Esterified Estrogens/Methyltestosterone (Estratest F.S., Estratest H.S., and others) - Uses, Side Effects, and More

What are the most common side effects of esterified estrogens/methyltestosterone?

The most common side effects of esterified estrogens/methyltestosterone are listed below. Tell your health care provider if you have any of these side effects that bother you.

• Breast tenderness or enlarged breasts
• Cramps
• Bloating
• Acne
• Changes in hair growth
• Headache
• Dizziness
• Weight changes
• Changes in sex drive
• Fluid retention (see below)
• Depression (see below)
• Nausea or vomiting

There may be other side effects of esterified estrogens/methyltestosterone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of esterified estrogens/methyltestosterone?

While less common, the most serious side effects of esterified estrogens/methyltestosterone are described below, along with what to do if they happen.

Severe Allergic Reactions. Esterified estrogens/methyltestosterone may cause allergic reactions, which can be serious. Stop taking esterified estrogens/methyltestosterone and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Cancer. There is some concern that esterified estrogens/methyltestosterone may cause a new cancer to develop or cause a previously treated cancer to recur. Tell your health care provider about any new symptoms that you may get. 

Gallbladder Problems. Esterified estrogens/methyltestosterone may increase the risk of gallbladder problems, including cholecystitis and cholelithiasis (also known as gallstones). Call your health care provider right away if you have any of the following symptoms.

• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
• Fever
• Pain in your upper stomach area
• Clay-colored stool (poop)

Blood Clots. Esterified estrogens/methyltestosterone may increase the risk of blood clots in your arteries or veins and could cause a stroke, heart attack, or venous thromboembolism, including a blood clot in the lungs (pulmonary embolism) or deep vein thrombosis (DVT). Stop taking esterified estrogens/methyltestosterone and get emergency help if you have any of the following signs of blood clots. 

• Chest pain or pressure
• Fast or abnormal heartbeat
• Trouble breathing
• Pain in your back, jaw, throat, or arm
• Sweating, upset stomach, vomiting, or dizziness
• Sudden weakness on one side of your body
• Sudden and severe headache
• Slurred speech or trouble understanding speech
• Pain, swelling, or tenderness in your arm or leg
• Vision loss
• Bulging eyes 
• Double vision

Increased Blood Pressure (Hypertension). Esterified estrogens/methyltestosterone may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your health care provider if your blood pressure increases while using this medicine.

If you measure your blood pressure and the top number (systolic) is 180 or higher or the bottom number (diastolic) is 120 or higher, get medical attention right away. Increases in blood pressure may not be noticeable, but look out for and tell your health care provider right away if you have any of the following symptoms of severely high blood pressure.

• Sudden severe headache
• Chest pain
• Dizziness or confusion
• Trouble breathing
• Nausea or vomiting
• Blurry or other changes to vision
• Anxiety
• Buzzing in the ears
• Nosebleed
• Feeling of skipped heartbeats

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking esterified estrogens/methyltestosterone. Call your health care provider right away if you have any of the following symptoms of liver damage.

• Nausea or vomiting
• Stomach or belly pain
• Fever
• Weakness or unusual tiredness
• Itching
• Loss of appetite
• Light-colored poop
• Dark-colored urine (pee)
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Fluid Retention (Edema). Esterified estrogens/methyltestosterone can cause fluid retention, also called edema. Fluid retention can cause serious issues in people with certain conditions, such as heart failure or kidney problems. Call your health care provider right away if you have any of the following symptoms. 

• Chest pain
• Irregular heartbeat
• Shortness of breath
• Stretched or shiny skin
• Swollen body parts, such as the belly or ankles

Estrogen-Related Symptoms. Esterified estrogens/methyltestosterone may cause certain symptoms related to high estrogen levels, such as new or increased vaginal bleeding or breast pain. Tell your health care provider if you have any symptoms that bother you.

Depression. Esterified estrogens/methyltestosterone may cause you to have a depressed mood. If you have any thoughts of harming yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your health care provider right away if you have any of the following symptoms.

• New or increased thoughts of suicide or death
• Suicide attempt
• New or increased feelings of anxiety, depression, or other unusual changes in your mood or behavior

Masculine Features. Esterified estrogens/methyltestosterone may cause masculine features in women. This may include deepening of the voice, excessive hair growth, acne, an enlarged clitoris, or menstrual cycle changes. Tell your health care provider right away if you have any of these symptoms.