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Details Product Name: Estrofem Drug Name: Oestradiol Packaging Type: Packets of 28 x 1 mg tablets Manufacturer: Novo Nordisk Use: Estrofem may be used as a supplement to, or substitution for, the ovaries' endogenous oestrogen production. Estrofem causes a decrease in or complete disappearance of oestrogen deficiency symptoms. How to take it: Oral estrogen usually is taken by mouth either every day or on a cyclical basis: once a day for 21 days and then none for 7 days; then the cycle is repeated. However, for treating cancer it usually is taken three times a day, every day for at least 3 months. Side effects: During the first few months of treatment with Estrofem breast tenderness may occur. Nausea, headache, and oedema occur rarely. Symptom are normally transient. Further more , skin reactions have been reported. Precautions: Physical examination and a complete medical and family history should be taken prior to the initiation of any oestrogen therapy with special reference to blood pressure, palpation of the breasts and the abdomen, and a gynaecological examination.Patients with intact uterus who are or have previously been treated with unopposed oestrogens should be examined with special care in order to investigate a possible hyperstimilation of the endometrium before commencing Estrofem therapy.As a general rule, oestrogens should not be prescribed for longer than one year without another physical examination including gynaecological examination being performed.If abnormal or irregular bleeding occurs during or shortly after therapy diagnostic aspiration biopsy or curettage should be performed to rule out the possibility of uterine malignancy.As a general rule for hormone replacement therapy (HRT) the lowest dose which alleviates the symptoms should be prescribed and medication should be discontinued as soon as possible.In patients treated with antihypertensive drugs and hormone replacement therapy (HRT) blood pressure should be monitored regularly. Patients with epilepsy, migraine, diabetes, asthma or cardiac failure should be carefully controlled as oestrogens may worsen these conditions.Thromboembolism has been reported in connection with oestrogen replacement therapy but there is no background to believe that the overall incidence is increased.The indications for immediate withdrawal of therapy are: Deep venous thrombosis, thromboembolic disorders, the emergence of migraine-type headaches, sudden visual disturbances, significant increase in blood pressure. It is also advisable to withdraw treatment 4 to 6 weeks before major surgery. Estrofem has no contraceptive effects.