Risks and Benefits of Treatment
Activella is a combination hormone therapy containing estrogen and progestin. Before starting treatment, a healthcare provider should review the possible benefits and risks based on your symptoms, age, medical history, and treatment goals.
Hormone therapy should generally be used at the lowest effective dose for the shortest appropriate period.
Blood Clots, Stroke, and Heart Attack
Activella may increase the risk of blood clots, stroke, heart attack, and other cardiovascular problems.
The risk may be higher if you:
- Smoke or use tobacco
- Have high blood pressure
- Have diabetes or high cholesterol
- Are overweight
- Have a personal or family history of blood clots
- Have limited mobility for an extended period
- Are older
Seek immediate medical care if you develop sudden chest pain, difficulty breathing, coughing up blood, swelling or pain in one leg, sudden weakness, difficulty speaking, or a sudden severe headache.
Endometrial Cancer
Using estrogen without a progestin can increase the risk of endometrial cancer in women who still have a uterus.
Activella contains norethindrone acetate, a progestin that helps reduce this risk. However, unusual or persistent vaginal bleeding should always be assessed by a healthcare provider.
Contact your healthcare provider if you experience bleeding after menopause, unusually heavy bleeding, or bleeding that continues or returns unexpectedly.
Breast Cancer
Long-term use of combined estrogen and progestin therapy may increase the risk of breast cancer.
Attend recommended breast examinations and mammograms. Tell your healthcare provider if you notice a breast lump, nipple discharge, skin changes, or any other unusual breast symptoms.
Dementia Risk
Combined hormone therapy may increase the risk of probable dementia when started in women aged 65 years or older.
Activella should not be used to prevent dementia or memory loss. Speak with a healthcare provider if you develop new or worsening problems with memory, thinking, or confusion.
Smoking and Tobacco Use
Smoking while using estrogen-containing therapy can further increase the risk of blood clots, stroke, heart attack, and high blood pressure.
Tell your healthcare provider if you smoke or use tobacco. They can help determine whether Activella is appropriate and discuss support for stopping tobacco use.
Surgery and Reduced Mobility
Surgery, prolonged bed rest, and extended periods of sitting can increase the risk of blood clots. This includes long flights or car journeys.
Tell your healthcare provider about any planned surgery or period of limited mobility. You may be advised to stop Activella temporarily or take additional precautions.
Do not stop the medication unless your healthcare provider tells you to do so.
Medication and Supplement Interactions
Activella may interact with certain medications and supplements. These interactions may affect hormone levels or increase the risk of side effects.
Tell your healthcare provider and pharmacist about all products you use, including:
- Prescription medications
- Nonprescription medications
- Vitamins and minerals
- Herbal products
- Dietary supplements
Do not start, stop, or change another medication without medical advice.
Regular Medical Review
Your healthcare provider should regularly review whether Activella is still needed and whether the benefits continue to outweigh the risks.
Attend all recommended follow-up appointments, blood pressure checks, breast screenings, and other examinations during treatment.
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