Before the beginning of the application it is necessary to conduct a complete general medical and gynecological examination,including examination of the organs of the abdominal cavity and small pelvis, mammary glands, measurement of blood pressure, cytological analysis of the endometrium. It is necessary to exclude pregnancy. With prolonged therapy, a similar examination should be performed every 6-12 months.
4-6 weeks before the planned surgical intervention and during a period of prolonged immobilization, it is recommended to discontinue treatment to avoid thrombosis.
The drug should be discontinued immediately in the following cases: deep vein thrombosis, thromboembolic disease, a significant increase in blood pressure, the appearance of jaundice, the appearance of migraine headache, sudden visual impairment.
During hormone replacement therapy, patients with hypertension should regularly monitor blood pressure.
The change in the level of estrogen in the blood can affect the performance of some endocrine and liver functions.
Estrogens can cause fluid retention in the body, so patients with impaired cardiac or renal function require careful monitoring.
It is necessary to inform the attending physician about the simultaneous administration of barbiturates, phenylbutazone, hydantoins, rifampicin,the occurrence of irregular bleeding or unusually heavy bleeding in the period between use of the drug, discomfort in the epigastric region.
In the event of irregular uterine bleeding during the administration of the drug, a cytological analysis of the endometrium should be performed.
During treatment, it should be borne in mind that prolonged use of only estrogens in the climacteric period can lead to endometrial hyperplasia and increases the risk of developing endometrial cancer. To reduce the risk of developing endometrial cancer, an additional progestogen should be taken (usually for 10-12 days per month), which leads to a transition of the mucous membrane of the uterus to the secretory phase, with its rejection and subsequent menstrual bleeding after discontinuing progestogen administration. When irregular menstrual flow (in women with an intact uterus) appears against the background of estradiol treatment, diagnostic scraping should be performed to exclude the malignant neoplasm of the uterus.
In postmenopausal women who have been on hormonal replacement therapy for a long time, the risk of breast cancer increases.If the duration of treatment is more than 5 years, it is necessary to carefully weigh the positive effects of treatment with adverse effects.
In patients who are on long-term treatment, regular examination of the mammary glands is necessary, including one should teach them regular self-examination. Special caution should be exercised when administering estrogens to women who have or have had nodular or fibrocystic breast changes in the past. In such cases careful monitoring and regular mammography should be performed.
For women taking estrogen preparations in the menopausal period, there is an increased risk of cholelithiasis (estrogens increase the lithogenicity of bile).
The drug is not a contraceptive and does not restore the ability to fertilize.
Do not put the band-aid on the area of the mammary glands or waist. If the patch is applied correctly, then you can take a bath or shower, but you need to take into account that in hot water the patch can get unstuck.
Transdermal systems with estradiol are prescribed only to women.
You should avoid getting the gel on the mammary glands and mucous membranes of the vulva and vagina.