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Esterified Estrogens/Methyltestosterone Coupon - Esterified Estrogens/Methyltestosterone 1.25mg/2.5mg tablet

esterified estrogens/methyltestosterone

Generic Estratest
Used for Menopause
Used for Menopause

Estratest (esterified estrogens / methyltestosterone) is a combination medication that has an estrogen and testosterone replacement. It helps treat vasomotor symptoms of menopause, like hot flashes and night sweats. This medication is used when estrogen therapy isn't enough by itself. Estratest (esterified estrogens / methyltestosterone) comes as a tablet that's taken by mouth every day in cycles (for example, 3 weeks on, 1 week off). Some side effects include nausea, headache, and breast tenderness.

Last reviewed on April 10, 2025
Estratest (esterified estrogens / methyltestosterone) is a controlled substance, which means that it's more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
basics-icon

What is Estratest (esterified estrogens / methyltestosterone)?

What is Estratest (esterified estrogens / methyltestosterone) used for?

How Estratest (esterified estrogens / methyltestosterone) works

Estratest (esterified estrogens / methyltestosterone) has two ingredients that act like the sex hormones your body naturally makes. They balance hormonal changes that happen in your body during menopause.

  • Esterified estrogens is an estrogen replacement. It helps replace the natural estrogen that your body loses during menopause. This helps relieve menopause symptoms like hot flashes and night sweats.

  • Methyltestosterone is a testosterone replacement. It helps bring these hormone levels back up when they start to drop during menopause.

Are you looking for information on Menest (esterified estrogens) or methyltestosterone (Methitest) instead?

Drug Facts

Common BrandsEstratest FS, Estratest HS, Covaryx, Covaryx HS, EEMT, EEMT HS
Drug ClassEstrogen replacement / Testosterone replacement
Controlled Substance ClassificationSchedule III
Generic StatusLower-cost generic available
AvailabilityPrescription only
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What are the risks and warnings for Estratest (esterified estrogens / methyltestosterone)?

Estratest (esterified estrogens / methyltestosterone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

risk-warning

Risk for blood clots and related complications (e.g., heart attack, stroke)

  • Risk factors: Personal or family history of blood clots | High blood pressure | Diabetes | High cholesterol | Smoking tobacco | Considered obese | Systemic lupus erythematosus (SLE) | Taking high doses of Estratest (esterified estrogens / methyltestosterone)

    Medications containing estrogen like Estratest can raise the risk of blood clots. These blood clots block blood flow to different parts of the body, like the leg, lungs, heart, or brain. Some clots can lead to dangerous complications, such as heart attack or stroke. What's more, the other ingredient in Estratest called methyltestosterone, can also raise this risk.

    Before starting Estratest (esterified estrogens / methyltestosterone), ask your prescriber if it's safe for you. There are many things that can raise your risk for blood clots, like high blood pressure and high cholesterol.

    Be sure you know the signs and symptoms of a blood clot, heart attack, and stroke.

    • Blood clot: swelling, pain, or tenderness in the arm or leg; skin that's warm to the touch; chest pain; cough; trouble breathing

      • Heart attack: chest pain traveling to the arm, neck, or jaw; shortness of breath; cold sweat; dizziness

        • Stroke: sudden weakness on one side of the body, drooping face, bad headache, changes in speech or vision, confusion

          Stop taking Estratest (esterified estrogens / methyltestosterone) and get medical help right away if you have any signs or symptoms of a blood clot, heart attack, or stroke.

          risk-warning

          Risk for breast cancer

          • Risk factors: Personal or family history of breast cancer | Breast nodules | Abnormal mammograms (breast scans) | Taking Estratest (esterified estrogens / methyltestosterone) for a long period of time

            It's not clear if taking estrogen therapy like Estratest (esterified estrogens / methyltestosterone) during menopause can raise the risk of breast cancer. But studies in animals suggest that the risk might go up if you take it for a long time.

            To lower your risk, your prescriber will make sure you're taking the lowest dose for the shortest time needed to help with your symptoms. Regularly check your breasts often for any changes and get breast scans (mammograms) on time. Let your prescriber know if you notice anything unusual with the shape, size, or color of your breasts.

            risk-warning

            Risk for uterine cancer (also called endometrial cancer)

            • Risk factors: Taking estrogens without a progestin | People with a healthy uterus | Taking estrogen therapy for a long time | Higher estrogen dose

              Estratest (esterified estrogens / methyltestosterone) is an estrogen medication. Estrogens can thicken and change the lining of your uterus, called the endometrium. If you have a healthy uterus, the lining can grow too much with estrogen therapy. This can lead to uterine cancer, or endometrial cancer. The risk is higher if you take estrogen therapy without another hormone called progestin to balance out the effect on the uterine lining.

