(See WARNINGS regarding induction of neoplasia, adverse effects on the fetus, increased incidence of gall bladder disease, and adverse effects similar to those of oral contraceptives, including thromboembolism.) The following additional adverse reactions have been reported with estrogenic therapy, including oral contraceptives:

1. Genitourinary system.
   Breakthrough bleeding, spotting, change in menstrual flow.
   Dysmenorrhea.
   Premenstrual-like syndrome.
   Amenorrhea during and after treatment.
   Increase in size of uterine fibromyomata.
   Vaginal candidiasis.
   Change in cervical eversion and in degree of cervical secretion.
   Cystitis-like syndrome.
2. Breasts.
   Tenderness, enlargement, secretion.
3. Gastrointestinal.
   Nausea, vomiting.
   Abdominal cramps, bloating.
   Cholestatic jaundice.
4. Skin.
   Chloasma or melasma which may persist when drug is discontinued.
   Erythema multiforme.
   Erythema nodosum.
   Hemorrhagic eruption.
   Loss of scalp hair.
   Hirsutism.
5. Eyes.
   Steepening of corneal curvature.
   Intolerance to contact lenses.
6. CNS.
   Headache, migraine, dizziness.
   Mental depression.
   Chorea.
7. Miscellaneous.
   Increase or decrease in weight.
   Reduced carbohydrate tolerance.
   Aggravation of porphyria.
   Edema.
   Changes in libido.

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