Evamist.com – What is Hormone Therapy?

Some women may need prescription medications to help control their menopausal symptoms. During menopause, your body produces less of the hormones estrogen and progesterone. Specifically, your body decreases production of estradiol—a type of estrogen produced by your ovaries.¹

Menopausal hormone therapy (MHT) works by supplementing your body with the hormones that your body used to make more of before menopause. Estrogens and progestogens are types of MHT.² MHT is the only proven therapy approved by the FDA to treat symptoms of menopause such as hot flashes, night sweats, and vaginal dryness.^*3 Only you and your doctor can decide if hormone therapy is right for you. Discuss your symptoms with your doctor, and together you can make an informed decision.

Estrogen therapy (ET)

The decreasing amount of estrogen produced by your ovaries is what causes menopausal symptoms. Estrogen therapy is designed to add estrogen to your body during menopause, to help reduce your symptoms. Estrogen therapy is available by prescription.

Estrogen plus progestogen therapy (EPT)

In addition to relieving many of the symptoms of menopause, estrogen causes the lining of the uterus (womb) to grow and thicken, just as it did naturally before you entered menopause. Before menopause, your body naturally lined the uterus every month and then “shed” this lining during your period. But if the lining stays thickened for longer than normal—if you don’t have a period—it can be unhealthy and may result in cancer of the uterus. Progestogen is a hormone that helps prevent the lining of the uterus from thickening, so it is usually prescribed together with estrogen in women who have not had a hysterectomy. Progestogen is available by prescription.²

Use of estrogen, alone or in combination with a progestin, should be with the lowest effective dose and for the shortest duration consistent with treatment goals and risks for the individual woman. You should talk with your doctor periodically (for example at 3-month to 6-month intervals) to determine if treatment is still necessary.³

Are there serious risks in taking estrogen therapy?

For women with a uterus (womb), using estrogen alone may increase your chance of getting cancer of the uterus. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, blood clots or dementia. Serious but less common side effects also include:

• Gallbladder disease
• Ovarian cancer
• High blood pressure
• Liver problems
• High blood sugar
• Enlargement of benign tumors of the uterus (“fibroids”)

What are the possible side effects of estrogens?

Common side effects include:

• Headache
• Breast pain
• Irregular vaginal bleeding or spotting
• Stomach/abdominal cramps
• Bloating
• Nausea and vomiting
• Hair loss
• Fluid retention
• Vaginal yeast infection

These are not all of the possible side effects of estrogen. For more information, ask your healthcare provider or pharmacist.

What else do you need to know about ET?

The guidelines set forth by the ACOG, the FDA, and the American Association of Clinical Endocrinologists state that estrogen should be used in the smallest dose to provide relief and for the shortest period of time possible. You should talk with your doctor periodically (for example at 3-month to 6-month intervals) to determine if treatment is still necessary. Your doctor can help you best understand your options in estrogen therapy.³

Evamist (estradiol transdermal spray) is approved by the FDA for use after menopause to reduce moderate to severe hot flashes. The effectiveness of Evamist in treating other menopausal symptoms has not been demonstrated.

» References

Important Safety Information

What is the most important information I should know about Evamist (an estrogen hormone)?

•	Using estrogen alone may increase your chance of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are using Evamist. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb). Your healthcare provider should check any unusual vaginal bleeding to find the cause.
•	Do not use estrogen alone to prevent heart disease, heart attacks, strokes or dementia (decline of brain function)
•	Using estrogen alone may increase your chances of getting strokes or blood clots
•	Using estrogen alone may increase your chance of getting dementia, based on a study of women 65 years or older
•	Do not use estrogens with progestins to prevent heart disease, heart attack or dementia
•	Using estrogens with progestins may increase your chances of getting heart attacks, strokes, breast cancer, or blood clots
•	Using estrogens with progestins may increase your chance of getting dementia, based on a study of women 65 years and older
•	You and your healthcare provider should talk regularly about whether you still need treatment with Evamist
•	The estrogen in Evamist (estradiol transdermal spray) spray can transfer from the area of skin where it was sprayed to other people. Do not allow others, especially children, to come into contact with the area of your skin where you sprayed Evamist. Young children who are accidentally exposed to estrogen through contact with women using Evamist (estradiol transdermal spray) may show signs of puberty that are not expected (for example, breast budding)

Evamist (estradiol transdermal spray) is an estrogen hormone used after menopause to reduce moderate to severe hot flashes.

Evamist should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the past year; currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.

The most common side effects that may occur with Evamist are headache, breast tenderness, the common cold, nipple pain, back pain, nausea, and joint pain.

Please see full patient information for Evamist.

Please see full prescribing information for Evamist, including boxed warnings.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.