              Be aware of the warning signs of uterine cancer, like vaginal bleeding that doesn't go away or keeps coming back. Tell your prescriber if you notice any unusual vaginal bleeding. If you're worried about uterine cancer, ask your prescriber if you need to take another medication called a progestin to help lower your risk.

              risk-warning

              Harm to an unborn baby

              Don't take estrogen therapy like Estratest (esterified estrogens / methyltestosterone) if you're pregnant or could be pregnant. This medication can harm an unborn baby if taken during pregnancy. For example, there's a small chance of birth defects. And baby girls might be at higher risk of vaginal or cervical cancer later in life. The methyltestosterone can also cause baby girls to develop male-like genital features. If you become pregnant while taking this medication, tell your prescriber right away.

              risk-warning

              Liver or gallbladder problems

              • Risk factors: History of liver problems or jaundice | High doses of methyltestosterone

                Estrogens can raise the risk of liver damage and gallbladder problems. And taking methyltestosterone for a long time can lead to serious liver problems. Tell your prescriber if you've had jaundice (yellowing of your skin or eyes) before to make sure Estratest (esterified estrogens / methyltestosterone) is safe for you.

                Stop taking this medication and talk to your prescriber if you have jaundice, stomach pain, light-colored stool, or dark urine. These can be signs of liver damage or gallbladder disease.

                risk-warning

                Buildup of fluids in the body (fluid retention)

                • Risk factors: Heart failure | Kidney or liver problems

                  Estratest (esterified estrogens / methyltestosterone) can make your body hold extra fluid. This can cause swelling in your hands, ankles, or feet. The risk of problems from fluid retention is higher if you have heart failure or certain kidney or liver conditions. Fluid retention can also make some health problems worse. These can include seizures, migraines, and certain heart or kidney conditions. Tell your prescriber if you notice swelling in the hands or feet while taking Estratest (esterified estrogens / methyltestosterone).

                  risk-warning

                  High calcium levels

                  • Risk factors: Breast cancer | Cancer that has spread to the bones | Kidney problems

                    Estratest (esterified estrogens / methyltestosterone) can cause you to have high calcium levels. The risk for severely high calcium is higher if you have breast cancer or cancer that's spread to the bones.

                    Tell your prescriber if you have constipation, feel more thirsty, urinate more, have weak muscles, feel tired, or have bone pain. These can be signs of high calcium levels. Your prescriber will probably check your calcium levels through blood tests. If your levels are too high, you might need to stop this medication.

                    risk-warning

                    Use with caution in people with diabetes

                    Estratest (esterified estrogens / methyltestosterone) might affect how your body processes sugars. Let your prescriber know if you have diabetes. And tell your diabetes care team you're taking this medication. Ask them how often you should check your blood sugar at home. If you take diabetes medications, your prescriber might adjust your doses to help keep your sugar under control.

                    basics-icon

                    What are the side effects of Estratest (esterified estrogens / methyltestosterone)?

                    The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

                    Common Side Effects

                    • Change in menstrual bleeding patterns, including spotting
                    • Breast tenderness
                    • Breast enlargement
                    • Deepening of the voice
                    • Voice hoarseness
                    • Acne
                    • Nausea
                    • Stomach cramps
                    • Bloating
                    • Headache or migraine
                    • Dizziness

                    Other Side Effects

                    • Vomiting
                    • Hair loss
                    • Excessive hair growth (e.g., more hair on the face)
                    • Depression
                    • Anxiety
                    • Swelling in the feet or ankles
                    • Changes in weight
                    • Changes in sex drive
                    • Patches of darkened skin on the face

                    Serious Side Effects

                    Contact your healthcare provider immediately if you experience any of the following.
                    • Blood clots: trouble breathing, leg pain or swelling, skin that's warm to the touch
                    • Heart attack: chest pain, arm pain, shortness of breath, cold sweat, lightheadedness
                    • Stroke: sudden weakness on one side of your body, drooping face, changes in your speech or vision, confusion, headache
                    • Breast lumps or pain: breast pain or soreness, swelling, rash
                    • High calcium levels: tiredness, muscle weakness, nausea, vomiting, constipation, frequent urination, thirst, blood in the urine
                    • Unusual vaginal bleeding

