Hot Flashes, Bone Loss, and More: 8 Myfembree Side Effects to Know About

While some period problems can be managed at home, others require help from a healthcare professional. If you’re living with uterine fibroids or endometriosis, there are medications available that can help manage your symptoms.

Myfembree (relugolix / estradiol / norethindrone acetate) is one medication your prescriber may suggest trying. This hormonal treatment can help with heavy periods due to fibroids. It can also relieve endometriosis pain.

Myfembree can be a helpful medication. But it does have side effects you’ll want to know about. For example, you might experience hot flashes and menstruation changes. That’s common with this treatment. But there’s also the possibility of long-term or serious side effects, such as bone loss or blood clots. This can be a scary prospect if this medication is new to you. We’ll try to ease some of that anxiety by going into detail about Myfembree side effects, and how you can prevent or manage them.

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Myfembree side effects at a glance

Many Myfembree side effects are mild. But long-term or serious side effects are possible too. It’s good to know what to expect when you first start taking it.

Common or mild Myfembree side effects include:

• Hot flashes

• Night sweats

• Headache

• Period changes

• Hair loss

• Low libido (sex drive)

• Mood changes

• Nausea

• Muscle or joint pain

• Toothache

• Fatigue

• Dizziness

Long-term or serious Myfembree side effects include:

• Bone loss

• Raised blood pressure

• Raised blood glucose (sugar)

• Raised cholesterol

• Being unable to recognize symptoms of early pregnancy

• Fibroids being pushed out of your uterus (expulsion)

• Suicidal thoughts

• Liver damage

• Gallbladder problems

• Allergic reactions

Myfembree also has a few boxed warnings. This is the FDA’s strictest warning for medications. While rare, these side effects can be life-threatening. Myfembree has the following boxed warnings:

• Blood clots

• Heart attack

• Stroke

EXPERT PICKS: WHAT TO READ NEXT

• Treatments for endometriosis: Myfembree (relugolix / estradiol / norethindrone acetate) is one of several endometriosis medications.

• Treating uterine fibroids: Experts review the available options for managing fibroids, from medications to surgery.

• Does Myembree shrink fibroids? Pharmacists explain how Myfembree works for uterine fibroids.

Let’s look closer at eight Myfembree side effects and what you can do to manage them.

1. Hot flashes and night sweats

Myfembree commonly causes vasomotor symptoms (VMS). These include hot flashes, night sweats, and flushing. It may feel similar to how some people describe menopause hot flashes. This Myfembree side effect happens because its relugolix component lowers estrogen levels in the body.

VMS can be uncomfortable. But they’re not harmful. And there are things you can do to minimize them, such as:

• Limiting spicy foods, alcohol, and caffeine

• Wearing loose-fitting clothing

• Keeping your bedroom cool (between 60°F and 67°F)

• Avoiding heavy blankets while sleeping

Let your prescriber know if hot flashes or night sweats become uncomfortable. They may be able to give you more advice on how to manage them.

2. Period changes

Myfembree can also cause period (menstruation) changes. In most cases, it significantly reduces bleeding. And it’s possible you may not have periods while taking Myfembree. But rarely, it can make heavy bleeding worse.

Experts recommend starting Myfembree within 7 days of getting your period. If you start it later in your cycle, it can temporarily cause heavy or irregular bleeding.

Contact your prescriber if you experience worsening bleeding or cramping while taking Myfembree. This can be a symptom of your uterus pushing a fibroid out of your body (expulsion). This is a rare but serious side effect that may require medical attention.

Good to know: Myfembree isn’t birth control, and it doesn’t prevent pregnancy. But it might be harder to tell if you’re pregnant with the period changes it causes. You should use nonhormonal birth control while you’re taking Myfembree for 7 days after your last dose. If you become pregnant, talk to a healthcare professional right away.

3. Hair loss

Myfembree can cause hair loss. This is because it contains hormones that can affect how your hair grows. Hair loss from Myfembree is generally mild and relatively uncommon. But it is possible.

