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• Risk factors: Personal or family history of blood clots | High blood pressure | Diabetes | High cholesterol | Tobacco use | Obesity | Systemic lupus erythematosus (SLE)

Estrogen/progestin combination therapies, such as Femhrt (ethinyl estradiol / norethindrone), and estrogen-only therapy can raise your risk of blood clots. These blood clots can travel anywhere in your body and block bloodflow, including your legs or arms (deep vein thrombosis, DVT) and your lungs (pulmonary embolism, PE), which can be life-threatening. They can also travel to your heart, which can lead to a heart attack, or your brain, which can lead to a stroke. Because of this risk, estrogen/progestin and estrogen-only therapies shouldn't be used to prevent heart disease. You're at higher risk of blood clots if you or anyone in your family has had them in the past, if you use tobacco, or if you have certain conditions, like high blood pressure, diabetes, or high cholesterol.

Let your healthcare provider know you're using Femhrt (ethinyl estradiol / norethindrone). Because of the risk of developing blood clots, you'll need to stop using Femhrt (ethinyl estradiol / norethindrone) before certain types of surgeries or periods of time when you won't be moving much. Your provider will let you know how long before the surgery you need to stop using Femhrt (ethinyl estradiol / norethindrone). To lower your risk of blood clots, wear compression leggings or get up and stretch often on long car or plane trips.

Let your provider know if you have pain or swelling in your legs or arms, as this can be a sign of a blood clot. Call 911 and get medical help right away if you have trouble breathing, chest or arm pain, facial drooping, weakness on one side of the body, severe headaches, or sudden changes in your speech or vision, since these can be signs of life-threatening complications of blood clots.

• Risk factors: Personal or family history of breast cancer | Using hormonal therapy for a long period of time

Estrogen/progestin combination therapies like Femhrt (ethinyl estradiol / norethindrone) can raise your risk of breast cancer. This risk might be higher compared to estrogen-only therapy. Don't use Femhrt (ethinyl estradiol / norethindrone) if you currently have or have had breast cancer in the past. You're also at greater risk if you've used Femhrt (ethinyl estradiol / norethindrone) or similar medications for a long period of time. To lower your risk of breast cancer, your provider will prescribe the lowest dose of estrogen for the shortest period of time possible. It's important that you regularly check your breasts for any changes and get breast scans (mammograms) done. Let your healthcare provider know if you notice any unusual changes in breast shape, size, or color.

• Risk factors: Estrogen therapy without progestin use | Women with a healthy uterus | Using estrogen therapy for more than 1 year | High estrogen dose

Femhrt (ethinyl estradiol / norethindrone) contains ethinyl estradiol, which works like estrogen in your uterus. It can thicken and change the lining of your uterus, called the endometrium. Uncontrolled growth of the uterus lining can cause uterine or endometrial cancer in people with a healthy uterus. This risk is especially high in people taking estrogen therapy without a progestin to balance out estrogen's effect on the growth of the uterine lining. Your risk is higher if you use estrogen therapy for more than 1 year and if you use high doses. You can still have the risk of uterine cancer several years after stopping estrogen therapy.

People using Femhrt (ethinyl estradiol / norethindrone) might have a lower risk of uncontrolled endometrial growth compared to those taking estrogen-only therapy, since Femhrt (ethinyl estradiol / norethindrone) contains a progestin. Regardless of the hormonal therapy you're taking, it's important to be aware of the warning signs of uterine (endometrial) cancer, including vaginal bleeding that doesn't go away or keeps coming back. Let your healthcare provider know if you notice any unusual vaginal bleeding. If you're worried about getting uterine cancer, talk to your provider.

• Risk factors: Age 65 years or older

Women taking estrogen/progestin combinations or estrogen-only therapy might be at greater risk for dementia, especially if hormonal therapy is started after age 65. Estrogen/progestin combination and estrogen-only therapies shouldn't be used to prevent dementia. Symptoms of dementia include forgetfulness, confusion, getting lost, and trouble with names of familiar objects or people. If the risk of dementia worries you, speak to your provider.

Estrogen/progestin combinations and estrogen-only therapy can potentially raise the risk of ovarian cancer in women using hormonal therapy for menopausal symptoms. If you notice any unusual vaginal bleeding, vaginal discharge, or pelvic pain, talk to your healthcare provider. These can be signs of ovarian cancer.

• Risk factors: History of liver disease or jaundice

Estrogen therapy can raise the risk of gallbladder disease. Let your healthcare provider know if you've had jaundice (yellowing of your skin or eyes, or dark urine) in the past. If your jaundice comes back while using Femhrt (ethinyl estradiol / norethindrone), stop the medication and talk to your provider. These can be signs of liver damage or gallbladder disease.

• Risk factors: Breast cancer | Cancer that has spread to the bones | Low parathyroid hormone levels

Estrogen therapy can change the calcium levels in your blood. Women with breast cancer and cancer that's spread to the bones are at higher risk of extremely high calcium levels while taking estrogens. Symptoms of high calcium levels include muscle weakness, nausea, vomiting, or constipation.

On the other hand, women with low parathyroid hormone levels from the parathyroid gland are at higher risk of low calcium levels during estrogen therapy. Symptoms of low calcium levels include muscle spasms or twitching and numbness and tingling in your fingers, toes, or around your mouth.

Let your provider know if you notice any of these symptoms. You might need regular blood tests done so that your provider can check your calcium levels while you're taking Femhrt (ethinyl estradiol / norethindrone).

Although rare, some people taking estrogens have had vision problems due to blood clot formation in the eyes. If you have sudden, partial or complete vision loss, bulging eyes, double vision, or migraines, stop Femhrt (ethinyl estradiol / norethindrone) and tell your provider.

• Risk factors: History of high triglyceride levels in the blood

Estrogen therapy might raise the triglyceride (fat) levels in your blood. Too much triglyceride in your blood can lead to problems in your pancreas, including swelling (pancreatitis). You might need to get blood tests done regularly while taking Femhrt (ethinyl estradiol / norethindrone) so your provider can make sure your pancreas is healthy. If you experience signs of pancreatitis, like stomach pain, nausea, or vomiting, let your provider know right away.

• Risk factors: Conditions that cause low thyroid hormone levels

Estrogens can cause changes in the thyroid hormone levels in your body. If you have conditions that cause low thyroid hormone levels, your body can't adjust these levels to keep them in the normal range. If you're taking thyroid replacement medication for your thyroid condition, you might need to take a higher dose. You also might need to get regular blood tests done while using Femhrt (ethinyl estradiol / norethindrone) to make sure your thyroid hormone levels are normal.

• Risk factors: Certain heart conditions | Kidney damage

Estrogen/progestin combination therapies can cause excess fluids to build up inside your body. Signs of fluid retention include swelling of your hands and ankles. You're at higher risk of fluid retention if you have certain heart conditions, like heart failure, or kidney damage. If you have these conditions, let your provider know if you notice any signs of worsening fluid retention while using Femhrt (ethinyl estradiol / norethindrone).

• Risk factors: Asthma | Diabetes | Seizures | Migraine | Blood problems | Lupus | Liver problems

Estrogen therapy might cause worsening of certain health conditions, including asthma, diabetes, seizures, migraine, blood problems (e.g., porphyria), systemic lupus erythematosus, and liver problems. Make sure your provider knows your full medical history so you can discuss if estrogen therapy is a good option for you.