                    Source: DailyMed

                    The following side effects have also been reported

                    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

                    Check with your doctor immediately if any of the following side effects occur:

                    More common

                    Absent, missed, or irregular menstrual periods

                    acne or oily skin

                    decreased breast size

                    enlarging clitoris

                    hoarseness or deepening of the voice

                    menstrual changes

                    stopping of menstrual bleeding

                    unnatural hair growth or loss

                    Rare

                    Continuing nausea

                    cough

                    dark-colored urine

                    difficulty with swallowing

                    dizziness

                    fast heartbeat

                    fever

                    hives

                    itching

                    light-colored stools

                    loss of appetite

                    puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

                    purple or red-colored spots on the body or inside the mouth or nose

                    shortness of breath

                    skin rash

                    sore throat

                    tightness in the chest

                    unusual tiredness or weakness

                    vomiting

                    wheezing

                    Incidence not known

                    Abdominal or stomach bloating, cramps, or pain

                    anxiety

                    bleeding from gums or nose

                    blistering, peeling, or loosening of the skin

                    bloating

                    bloody or cloudy urine

                    burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

                    change in vaginal discharge

                    changes in skin color, pain, or tenderness

                    chest pain or discomfort

                    chills

                    clay-colored stools

                    clear or bloody discharge from nipple

                    confusion

                    constipation

                    convulsions

                    darkening of urine

                    decrease in amount of urine

                    diarrhea

                    difficult, burning, or painful urination

                    difficulty with breathing

                    difficulty with moving

                    difficulty with speaking

                    dimpling of the breast skin

                    dizziness or lightheadedness

                    double vision

                    eye pain

                    fainting

                    fever

                    fluid-filled skin blisters

                    frequent urge to urinate

                    headache

                    heavy bleeding

                    inability to move the arms, legs, or facial muscles

                    inability to speak

                    indigestion

                    inverted nipple

                    irregular heartbeats

                    itching of the vagina or genital area

                    joint or muscle pain

                    large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

                    light-colored stools

                    loss of appetite

                    lump in the breast or under the arm

                    mood or mental changes

                    muscle cramps in the hands, arms, feet, legs, or face

                    muscle pain or stiffness

                    nausea

                    noisy, rattling breathing

                    numbness and tingling around the mouth, fingertips, or feet

                    pain

                    pain during sexual intercourse

                    pain in the ankles or knees

                    pain or discomfort in the arms, jaw, back, or neck

                    pain or feeling of pressure in pelvis

                    painful, red lumps under the skin, mostly on the legs

                    pains in the stomach, side, or abdomen, possibly radiating to the back

                    pelvic pain

                    persistent crusting or scaling of the nipple

                    pinpoint red or purple spots on the skin

                    poor insight and judgment problems with memory or speech

                    red, irritated eyes

                    redness or swelling of the breast

                    ringing in the ears

                    sensitivity to the sun

                    shortness of breath

                    skin thinness

                    slow speech

                    sore on the skin of the breast that does not heal

                    sore throat

                    sores, ulcers, or white spots in the mouth or on the lips

                    stomach pain

                    sudden shortness of breath or troubled breathing

                    sweating

                    swelling

                    swelling of the fingers, hands, feet, or lower legs

                    tenderness of the breast

                    thick, white curd-like vaginal discharge without odor or with mild odor

                    tiredness

                    tremor

                    trouble recognizing objects

                    trouble thinking and planning

                    trouble walking

                    troubled breathing at rest

                    unexpected or excess milk flow from breasts

                    unpleasant breath odor

                    vaginal bleeding

                    vision changes

                    vomiting of blood

                    weakness

                    weight gain

                    yellow eyes or skin

                    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

                    Incidence not known

                    Blemishes on the skin

                    brown, blotchy spots on the exposed skin

                    decreased interest in sexual intercourse

                    depression

                    headache, severe and throbbing

                    inability to have or keep an erection

                    increase or decrease in weight

                    increased hair growth, especially on the face

                    increased in sexual ability, desire, drive, or performance

                    increased interest in sexual intercourse

                    irritability

                    leg cramps

                    loss in sexual ability, desire, drive, or performance

                    loss of hair

                    mental depression

                    pimples

                    redness of the skin

                    swelling or inflammation of the mouth

                    twitching, uncontrolled movements of the tongue, lips, face, arms, or legs

                    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

                    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

                    pros-and-cons

                    Pros and cons of Estratest (esterified estrogens / methyltestosterone)

                    thumbs-up

                    Pros

                    An option to help with hot flashes and night sweats from menopause if estrogen therapy alone isn't enough

