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Conjugated estrogens increase the risk of developing a condition (endometrial hyperplasia) that may lead to cancer of the lining of the uterus. Taking progestins, another hormone drug, with conjugated estrogens lowers the risk of developing this condition. Therefore, if your uterus has not been removed, your doctor may prescribe a progestin for you to take together with the estrogen. Visit your doctor regularly and report any unusual vaginal bleeding right away. Treatment with conjugated estrogens may increase the risk of heart attack, stroke, breast cancer, and blood clots in the lungs or legs. Because of these risks, conjugated estrogens should be prescribed at the lowest effective dose, for the shortest amount of time necessary. If you experience any of the following serious side effects, stop taking conjugated estrogens and seek emergency medical attention: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); shortness or breath or pain in the chest; a painful, red, or swollen leg; abnormal vaginal bleeding; pain, swelling, or tenderness in the abdomen; severe headache or vomiting, dizziness, faintness or changes in vision or speech; yellowing of the skin or eyes; or a lump in a breast. Other, less serious side effects may be more likely to occur. Continue to take conjugated estrogens and talk to your doctor if you experience decreased appetite, nausea, or vomiting; swollen or tender breasts; acne or skin color changes; decreased sex drive; migraine headaches or dizziness; water retention (swollen hands, feet, or ankles); problems with wearing contact lenses; depression; or changes in menstrual cycle or breakthrough bleeding. Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. Tablets: 0.3, 0.45, 0.625, 0.9, and 1.25 mg. To minimize side effects, the lowest effective oral dose of conjugated estrogens is used. The usual starting dose for treating symptoms associated with menopause and for preventing postmenopausal osteoporosis is 0.3 mg|day. The dose should be increased based on the response of patients' symptoms. Hypogonadism is treated with doses of 0.3 mg or 0.625 daily with a cyclical interval of three weeks on treatment followed by one week off treatment. The dose for women who have been castrated or have ovarian failure is 1.25 mg daily in a cyclical interval of three weeks on treatment and one week off treatment. (In reality, most women take estrogens continuously since during the week off treatment, symptoms return because of the lack of estrogen.) For treatment of breast cancer the recommended dose is 10 mg daily for three months.

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