Menopause is a time of great change in a woman's life. You may experience hot flashes, hot flashes, and mood swings. Sometimes, your bones may also start to weaken during this time. If you have any of these symptoms, your doctor may have told you to start hormone therapy. Estradiol and Norethindrone are two of these hormones combined in a pill. So let's talk about this in a simple way today.
What is this medicine used for?
Simply put, this is Hormone Replacement Therapy (HRT). This medication is given to restore, to some extent, the levels of estrogen and progesterone hormones in your body that decrease with menopause.
This mainly aims to:
- Reducing discomfort during menopause: This helps control things like hot flashes and night sweats.
- Keeping bones strong: After menopause, bones become thinner and more easily broken (osteoporosis). This medicine reduces that risk.
Most importantly, this medicine is given to women who still have their uterus because the hormone Norethindrone in it helps protect the walls of the uterus.
Things you need to tell your doctor before taking this medicine
Before your doctor prescribes this medicine, he or she will need to know your complete health history. This is because some medical conditions can make it risky to use this medicine. So, if you have any of the following conditions, be sure to tell your doctor about them.
| Your health condition | Why should I inform you? (Simply) |
|---|---|
| Breast, cervical, uterine cancer, or other cancerous condition | Because some cancers are hormone-dependent, this medicine can cause them to grow. |
| Heart disease, recent heart attack or stroke | This can be dangerous if you have a history of heart disease, as these hormones can increase the risk of blood clots. |
| Blood vessel disease or blood clotting problems | Same reason as above. Increases the risk of blood clots. |
| Liver disease or gallbladder disease | The body processes these hormones through the liver. If the liver is weak, the medication can accumulate in the body and become toxic. |
| Unexplained vaginal bleeding | Because this may be a symptom of a serious underlying condition, hormone treatment is not appropriate until the cause is found. |
| Diabetes, high cholesterol, high blood pressure | This medicine may have an effect on controlling these conditions. |
| Migraine, Depression, Endometriosis, Fibroids | These conditions may worsen or change due to hormonal changes. |
| If you are pregnant, trying to get pregnant, or breastfeeding | This medicine is not suitable at all in these cases. |
| If you smoke (especially if you are over 35) | The combination of smoking and these hormones greatly increases the risk of blood clots and stroke. |
How do you use this medicine?
This is very simple. Take one pill with a glass of water at about the same time every day as your doctor tells you. Some people may experience stomach discomfort if taken on an empty stomach. If so, take it with a meal. Do not take more than the amount prescribed by your doctor for any reason.
What if I forget to take my medicine?
Imagine that you take your pill at 8 am every day. Today you remembered at 12 noon. Then take the missed pill right away. But if it is around 6-7 pm when you remember, meaning it is very close to the time you are supposed to take it at 8 am the next day, then forget about the missed pill. Take only one pill at 8 am the next day as usual. Never take two pills at once to make up for the missed one.
Other things that may interact with this medicine
It is very important to tell your doctor about every medication, vitamin, and herbal remedy you are taking, as some medications can interact with these hormonal pills and reduce or increase the effectiveness of the medication, or cause dangerous side effects.
In particular, some cancer drugs (Aromatase inhibitors), epilepsy drugs (e.g. Carbamazepine, Phenytoin), some antibiotics (e.g. Rifampin), and even grapefruit juice can interact with this medication. So be sure to tell your doctor about everything you take.
Things to be careful about when taking medicine
It is very important to pay a little attention to your body when using this medicine.
- Regular medical checkups: See your doctor at least once every 6 months for a complete checkup. It is essential to have a breast exam, a pelvic exam, and a mammogram if necessary.
- Avoid smoking: As we mentioned earlier, smoking while taking this medication for a woman over 35 is like opening the door to heart attack and stroke. So, avoid smoking completely.
- Swelling: Sometimes this medicine can cause water retention in the body, causing swelling in the fingers, hands, or ankles. It can also increase blood pressure. If this happens, tell your doctor .
- Before surgery: If you have a scheduled surgery, talk to your doctor about it and ask if you need to stop taking this medication before the surgery.
Possible side effects of the medicine
Like any medicine, this one can cause side effects in some people. Some of these are serious, some are common.
| Serious side effects that require immediate medical attention | |
|---|---|
| Sudden severe chest pain, difficulty breathing | It may be a sign of a blood clot in the lungs. |
| Leg pain, swelling, redness, and a feeling of warmth | A blood clot in a vein in the leg may be a sign of deep vein thrombosis (DVT). |
| Difficulty speaking, sudden numbness/numbness in the face, arm, or leg, difficulty walking | These may be signs of a stroke. |
| Severe headaches, vision changes | These may be signs of high blood pressure or another serious condition. |
| Yellowing of the eyes or skin (jaundice), dark urine, pain in the upper right side of the stomach | These may be signs of liver damage. |
| Breast lumps or changes, breast discharge, unusual vaginal bleeding | These may be serious conditions that need to be checked immediately. |
| Side effects that are usually nothing to worry about, but should be reported to the doctor if they persist | |
|---|---|
| Acne formation | Brown spots on the face |
| Changes in appetite | Changes in sexual desire |
| Mood swings, feeling a little depressed | Stomach ache or bloating |
| Weight gain | Feeling unusually tired |
What if I take too much medicine?
If you think you have taken more medicine than you think, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
Take-Home Message
- Estradiol and Norethindrone are hormone treatments used to treat menopausal symptoms and bone loss.
- Before taking this medication, you should tell your doctor about your complete health history (especially cancer, heart disease, blood clotting problems).
- Take the medicine at the same time every day. Never take more than the doctor prescribed.
- Smoking while taking this medicine is very dangerous , especially if you are over 35.
- If you experience serious symptoms such as chest pain, difficulty breathing, leg swelling, or difficulty speaking, seek medical advice immediately.
- If you have any questions about this medication, never be afraid to discuss it with your doctor.
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