Estrogen may cause sodium and water retention. Therefore, particular caution is indicated in cardiac or renal dysfunction, epilepsy, or asthma. Elevation of blood pressure in previously normotensive or hypertensive patients necessitates cessation of medication. Diabetic patients or those with a predisposition to diabetes should be observed closely to detect any alterations in carbohydrate metabolism. When liver or endocrine function tests are indicated, the results should not be considered reliable unless therapy has been discontinued for 2 to 4 months.
Virilization appears to be reversible if detected early, except for some instances of voice changes.
An increase in blood pressure in susceptible individuals has also been reported following use of estrogen. There have been a few reported cases of a temporary growth of hair at the injection site. This adverse effect is believed caused by a direct stimulation of the hair follicle at the injection site. Since this may occur in either sex, it should not be considered as a masculinization symptom. Altered coagulation tests such as increase in prothrombin and Factor VII, VIII, IX, and X have been reported following use of preparations containing estrogen.