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Side Effects



Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The adverse reaction information from clinical trials does, however, provide a basis for identifying the adverse events that appear to be related to drug use and for approximating rates.

Summary of Most Frequently Reported Treatment Emergent Adverse Experiences/Medical Events ( ≥ 5%) By Treatment Groups

AE per Body System Menostar 14 mcg/day
Body as a Whole 95 (46%) 100 (48%)
  Abdominal Pain 17 (8%) 17 (8%)
  Accidental Injury 29 (14%) 23 (11%)
  Infection 11 (5%) 10 (5%)
  Pain 26 (13%) 26 (12%)
Cardiovascular 20 (10%) 19 (9%)
Digestive System 52 (25%) 44 (21%)
  Constipation 11 (5%) 6 (3%)
  Dyspepsia 11 (5%) 9 (4%)
Metabolic and Nutritional Disorders 25 (12%) 22 (11%)
Musculoskeletal System 54 (26%) 51 (24%)
  Arthralgia 24 (12%) 13 (6%)
  Arthritis 11 (5%) 15 (7%)
  Myalgia 10 (5%) 6 (3%)
Nervous System 30 (14%) 23 (11%)
  Dizziness 11 (5%) 6 (3%)
Repiratory System 62 (30%) 67 (32%)
  Bronchitis 12 (6%) 9 (4%)
  Upper Respiratory Infection 33 (16%) 35 (17%)
Skin and Appendages 50 (24%) 54 (26%)
  Application Site Reaction 18 (9%) 18 (9%)
  Breast Pain 10 (5%) 8 (4%)
Urogenital System 66 (32%) 40 (19%)
  Cervical Polyps 13 (6%) 4 (2%)
  Leukorrhea 22 (11%) 3 (1%)

The following additional adverse reactions have been reported with estrogens and/or progestin therapy.

Genitourinary system

Changes in vaginal bleeding pattern and abnormal withdrawal bleeding or flow; breakthrough bleeding; spotting; dysmenorrhea; increase in size of uterine leiomyomata; vaginitis, including vaginal candidiasis; change in amount of cervical secretion; changes in cervical ectropion; ovarian cancer; endometrial hyperplasia; endometrial cancer.


Tenderness, enlargement, pain, nipple discharge, galactorrhea; fibrocystic breast changes; breast cancer.


Deep and superficial venous thrombosis; pulmonary embolism; thrombo-phlebitis; myocardial infarction; stroke; increase in blood pressure.


Nausea, vomiting; abdominal cramps, bloating; cholestatic jaundice; increased incidence of gallbladder disease; pancreatitis; enlargement of hepatic hemangiomas.


Chloasma or melasma, which may persist when drug is discontinued; erythema multiforme; erythema nodosum; hemorrhagic eruption; loss of scalp hair; hir-sutism; pruritus, rash.


Retinal vascular thrombosis; intolerance to contact lenses.

Central nervous system

Headache; migraine; dizziness; mental depression; chorea; nervousness; mood disturbances; irritability; exacerbation of epilepsy; dementia.


Increase or decrease in weight; reduced carbohydrate tolerance; aggravation of porphyria; edema; arthalgias; leg cramps; changes in libido; anaphylactoid/ana-phylactic reactions including urticaria and angioedema; hypocalcemia; exacerbation of asthma; increased triglycerides.

Read the Menostar (estradiol transdermal system) Side Effects Center for a complete guide to possible side effects


Drug/Laboratory Test Interactions

  1. Accelerated prothrombin time, partial thromboplastin time, and platelet aggregation time; increased platelet count; increased factors II, VII antigen, VIII antigen, VIII coagulant activity, IX, X, XII, VII-X complex, II-VII-X complex, and beta-thromboglobulin; decreased levels of antifactor Xa and antithrombin III, decreased antithrombin III activity; increased levels of fibrinogen and fibrinogen activity; increased plasminogen antigen and activity.
  2. Increased thyroid-binding globulin (TBG) levels leading to increased circulating total thyroid hormone levels as measured by protein-bound iodine (PBI), T4 levels (by column or by radioimmunoassay) or T3 levels by radioim-munoassay. T3 resin uptake is decreased, reflecting the elevated TBG. Free T4 and free T3 concentrations are unaltered. Patients on thyroid replacement therapy may require higher doses of thyroid hormone.
  3. Other binding proteins may be elevated in serum (i.e., corticosteroid binding globulin (CBG), sex hormone-binding globulin (SHBG) leading to increased total circulating corticosteroids and sex steroids, respectively. Free hormone concentrations may be decreased. Other plasma proteins may be increased (angiotensinogen/renin substrate, alpha-l-antitrypsin, ceruloplasmin).
  4. Increased plasma HDL and HDL2 subfraction concentrations, reduced LDL cholesterol concentration, and in oral formulations increased triglyceride levels.
  5. Impaired glucose tolerance.
  6. Reduced response to metyrapone test.
This monograph has been modified to include the generic and brand name in many instances.

Last reviewed on RxList: 3/27/2009

Side Effects

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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

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