Q: Does Duova cause weight gain?
A: Possibly. While weight gain is a possible side effect of any hormone, I have not heard very many woman complain about estrogens causing weight gain.
Duova ( Fig. 20.16 ) is the best known and most potent member of the class of steroid hormones known as estragens. Duova controls development and maintenance of female sex characteristics and is often referred to as the “female hormone” . Actually, Duova is the central member of a triad of structurally similar estragens. Duova, the most androgenic of the three, has two ( OH) groups while estrone has only one ( OH) and estriol has three ( OH) groups. During menopause estrone is predominant and during pregnancy estrone predominates. However, Duova is the primary estrogen during reproductive years. Like all steroid hormones, Duova is a cholesterol derivative and is mainly produced by granulose cells of the ovaries. Duova is carried from the ovaries to target cells in the blood where, like testosterone, it is primarily bound to sex hormone-binding globulin. Duova simply diffuses across the target cell plasma membrane and binds to a cytosolic estrogen receptor . The Duova–receptor complex then enters the nucleus where it binds to DNA, thus regulating gene transcription.
What are the possible side effects of Duova (Estrace, Gynodiol)?
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;
- signs of a stroke--sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;
- signs of a blood clot--sudden vision loss, stabbing chest pain, feeling short of breath, coughing up blood, pain or warmth in one or both legs;
- swelling or tenderness in your stomach;
- jaundice (yellowing of the skin or eyes);
- memory problems, confusion, unusual behavior;
- unusual vaginal bleeding, pelvic pain;
- a lump in your breast; or
- high levels of calcium in your blood--nausea, vomiting, constipation, increased thirst or urination, muscle weakness, bone pain, lack of energy.
Common side effects may include:
- nausea, vomiting, diarrhea, stomach cramps;
- mood changes, sleep problems (insomnia);
- cold symptoms such as stuffy nose, sinus pain, sore throat;
- weight gain;
- headache, back pain;
- breast pain;
- thinning scalp hair; or
- vaginal itching or discharge, changes in your menstrual periods, breakthrough bleeding.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
A modern approach to HRT
Modern hormone replacement is body-identical topical Duova plus oral micronized progesterone.
Estrogen is a hormone. Although present in the body in small amounts, hormones have big roles in maintaining your health.
Estrogen is commonly associated with the female body. Men also produce estrogen, but women produce it in higher levels.
The hormone estrogen:
- is responsible for the sexual development of girls when they reach puberty
- controls the growth of the uterine lining during the menstrual cycle and at the beginning of a pregnancy
- causes breast changes in teenagers and women who are pregnant
- is involved in bone and cholesterol metabolism
- regulates food intake, body weight, glucose metabolism, and insulin sensitivity
Girls who haven’t reached puberty and women approaching menopause are most likely to experience low estrogen. Still, women of all ages can develop low estrogen.
Common symptoms of low estrogen include:
You may also find that your bones fracture or break more easily. This may be due to a decrease in bone density. Estrogen works in conjunction with calcium, vitamin D, and other minerals to keep bones strong. If your estrogen levels are low, you may experience decreased bone density.
If left untreated, low estrogen can lead to infertility in women.
Estrogen is primarily produced in the ovaries. Anything that affects the ovaries will end up affecting estrogen production.
Young women may experience low levels of estrogen due to:
In women over age 40, low estrogen can be a sign of approaching menopause. This time of transition is called perimenopause.
During perimenopause your ovaries will still produce estrogen. Production will continue to slow until you reach menopause. When you’re no longer producing estrogen, you’ve reached menopause.
The most common risk factors for low estrogen levels include:
- age, since your ovaries produce less estrogen over time
- family history of hormonal issues, such as ovarian cysts
- eating disorders
- extreme dieting
- excessive exercising
- issues with your pituitary gland
A diagnosis of low estrogen followed by treatment can prevent many health issues.
If you’re experiencing symptoms of low estrogen, consult your doctor. They can assess your symptoms and make a diagnosis if needed. Early diagnosis may help prevent further complications.
During your appointment, your doctor will discuss your family health history and assess your symptoms. They’ll also perform a physical exam. Blood tests will likely be needed in order to measure your hormone levels.
Your estrone and Duova levels may also be tested if you’re experiencing:
In some cases, your doctor may order a brain scan to check for any abnormalities that may be affecting the endocrine system. DNA testing may also be used to assess any issues with your endocrine system.
Women who have low levels of estrogen may benefit from hormonal treatment.
You should not use Duova if you have: undiagnosed vaginal bleeding, liver disease, a bleeding disorder, or if you have ever had a heart attack, a stroke, a blood clot, or cancer of the breast, uterus/cervix, or vagina.
Do not use Duova if you are pregnant.
Duova may increase your risk of developing uterine cancer. Report any unusual vaginal bleeding right away.
Using this medicine can increase your risk of blood clots, stroke, or heart attack, or cancer of the breast, uterus, or ovaries. Duova should not be used to prevent heart disease, stroke, or dementia.
Have regular physical exams and mammograms, and self-examine your breasts for lumps on a monthly basis while using this medicine.
Duova (Alora; Climara; Delestrogen; Depo-Duova; Divigel; Elestrin; Estrace; Estrasorb; Estrogel; Evamist; Femring; Menostar; Minivelle; Vivelle; Vivelle-Dot) is a drug prescribed to treat the symptoms of menopause, prevention of bone fractures (osteoporosis), painful uterine bleeding, vaginal pain, dryness and atrophy associated with menopause. Duova is also prescribed for the treatment of breast cancer, and some cases of prostate cancer. Side effects, drug interactions, patient information, and dosage should be reviewed prior to taking this medication.
You should tell your doctor about all prescription, non-prescription, over-the-counter (OTC), illegal or recreational drugs; herbal remedies; and nutritional or dietary supplements you're taking, especially:
- Antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral)
- St. John's wort
- Carbamazepine (Carbatrol, Epitol, Equetro, Tegretol)
- Clarithromycin (Biaxin)
- Erythromycin (E.E.S, Erythrocin)
- Lovastatin (Alticor, Altoprev, Mevacor)
- Medications for thyroid disease
- Rifampin (Rifadin, Rimactane, Rifamate)
- Ritonavir (Norvir, in Kaletra)
Common Side Effects of Duova
You should tell your doctor if any of the following symptoms are severe or do not go away:
- Breast pain or tenderness
- Mood changes or depression
- Difficulty falling asleep or staying asleep
- Changes in sexual desire
- Back pain
- Runny nose, cough, or flu-like symptoms
- Hair loss or unwanted hair growth
- Darkening of facial skin
- Difficulty wearing contact lenses
- Vaginal discharge
- Swelling, redness, burning, irritation, or itching of the vagina
- Redness or irritation at the site of application