin irritation.

Some of these side effects, such as headaches, nausea, fluid retention, weight gain, and breast tenderness, may go away after a few weeks of use.

Progestin side effects

The side effects of progestin often cause women to stop using hormone therapy (HT). Adjusting the progestin dose, changing the dosing schedule, or changing the type of progestin may reduce side effects. The progestin Reference intrauterine device (IUD) Opens New Window reduces or eliminates side effects that are common with oral progestin.^{Reference 1}

Progestin side effects include:

• Mood changes, such as anxiety, irritability, or depression.
• Headache.
• Breast pain or tenderness.
• Abdominal pain or bloating (distention).
• Dizziness or drowsiness.
• Diarrhea.
• Vaginal discharge.

Cyclic progestin (taken 10 to 14 days a month) is more likely to cause:

• Premenstrual-like symptoms, such as bloating, cramping, breast tenderness, nausea, and depression.
• Monthly withdrawal bleeding.

The combination transdermal patch may cause skin irritation.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

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