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Last reviewed on RxList: 6/16/2017
Evamist Side Effects Center

Last reviewed on RxList 6/16/2017

Evamist (estradiol transdermal) Spray is a form of estrogen, a female sex hormone, used to treat certain symptoms of menopause such as hot flashes, and vaginal dryness, burning, and irritation. Common side effects of Evamist Spray include:

Evamist therapy should be initiated with one spray per day. Dosage adjustment should be guided by patient's response. Evamist may interact with St. John's wort, blood thinners, ritonavir, carbamazepine, phenobarbital, antibiotics, or antifungal medications. Tell your doctor all medications and supplements you use. Evamist must not be used during pregnancy. If you become pregnant or think you may be pregnant, tell your doctor immediately. Evamist passes into breast milk. It may reduce the quality and amount of breast milk produced. Consult your doctor before breastfeeding.

Our Evamist (estradiol transdermal) Spray Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Evamist Consumer Information

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using estradiol topical and call your doctor at once if you have a serious side effect such as:

  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • sudden numbness or weakness, headache, confusion, or problems with vision, speech, or balance;
  • pain, swelling, warmth, or redness in one or both legs;
  • abnormal vaginal bleeding;
  • pain, swelling, or tenderness in your stomach;
  • jaundice (yellowing of the skin or eyes); or
  • a lump in your breast.

Topical estradiol is absorbed through the skin and can cause premature puberty in a child who comes into contact with this medicine or with skin where the medicine was applied. Call your doctor if a child who has close contact with you develops swollen nipples or enlarged breasts.

Less serious side effects may include:

  • nausea, vomiting, loss of appetite;
  • swollen breasts;
  • acne or skin color changes;
  • vaginal pain, dryness, or discomfort, decreased sex drive, or difficulty having an orgasm;
  • swelling, weight gain;
  • migraine headaches, dizziness, depression; or
  • break-through bleeding, vaginal itching or discharge.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Evamist (Estradiol )

Evamist Professional Information


The following serious adverse reactions are discussed elsewhere in the labeling:

Clinical Trials Experience

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 clinical practice.

In a 12-week, randomized, placebo-controlled trial of Evamist in 454 women, 80 to 90 percent of women randomized to active drug received at least 70 days of therapy and 75 to 85 percent randomized to placebo received at least 70 days of therapy.

The adverse reactions that occurred in at least 5 percent of women in any treatment group are shown in Table 1.

Table 1: Frequency of Adverse Reactions ( ≥ 5 Percent) in Any Treatment Group in a Controlled Study of Evamist

System Organ Class Preferred Term Frequency n (%)
1 Spray 2 Sprays 3 Sprays
(N = 77)
(N = 76)
(N = 76)
(N = 74)
(N = 75)
(N = 76)
Reproductive System and Breast Disorders
Breast tenderness 0 (0) 4 (5) 4 (5) 5 (7) 0 (0) 4 (5)
Nipple pain 0 (0) 2 (3) 0 (0) 5 (7) 0 (0) 1 (1)
Gastrointestinal Disorders
Nausea 5 (7) 1 (1) 1 (1) 2 (3) 4 (5) 2 (3)
Infections and Infestations
Nasopharyngitis 1 (1) 4 (5) 2 (3) 3 (4) 1 (1) 1 (1)
Musculoskeletal and Connective Tissue Disorders
Back pain 1 (1) 2 (3) 2 (3) 4 (5) 1 (1) 2 (3)
Arthralgia 1 (1) 1 (1) 4 (5) 1 (1) 0 (0) 3 (4)
Nervous system
Headache 4 (5) 7 (9) 5 (7) 9 (12) 7 (9) 8 (11)

Application site reactions were reported in 3 out of 226 (1.3%) women treated with Evamist.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of Evamist. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Breasts: Breast swelling, breast mass, breast enlargement

Cardiovascular: Heart rate increased

Central nervous system: Dizziness, dysgeusia, paresthesia, lethargy, hypoesthesia

Eyes: Eye irritation, ocular hyperemia

Gastrointestinal: Abdominal pain, diarrhea, constipation, abdominal distension, dry mouth, decreased appetite

Genitourinary system: Vaginal bleeding

Musculoskeletal: Muscle spasms, arthritis

Psychiatric: Insomnia, mood swings, anxiety, irritability, mood altered, depression

Respiratory tract: Cough, dyspnea, dry throat

Skin: Nipple and areola discoloration, usually on the same side of the body as the inner forearm on which Evamist is applied, rash, pruritus, alopecia, urticaria, dry skin, skin discoloration, chloasma

Miscellaneous: Weight increased, malaise, fatigue, asthenia

Read the entire FDA prescribing information for Evamist (Estradiol )

Related Resources for Evamist

Read the Evamist User Reviews »

© Evamist Patient Information is supplied by Cerner Multum, Inc. and Evamist Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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