Climara, or estradiol, is used to treat vasomotor menopausal symptoms (night sweats and hot flushes), ovarian failure, vulval and vaginal atrophy in menopause and as a postmenopausal preventive for osteoporosis. This drug is also used as a palliative treatment for advanced inoperable breast cancer and, similarly, for men with prostate cancer. Numerous side effects exist. The most serious of these affect the cardiovascular system and central nervous systems. There are also increased risks of cancer development and pancreatic complications.
Blood Clots
According to the "PDR Nurse's Drug Handbook," medications containing estrogen carry very serious risks of thromboembolism (blood clot in a blood vessel) and pulmonary embolism (blood clot in the lungs). Both clots then increase the possibility of myocardial infarction (heart attack). A patient should report immediately any signs or symptoms of swelling, heat, redness or distended blood vessels, more commonly in the calf area than elsewhere, to her physician. Any sudden, acute shortness of breath, dizziness, chest pain, blood-tinged sputum or pain with breathing should also be reported immediately to a physician. Immediate medical treatment sought as these symptoms may be rapidly fatal.
Climara also carries a high risk of stroke and seizures. Sudden confusion, inability to speak, unintelligible or slurred speech, facial or eyelid drooping, sudden severe headache, weakness on one side, numbness and tingling in the extremities are signs of possible stroke. The patient should be immediately transported to the emergency department ; the primary care physician should be notified. Any seizure activity should be reported to a physician immediately.
Increased Risk of Cancers
Patients are at higher risk for developing endometrial (uterine) or breast cancer while taking Climara. According to "Pathophysiology, A 2-in-1 Reference for Nurses," breast cancer may be detected on a mammogram before a patient notices a lump or mass, or a patient may see nipple retraction, scaly skin around the nipple, change in the general appearance of the breast or a discharge from the nipple. A lump in the armpit is also a possible sign of cancer development. These changes should be discussed with a physician immediately.
Signs and symptoms of uterine cancer are much more subtle. Painless vaginal bleeding in postmenopausal women may be dismissed as a "last period." This bleeding may occur a year or more after cessation of the menses. This bleeding may also be accompanied by fever or bowel and bladder irregularities, such as incontinence or retention. Women experiencing postmenopausal bleeding should report these symptoms to their doctor immediately.
Pancreatic Complications
Climara carries the serious risk of pancreatitis development. This painful condition, made worse by food or drink, generally requires hospitalization for treatment and monitoring. Tachycardia (fast heartbeat), dehydration, low-grade fever, diaphoresis (sweating), vomiting, abdominal distention and constipation are possible. The patient may complain of severe abdominal pain after eating. In a severe attack, pancreatitis can become quite serious. If a patient experiences these symptoms, she should discuss them immediately with her doctor.
References
- "PDR Nurse's Drug Handbook 2010;" Thomson Reuters and Alexander Ivy; 2009
- "Pathophysiology: A 2-in-1 Reference for Nurses;" Lippincott Williams & Wilkins; 2005
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