Benefits

The patch are FDA-approved treatments that are structurally identical to the estrogen produced by your body, and are therefore referred to as a bioidentical hormone therapy. When your own estrogen declines during menopause, treatment with estradiol provides  effective relief for the vasomotor symptoms of menopause, including hot flushes and night sweats.

Safety Information

The Women’s Health Initiative (WHI) Study reported increased risks of myocardial infarction, certain types of blood clots (deep vein thrombosis and pulmonary embolus),endometrial cancer, and invasive breast cancer during 5 years of treatment with conjugated equine estrogens (CE 0.625 mg) combined with medroxyprogesterone acetate (MPA 2.5 mg) relative to placebo. Other doses of conjugated estrogens with medroxyprogesterone, and other combinations of estrogens (including estradiol) and progestins were not studied in the WHI and, in the absence of comparable data, these risks should be assumed to be similar for all estrogens and estrogen-progestin combinations.  

If you’re considering the estradiol patch or the estradiol pill, be sure to talk to your Evernow medical provider about possible contraindications, especially if you have a history of an estrogen-sensitive cancer, liver disease, undiagnosed vaginal bleeding, coronary heart disease, a history of blood clots, or stroke.

Benefits

The patch are FDA-approved treatments that are structurally identical to the estrogen produced by your body, and are therefore referred to as a bioidentical hormone therapy. When your own estrogen declines during menopause, treatment with estradiol provides  effective relief for the vasomotor symptoms of menopause, including hot flushes and night sweats.

Safety Information

The Women’s Health Initiative (WHI) Study reported increased risks of myocardial infarction, certain types of blood clots (deep vein thrombosis and pulmonary embolus),endometrial cancer, and invasive breast cancer during 5 years of treatment with conjugated equine estrogens (CE 0.625 mg) combined with medroxyprogesterone acetate (MPA 2.5 mg) relative to placebo. Other doses of conjugated estrogens with medroxyprogesterone, and other combinations of estrogens (including estradiol) and progestins were not studied in the WHI and, in the absence of comparable data, these risks should be assumed to be similar for all estrogens and estrogen-progestin combinations. 

If you’re considering the estradiol patch or the estradiol pill, be sure to talk to your Evernow medical provider about possible contraindications, especially if you have a history of an estrogen-sensitive cancer, liver disease, undiagnosed vaginal bleeding, coronary heart disease, a history of blood clots, or stroke.

What it's for

The vaginal estradiol tablet is an FDA-approved, bioidentical treatment that helps relieve the symptoms of Genitourinary Syndrome of Menopause (eg, vaginal dryness, painful sex, vulvar irritation, frequent urination, and/or recurrent UTIs).

What to expect

Initial improvement in symptoms may be seen as early as 2-4 weeks after initiating treatment. Full relief is typically experienced after 2-3 months.

How to use

During the first two weeks of your treatment, you will place the tablet every night immediately before bed. After this 2-week “loading dose”, you will only use the medication 2 nights a week.

Safety information

Please make sure to read all of the important safety information before starting this medication. If you are concerned that you are having side effects related to the medication, please contact your Evernow medical provider through our platform.

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Benefits

As part of a menopausal hormone therapy regimen, progesterone is prescribed in order to protect the lining of the uterus from the effects of estrogen. Individuals taking estrogen alone are at risk for uterine lining overgrowth (hyperplasia) or cancer. Taking progesterone significantly decreases that risk in women with a uterus. Women without a uterus do not need to take progesterone as part of their menopausal hormone therapy.

Safety Information

Please make sure to read all of the important safety information before starting this medication. If you are concerned that you are having side effects related to the medication, please contact your Evernow medical provider through our platform.

Benefits

The vaginal estradiol cream is an FDA-approved bioidentical estrogen cream that helps relieve the symptoms of Genitourinary Syndrome of Menopause (eg, vaginal dryness, painful sex, vulvar irritation, frequent urination, and/or recurrent UTIs).

