Side effects of estrogen

Estrogens cause abnormalities of tryptophan metabolism that resemble those seen in vitamin Be deficiency, and the vitamin is widely used to treat the side effects of estrogen administration and estrogen-associated symptoms of the premenstrual syndrome, although there is litde evidence of its efficacy. High doses of the vitamin, of the order of 100 times requirements, cause peripheral sensory neuropathy. 

Estrogens do not cause vitamin Bg deficiency. However, there is evidence that high doses of vitamin Bg may overcome some of the side effects of estrogenic steroids used in contraceptives and as menopausal hormone replacement therapy. At very high levels of intake, supplements may cause sensory nerve damage. 

The effects of pure antiestrogens in the uterus have also been extensively studied, since it is an estrogen-dependent organ and the target of the main side effects of tamoxifen therapy, such as endometrial hyperplasia, hypertrophy of glandular epithelium, or even focal cellular atypia (Sourla et al. 1997). 

A low dosage of progestin ( mini-pill ) is used, in the form of medroxyprogesterone acetate, which is active at a very low dose. The mini-pill does not inhibit ovulation, but rather interferes with the endometrium and the cervical mucus. The use of this pill prevents most of the side effects of oral contraception, specifically nausea, water retention, and in some cases thrombophlebitis. However, a lower success rate and other frequent side effects have reduced the widespread acceptance of this preparation. Nevertheless, the mini-pill has a role to play in certain specific situations. For example, in an uncommon form of epilepsy called catamenial epilepsy, female patients will experience seizures at particular times during their menstrual cycle, reflecting the fact that seizure focus is stimulated by estrogens but inhibited by progestins. In such women, the mini-pill may afford not only birth control but also improved seizure control. 

Loder EW, Buse DC, Golub JR. Headache as a side effect of combination estrogen-progestin oral contraceptives a systematic review. Am J Obstet Gynecol 2005 193 636-49. 

This strategy is based on evidence that the most serions side effects of combination OCs (i.e., thromboembolic events, stroke, or MI) result from excessive estrogen content." 3.24... 

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