As an estrogen replacement drug, the side effects of estradiol tablets (Julina) involve multiple systems, and medication should strictly follow individualized principles and pay attention to contraindications. Special populations need to strengthen monitoring to ensure medication safety.

Common side effects

1. Digestive system response

Nausea, vomiting, bloating, and other symptoms are more common in the early stages of medication and usually resolve on their own within 2-3 weeks. It is recommended to take medication after meals, and in severe cases, it is necessary to evaluate whether to adjust the dosage.

2. Effects on the reproductive system

Breast tenderness and breakthrough bleeding are common in individuals who have not received progesterone treatment. Abnormal uterine bleeding should exclude endometrial lesions.

3. Metabolic abnormalities

It may cause water and sodium retention and lead to weight gain. Those with abnormal glucose tolerance need to monitor blood sugar. Long term use requires attention to changes in blood lipids.

Serious adverse reactions

1. Thromboembolic events

The risk of deep vein thrombosis and pulmonary embolism increases, especially for postoperative or long-term bedridden patients. Personal and family history of thrombosis should be evaluated before medication.

2. Hepatobiliary diseases

Cholestasis jaundice and elevated liver enzymes are occasionally seen. During the medication period, liver function should be checked every 6 months. If there is upper right abdominal pain, the medication should be stopped immediately.

3. Malignant tumor risk

The risk of endometrial cancer can be controlled through the combination of progesterone. The risk of breast cancer is still controversial, and breast examination is required before medication.

Medication precautions

1. Contraindications screening

Absolute contraindications include active thrombosis, estrogen dependent tumors, and severe liver disease. Before medication, it is necessary to complete gynecological examination and liver and kidney function testing.

2. Optimization of dosing regimen

Adopt the lowest effective dose and regularly evaluate the necessity of continuing medication. Combination progesterone therapy requires standardized periodic withdrawal bleeding.

3. Monitoring requirements

Annual breast ultrasound, bone density testing, and blood pressure monitoring every 3 months. Seek medical attention immediately if visual impairment or severe headache occurs.

4. Drug interactions

CYP3A4 inducers may reduce efficacy, while inhibitors increase side effects. The dosage of warfarin needs to be adjusted when used in combination with anticoagulants.