Safety Information

Please make sure to read all of the important safety information before starting this medication. If you are concerned that you are having side effects related to the medication, please contact your Evernow medical provider through our platform.

Benefits

Used as part of a menopausal hormone therapy regimen to protect the uterus against the effects of estrogen, it can also be used as a form of perimenopausal contraception.

Safety Information

Please make sure to read all of the important safety information before starting this medication. If you are concerned that you are having side effects related to the medication, please contact your Evernow medical provider through our platform.

Benefits

By 4-6 weeks, most women feel the benefits of the treatment, including a reduction in hot flashes and night sweats, and may also notice better sleep quality.

Safety information

Please make sure to read all of the important safety information before starting this medication. If you are concerned that you are having side effects related to the medication, please contact your Evernow medical provider through our platform.

Oral Minoxidil

Important Safety Information

ORAL MINOXIDIL MAY CAUSE SERIOUS SIDE EFFECTS THAT IMPACT THE HEART, INCLUDING PERICARDIAL EFFUSION AND TAMPONADE. WHEN TESTED ON ANIMALS, MINOXIDIL CAUSED LESIONS OF THE HEART AS WELL AS OTHER ADVERSE HEART EFFECTS

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Side Effects & Risks:

Oral minoxidil has a black boxed warning for serious cardiac events. 

• Minoxidil may cause pericardial effusion, the accumulation of fluid in the sac that surrounds the heart (pericardium). This may progress to tamponade and angina pectoris
• When tested on animals, minoxidil caused lesions of the heart as well as other adverse heart effects.

Oral minoxidil may also contribute the following:

• Pleural effusion, the accumulation of fluid between the layers of tissue that line the lungs and chest cavity
• Hypotension or blood pressure that is lower than normal. This may also result in lightheadedness
• Hypertrichosis, or increased hair growth on the face or body
• Lower extremity edema (fluid retention) or the swelling of the legs, ankles and/or feet
• Palpitations or tachycardia
• Headaches
• Swelling around the eyes
• Insomnia
• Nausea

If you experience any of the above side effects, contact your provider in order to cease treatment or adjust your dose.

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Minoxidil may also cause changes to your EKG; tell your doctor prior to an EKG if you are taking oral minoxidil.

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Contraindications:

Do not use oral minoxidil if:

• You are pregnant or breastfeeding
• You have a cardiac history of CHF, hypotension (below 90/60), pulmonary hypertension, kidney or liver disease
• You are taking blood pressure medications for hypertensions
• You have experienced dizziness or fainting that occurs upon standing after sitting or lying down
• You have experienced a sudden onset of muscularity, a deepening of the voice, enlargement of the clitoris or excessive hair growth on the face and body
• You have frontal fibrosing alopecia: If hairline is pushing back (or eyebrow hair loss or skin-colored bumps in the eyebrows, sometimes with associated eyebrow hair loss) with symptoms (itching, burning, dry skin around hair follicle, stinging, erythema)
• You have Alopecia areata
• You have Lichen planopilaris
• You have Ludwig stage II-2 and above
• You have  history of pheochromocytoma, a tumor in the adrenal gland
• You have a known allergic reaction to minoxidil

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Check with your physician to determine if oral minoxidil is right for you. Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

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Drug Interactions

Oral minoxidil has certain drug interactions. It’s important to tell your provider of all the medications you are currently taking, including prescription, over the counter medications, vitamins, and herbal or dietary supplements.

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Some medications to what out for include:

• Guanethidine should be discontinued before starting treatment

Seek emergency medical care if you experience any of these side effects:

• Salt and water retention
• Increased heart rate (tachycardia)
• New or worsening chest, arm or shoulder paid
• Shortness of breath
• Dizziness, lightheadedness and fainting
• Sudden changes to your vision or hearing
• Very severe heartburn or signs of indigestion
• A sudden or too large of a drop in blood pressure

This information is not comprehensive. For more information, ask your healthcare provider or pharmacist. You may report side effects to the FDA by calling 1-800-FDA-1088 or visiting www.fda.gov/medwatch.Please see the full Prescribing Information for complete safety information. 