                    Might also help with improving sex drive

                    thumbs-down

                    Cons

                    Is a controlled substance, so there might be special requirements to get the medication filled

                    Might need to take another medication called a progestin to help lower your risk of endometrial cancer

                    pharmacist-tips

                    Pharmacist tips for Estratest (esterified estrogens / methyltestosterone)

                    pharmacist
                    • Take Estratest (esterified estrogens / methyltestosterone) at the same time every day for 3 weeks. Then, stop taking it for 1 week. After the break, start the cycle again. It can help to keep track of when to take your medication and when your break weeks are so you don't forget.

                      • Check in with your prescriber regularly, like every 3 to 6 months, about how well Estratest (esterified estrogens / methyltestosterone) is helping with your menopause symptoms. This medication has many side effects and risks. So it's important to take it for the shortest time needed to help your symptoms.

                        • You might notice your voice getting deeper, acne, and more hair on your face and body while you're taking Estratest (esterified estrogens / methyltestosterone). If you see these changes, stop taking the medication and tell your prescriber right away. Talk to them if you're worried about this side effect.

                          • Your blood pressure might get higher while taking Estratest (esterified estrogens / methyltestosterone). Your prescriber might check your blood pressure before starting treatment to make sure it's safe for you. And they might ask you to check at home as well. If your blood pressure stays higher than usual, tell your prescriber.

                            • Tell your prescriber at least 4 to 6 weeks before any surgeries, bedrest, or other situations where you need to sit still or lie down for a long time. They'll let you know if you should stop taking Estratest (esterified estrogens / methyltestosterone) before and when to restart it after your procedure. This helps lower your risk for blood clots.

                              • Estratest (esterified estrogens / methyltestosterone) can cause changes to the thyroid hormone levels in your body. Tell your prescriber if you have any conditions that affect your thyroid hormone levels. They can make sure your hormone levels stay in a normal range.

                                faqs

                                Frequently asked questions about Estratest (esterified estrogens / methyltestosterone)

                                Is Estratest (esterified estrogens / methyltestosterone) a controlled substance?
                                Yes, Estratest (esterified estrogens / methyltestosterone) is a controlled substance. This medication contains methyltestosterone, which has a potential for misuse and addiction. So, there are strict rules from the government that help make sure people take Estratest (esterified estrogens / methyltestosterone) responsibly. This includes when your prescription expires and how many times you can refill it. Ask your prescriber if you have more questions.
                                Is Estratest (esterified estrogens / methyltestosterone) FDA approved?
                                Estratest (esterified estrogens / methyltestosterone) hasn't been formally approved by the FDA. The medication was first marketed in 1964. This was two years after the government started a formal approval process to make sure a medication is safe and works for what it's meant to treat. This has led to controversy around the medication. Also note that Estratest (esterified estrogens / methyltestosterone) has generally been replaced by newer medications. Talk to your prescriber if you have concerns about this.
                                Is Estratest (esterified estrogens / methyltestosterone) still available?
                                Yes, the Estratest brand name is still available with a prescription from a healthcare professional. The generic version, esterified estrogens and methyltestosterone, is also available.
                                Does Estratest (esterified estrogens / methyltestosterone) cause weight gain?
                                Some people taking Estratest (esterified estrogens / methyltestosterone) have reported weight gain. But others have also noted weight loss. This medication can also make your body hold onto more fluids. This can lead to more water weight, which can appear as weight gain. If you notice any weight changes that worry you while taking this medication, talk to your prescriber.
                                How long does it take for Estratest (esterified estrogens / methyltestosterone) to work?
                                It's not clear how long it takes for Estratest (esterified estrogens / methyltestosterone) to help with menopause symptoms. Also note that everyone can have a different experience with treatment. It's a good idea to keep track of how you're feeling and how often you have symptoms while taking this medication. And to help even more, wear loose layers and use lightweight sheets to keep comfortable. Follow up with your prescriber and work with them to come up with a plan that's right for you.
                                Is Estratest (esterified estrogens / methyltestosterone) bioidentical?
                                No, Estratest (esterified estrogens / methyltestosterone) isn't bioidentical. Bioidentical hormones are hormones that are chemically similar to the ones your body makes. And they're made in the lab from a plant source. Estratest contains esterified estrogens and methyltestosterone. These ingredients are made in the lab from chemicals. Talk to your prescriber for bioidentical menopause hormonal therapy.
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                                dosage

