Coronary heart disease – Based on randomized controlled trials is impossible to make conclusions about the advantages of continuous application of equine estrogens . Two large clinical trials phenyl propionate showed a possible increased risk of diseases of the cardiovascular system in the first year of application combinations and generally found no benefit. For otherproducts there are only limited data from randomized results of controlled studies evaluating their effect on the incidence of cardiovascular or mortality.
Therefore, it is unclear whether this effect applies also to other products.
Cerebrovascular accidents – A large randomized clinical trial found, as a secondary outcome, an increased risk of ischemic stroke in healthy women who receive continuous treatment combination equine estrogens and MPA. According to the assessment of women, does not pass the course, the incidence of cerebrovascular accidents, which may occur for over 5 years, is about 3 per 1000 women aged 50-59 years and 11 per 1000 women aged 60-69 years . For those women who are within 5 years of taking a combination of conjugated estrogens and MPA, the number of additional cases of cerebrovascular accidents ranges from 0 to 3 (best estimate = 1) per 1000 women aged 50-59 years and 1-9 cases per 1000 women aged 60-69 years (best estimate = 4). Data on whether this increased risk of spreading to other phenyl propionate preparations are unknown.
Ovarian cancer – Long-term use (at least 5-10 years) only estrogen preparations in women with hysterectomy associated in some epidemiological studies to an increased risk of ovarian cancer. It is unclear – whether long-term use increases the combined preparations the risk of developing ovarian cancer compared to the risk caused by using only products containing estrogen.
Other conditions – Estrogens can cause fluid retention, and therefore patients with dysfunction of cardiovascular or kidney should be monitored carefully. Patients with terminal renal insufficiency should be monitored carefully, since it is expected that the level of circulating active ingredients while taking the drugphenyl propionatewill increase.
Women with hypertriglyceridemia in history to be a thorough examination , since it has been reported that this condition with treating estrogen marked rare cases a significant increase of triglyceride in plasma, which leads to pancreatitis.
Estrogens increase the concentration of thyroxine-binding globulin, which leads to an increase in the total concentration of circulating thyroid hormones determined content of protein-bound iodine, the concentration of thyroxine (determined by column chromatography or by radioimmunoassay) or triiodothyronine (determined by radioimmunoassay during the study). The level of absorption of triiodothyronine decreases, indicating an increase in the concentration of thyroxine-binding globulin . The concentrations of free thyroxine and triiodothyronine remain unchanged. May increase the concentrations of other binding proteins of blood serum, including corticoid-binding globulin binding globulin sex hormones, which leads to increased concentration of circulating sex hormones and corticosteroids, respectively. The concentrations of free or biologically active hormones do not change. It may increase the concentration and other plasma proteins (substrate angiotensinogen / renin, alpha 1-antitrypsin, ceruloplasmin).
There is no conclusive evidence to improve cognitive function. There is some evidence of the existence of risk resulting in the study, possible dementia in women who are over 65 years old began to constantly take combination drug containing horse estrogens . It is not known whether this female subject at a younger age in the state of menopause products.