Topical Minoxidil & Finasteride

Important Safety Information

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Side Effects & Risks:

Possible side effects and risks of using topical minoxidil & finasteride:

• Local scalp irritation including itching, redness, irritation, burning sensation, dry and flaky scale, contact dermatitis & more
• Facial hypertrichosis or the growth of excessive hair on the face.
• Headaches
• Metallic taste in the mouth
• Breathlessness
• Palpitations
• Tachycardia

If you experience any of the above side effects, contact your provider in order to cease treatment or adjust your dose.

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These are not all of the possible side effects of topical minoxidil & finasteride. For more information, ask your healthcare provider or pharmacist.

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Contraindications:

Do not use topical minoxidil & finasteride if:

• You are pregnant or may become pregnant
• You are breastfeeding
• You have frontal fibrosing alopecia: If hairline is pushing back (or eyebrow hair loss or skin-colored bumps in the eyebrows, sometimes with associated eyebrow hair loss) with symptoms (itching, burning, dry skin around hair follicle, stinging, erythema)
• You have Alopecia areata
• You have Lichen planopilaris
• You have Ludwig stage II-2 and above
• You have used topical minoxidil or finasteride in the past and either:
  - Had an allergic reaction to any of the ingredients
  - Did not see results

• You have active eczema/psoriasis or allergic contact dermatitis
• Your scalp is red, inflamed, infected, irritated, or painful 
• You have a history of breast cancer, uterine, cervical or ovarian cancer
• You have a history of liver disease - inform your doctor before use
• You have a psychiatric history – inform your doctor before use
• Your hair loss is sudden and/or patchy 
• Your hair loss is associated with childbirth 
• You are under 18 years of age
• You are currently taking oral finasteride or other medications in the same class as finasteride

Ask a doctor before use if you have heart disease.

Check with your physician to determine if this product is right for you. Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

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Drug Interactions

Minoxidil and finasteride have certain drug interactions. It’s important to tell your provider of all the medications you are currently taking, including prescription, over the counter medications, vitamins, and herbal or dietary supplements.

Seek immediate medical care or consult your physician if you experience any of these side effects:

• Chest pain
• Rapid heart beat (tachycardia)
• Faintness or dizziness
• Sudden and unexplained weight gain
• Edema, or swelling of hands or feet
• Breast tenderness/enlargement
• Facial hypertrichosis (unwanted facial hair growth)
• Sexual dysfunction (e.g., low libido etc.)
• Symptoms of depression
• No scalp hair regrowth after 6 months of use
• Severe scalp irritation
  

Other Warnings

• For External Use only
• Flammable
• Keep out of reach of children
• Do not donate blood if you are using this medication
• Inform your physician that you are taking this medication
• Women of child-bearing potential should not handle this medication
• Using more medication than prescribed will not speed up results and may lead to increased risk of side effects
• Inform your doctor if you experience breast tenderness or enlargement
• Do not use this medication for a condition for which it was not prescribed.
• Do not give this medication to other people, even if they have the same symptoms you have. It may harm them.
• Do not apply on other parts of the body 
• Avoid contact with the eyes. In case of accidental contact, rinse eyes with large amounts of cool tap water. 
• Some people have experienced changes in hair color and/or texture 
• Minoxidil is suspected to be toxic to cats and dogs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988634/, Please do not allow cats, dogs, or other pets to ingest this medication or to come into contact with the treatment site after the medication has been applied. If these occur, consult your pet's veterinarian

This information is not comprehensive. For more information, ask your healthcare provider or pharmacist. The content herein is not intended to be, act as, or replace medical advice or diagnosis for individual health conditions nor is it making evaluations as to the risks or benefits of particular compounded preparations. Please consult a licensed healthcare professional about diagnosis and treatment. Information and statements within this handout have not been evaluated by the Food and Drug Administration

You may report side effects to the FDA by calling 1-800-FDA-1088 or visiting www.fda.gov/medwatch. Please see the full Prescribing Information for complete safety information.