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estrogens/methyltestosterone (Estratest) Side Effects & Dosage

What is esterified estrogens and methyltestosterone, and how does it work (mechanism of action)?

Esterified estrogens are a mixture of related estrogens. Estrogens, when taken alone or in combination with a progestin, have been shown to reduce the risk for hip fracture
due to osteoporosis by 25% as well as the risk of heart attack
(myocardial infarction) and stroke by 40-50%. Esterified estrogens are used for numerous
medical situations. Estrogens cause growth and development of female sex
organs and the maintain sex characteristics, including growth of underarm and
pubic hair and shaping of body contours and skeleton. Estrogens also
increase secretions from the cervix and growth of the inner lining of
the uterus (endometrium). Estrogens reduce LDL-cholesterol (“bad” cholesterol)
and increase HDL-cholesterol (“good” cholesterol) concentrations.

Testosterone is the major male sex hormone that is responsible for
many male sexual characteristics, but women also produce small
amounts of testosterone. Following
menopause, a woman’s production of testosterone decreases. When
testosterone in the form of methyltestosterone is added to estrogens,
there may be a further alleviation of the hot flashes seen after
menopause, and there also may be an improvement in a woman’s sexual

What brand names are available for esterified estrogens and methyltestosterone?

Estratest (discontinued), Covaryx, Covaryx H.S., EEMT HS, EEMT

Is esterified estrogens and methyltestosterone available as a generic drug?


Do I need a prescription for esterified estrogens and methyltestosterone?


What are the side effects of esterified estrogens and methyltestosterone?

For side effects, please read the esterified estrogens article.

Important side effects of methyltestosterone can have masculinizing effects in women, including:

  • the development of acne,
  • growth of facial hair,
  • enlargement of the clitoris,
  • reduction in breast size, and
  • deepening of the voice.

If treatment is discontinued when these symptoms first appear, they usually diminish or disappear; however, prolonged treatment can cause irreversible masculinizing effects.

What is the dosage for esterified estrogens and methyltestosterone?

Estratest usually is prescribed as 1 or 2 tablets
daily for 21 consecutive days followed by 7 days without medication.

Which drugs or supplements interact with esterified estrogens and methyltestosterone?

For drug interactions for esterified
estrogens, please read the esterified estrogens article.

Methyltestosterone can increase the effects of warfarin (Coumadin),
increasing the risk of bleeding. Taking methyltestosterone and
imipramine (Tofranil) together has led to paranoia in a few patients.
Methyltestosterone can increase blood concentrations of cyclosporine (Sandimmune;
Neoral), which can increase the risk of kidney damage.

Is esterified estrogens and methyltestosterone safe to take if I’m pregnant or breastfeeding?

Both methyltestosterone and estrogens should not
be used during pregnancy due to an increased risk of fetal

Estrogens are secreted in milk and cause
unpredictable effects in the infant. They should not be used during

What else should I know about esterified estrogens and methyltestosterone?

What preparations of esterified estrogens and methyltestosterone are available?

Estratest tablets: esterified estrogens
0.625mg plus
methyltestosterone 1.25mg; esterified estrogens 1.25mg plus
methyltestosterone 2.5mg. Estratest HS is one-half the strength of

How should I keep esterified estrogens and methyltestosterone stored?

Tablets should be stored at 36 F – 86 F
(20 C – 30 C).


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