Experts don’t know if lost hair grows back after stopping Myfembree. Talk to your prescriber if you have concerns about your hair growth. They may recommend a hair-loss treatment. They can also help you decide whether Myfembree is the best choice for you.

4. Low libido

Low libido (sex drive) is another possible Myfembree side effect. While uncommon, it can be distressing. Low libido feels different for everyone. You may have a lack of desire or trouble getting aroused (turned on).

There are steps you can take to help boost your libido, such as:

• Getting regular exercise

• Practicing stress-lowering activities, such as yoga

• Optimizing your sleep routine to help get enough rest

• Dedicating time for intimacy with your partner, such as scheduling regular date nights

If low libido is disrupting your sex life, talk with your prescriber. They can help you manage this Myfembree side effect and screen for other factors that cause libido changes.

5. Mood changes

Mood changes are another possible Myfembree side effect. These changes could be mild, and might look like irritability, feeling emotional, or brief mood swings. But rarely, Myfembree could cause or worsen depression. And it may lead to suicidal thoughts in severe cases. If you have a history of certain mental health conditions, you may have a higher risk of this side effect.

Talk to your prescriber about any new or worsening mood problems. They may suggest an alternative to Myfembree. But if your symptoms are severe, get help right away.

If you or someone you know is having thoughts of suicide, you’re not alone and help is available. Call the National Suicide Prevention Lifeline at 1-800-273-8255 or text HOME to 741-741 to reach the Crisis Text Line.

6. Bone loss

When taken long term, the relugolix component of Myfembree can reduce bone mineral density (BMD). This can weaken your bones and raise your risk of fractures (bone breaks). The estradiol in Myfembree helps to lower the risk of this side effect. But bone loss is still a concern if you’re taking it for a long time.

Myfembree’s manufacturer recommends only taking it for a total of 2 years. This helps limit the medication’s effects on your bones. But your prescriber may suggest taking it longer than 2 years. They’ll weigh your personal risks of continuing Myfembree long term when making this decision.

Your healthcare team should monitor your BMD with a DEXA scan before starting Myfembree and yearly while taking it. If you have osteoporosis, you shouldn’t take Myfembree. You also might not be able to take it if you have other risk factors for bone loss, or if you take certain medications.

7. Raised blood pressure

Myfembree can raise your blood pressure. In some cases, it may cause chronic high blood pressure (hypertension).

If you already have hypertension, make sure your prescriber knows before you start taking Myfembree. If your blood pressure is well managed with medications or lifestyle changes, you may still be able to take Myfembree. But it’s not recommended to take it if your blood pressure isn’t managed well. This can raise your risk of unwanted blood clots, a rare but serious Myfembree side effect.

Your prescriber should measure your blood pressure before starting and while taking Myfembree. You may also want to ask your healthcare team if you should check your blood pressure at home.

8. Blood clots

Rarely, Myfembree can cause unwanted blood clots. These can lead to complications such as blood clots in the legs or lungs. It can also cause a heart attack or stroke. Each of these situations can be life-threatening.

Certain people have a higher risk of blood clots while taking Myfembree. This includes those over age 35 who smoke. Make sure your prescriber knows if you smoke or vape before starting Myfembree.

There are other situations that can raise your blood clot risk, too. You shouldn’t take Myfembree if you have:

• A history of blood clots

• Conditions that affect the blood vessels, such as coronary artery disease

• Heart rhythm problems, such as atrial fibrillation

• Conditions that cause problems with bleeding

• High blood pressure that isn’t well managed

• Migraines with aura and are over age 35

Call 911 or get medical help right away if you have any of the following symptoms while taking Myfembree:

• Sudden or severe leg pain or swelling

• Sudden shortness of breath

• Trouble seeing

• Pain or pressure in your chest, arm, or jaw

• Sudden, severe headache

• Trouble speaking

• Weakness in an arm or leg

Why trust our experts?

Written by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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