What adverse reactions may occur after injection of estradiol heptanoate (Progynon Depot)?
Progynon Depot, as an estrogen preparation, has adverse reactions involving multiple systems, mainly including reproductive system abnormalities, metabolic disorders, and the risk of thrombosis. The following will classify and describe common and serious adverse reactions, and provide corresponding monitoring recommendations.
1. Reproductive system related reactions
(1) Endometrial hyperplasia: Long term use of estrogen alone may cause abnormal thickening of the endometrium, manifested as breakthrough bleeding. It is recommended to monitor endometrial thickness every 6 months using ultrasound.
(2) Breast tenderness: The incidence rate is about 15% -20%, mostly temporary. It needs to be differentiated from breast cancer, and baseline breast examination before medication is recommended.
2. Metabolic abnormalities
(1) Impaired glucose tolerance: it may interfere with insulin sensitivity, and diabetes patients need to strengthen blood glucose monitoring.
(2) Changes in blood lipids: HDL increases while LDL decreases, but triglycerides may increase by 50% -80%.
3. Risk of thromboembolism
(1) Deep vein thrombosis: The risk is highest in the first year of medication, with an incidence rate of approximately 1.5-3 times the baseline level. Be alert to symptoms of lower limb swelling and pain.
(2) Pulmonary embolism: The incidence of fatal embolism is about 0.5-1.2/10000 person years, and the risk for smokers doubles.
4. Digestive system reactions
(1) Cholestasis: manifested as jaundice, itching, and an incidence of liver dysfunction of about 5%. Regular monitoring of transaminase is required.
(2) Nausea and vomiting: often occur in the early stages of medication, it is recommended to inject before bedtime to alleviate symptoms.
5. Other significant adverse reactions
(1) Migraine aggravation: People with a history of migraine with premonitory symptoms may have an increased frequency of attacks.
(2) Visual impairment: Changes in corneal curvature may cause discomfort in contact lenses.
(3) Allergic reactions: including rash, angioedema, and isokinetic hypersensitivity reactions.
6. Risks for special populations
(1) Perimenopausal women: The incidence of irregular bleeding is as high as 30%, and organic lesions need to be ruled out.
(2) Patients with liver and kidney dysfunction: Delayed drug clearance may exacerbate adverse reactions.
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