                                Estratest (esterified estrogens / methyltestosterone) dosage forms

                                Typical dosing for Estratest (esterified estrogens / methyltestosterone)

                                The typical dose is 0.625 mg/1.25 mg or 1.25 mg/2.5 mg (esterified estrogens/methyltestosterone) by mouth once a day. Take the medication every day for 3 weeks, then stop for 1 week. After the 1-week break, start the cycle again until your prescriber tells you to stop.

                                interactions

                                Interactions between Estratest (esterified estrogens / methyltestosterone) and other drugs

                                Estratest (esterified estrogens / methyltestosterone) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Estratest (esterified estrogens / methyltestosterone). Please note that only the generic name of each medication is listed below.

                                Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                                Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                                drug-cost

                                How much does Estratest (esterified estrogens / methyltestosterone) cost?

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                                contraindications-icon

                                Estratest (esterified estrogens / methyltestosterone) contraindications

                                Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Estratest (esterified estrogens / methyltestosterone) will not be safe for you to take.
                                • Breast cancer (except in certain people with metastatic cancer, or cancer that's spread to other parts of the body)

                                • Estrogen-sensitive cancer or tumor

                                • Abnormal vaginal bleeding that hasn't been diagnosed

                                • Conditions that cause blood clots

                                • History of blood clot or problems from a blood clot when using estrogen therapy in the past

                                • Severe liver damage

                                • Currently pregnant

                                • Currently breastfeeding

                                alternatives

                                What are alternatives to Estratest (esterified estrogens / methyltestosterone)?

                                There are a number of medications that your doctor can prescribe in place of Estratest (esterified estrogens / methyltestosterone). Compare a few possible alternatives below.
                                Estratest (esterified estrogens / methyltestosterone)
                                Used for:
                                $34.70 Lowest GoodRx priceView Prices
                                Used for:
                                • Hot flashes and night sweats due to menopause

                                • Vaginal itching, dryness, and burning due to menopause

                                • Low estrogen levels

                                • Breast cancer or prostate cancer in certain people

                                • To prevent bone loss (osteoporosis) after menopause

                                $31.63 Lowest GoodRx priceView Prices
                                Used for:
                                $44.00 Lowest GoodRx priceView Prices
                                images

                                Estratest (esterified estrogens / methyltestosterone) images

                                Green Oval Ip 78 - Esterified Estrogens / Methyltestosterone 1.25mg-2.5mg DS Tablet
                                This medicine is Green, Oval Tablet Imprinted With "Ip 78".Green Oval Ip 78 - Esterified Estrogens / Methyltestosterone 1.25mg-2.5mg DS Tablet
                                Green Oblong 1490 - Esterified Estrogens / Methyltestosterone 1.25mg-2.5mg Tablet
                                This medicine is Green, Oblong Tablet Imprinted With "1490".Green Oblong 1490 - Esterified Estrogens / Methyltestosterone 1.25mg-2.5mg Tablet
                                Green Oval Syntho And 231 - Esterified Estrogens / Methyltestosterone Full Strength 1.25mg-2.5mg Tablet
                                This medicine is Green, Oval Tablet Imprinted With "Syntho" And "231".Green Oval Syntho And 231 - Esterified Estrogens / Methyltestosterone Full Strength 1.25mg-2.5mg Tablet
                                Green Oval E And 830 - Esterified Estrogens / Methyltestosterone Full Strength 1.25mg-2.5mg Tablet
                                This medicine is Green, Oval Tablet Imprinted With "E" And "830".Green Oval E And 830 - Esterified Estrogens / Methyltestosterone Full Strength 1.25mg-2.5mg Tablet

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                                References

                                Best studies we found

                                Brzozowska, M., et al. (2020). Changes of androgens levels in menopausal women. Menopause Review.

                                Endocrine Society. (2019). Compounded bioidentical hormone therapy.

                                Furness, S., et al. (2012). Hormone therapy in postmenopausal women and risk of endometrial hyperplasia. The Cochrane Database of Systematic Reviews.

                                GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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