← All drugs
Drug · FAERS side-effect profile with label screen

Conjugated Estrogens and Medroxyprogesterone side effects: what 23,463 FDA adverse event reports show

Conjugated Estrogens And Medroxyprogesterone Acetate · Premarin Vaginal · 1,071 reaction terms · 51,702 drug–reaction co-reports · data 2026-09-14
Share: X Facebook Reddit Email

Drug class

Estrogen

FDA label (Established Pharmacologic Class) · compare the class

Brand names

Premarin Vaginal

openFDA label

Who reports

23,463 reports · 85% serious · 647 with death outcome · 100% female

openFDA FAERS counts, all years, deduplication not applied

Used for

PREMARIN (conjugated estrogens) vaginal cream is a mixture of estrogens indicated for: • Treatment of Atrophic Vaginitis and Kraurosis Vulvae ( 1.1 ) • Treatment of Moderate to Severe Dyspareunia, a Symptom of Vulvar and Vaginal Atrophy, due to Menopau.

FDA label, Indications and Usage

What it is

Each gram of PREMARIN (CE) vaginal cream contains 0.625 mg CE, USP in a nonliquefying base containing cetyl esters wax, cetyl alcohol, white wax, glyceryl monostearate, propylene glycol monostearate, methyl stearate, benzyl alcohol, sodium lauryl sulfate, glycerin, and mineral oil.

FDA label, Description section

Boxed warning

ENDOMETRIAL CANCER, CARDIOVASCULAR DISORDERS, BREAST CANCER and PROBABLE DEMENTIA Estrogen-Alone Therapy Endometrial Cancer There is an increased risk of endometrial cancer in a woman with a uterus who uses unopposed estrogens.

FDA label
How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled — boxed warning 2Labeled adverse reaction 1Labeled (related wording) 8Likely indication confounding 1Reporting / coding artifact 2Lab value / disease marker 3Not in label — unassessed 23
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 1,031 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Contralateral breast cancer90683.4
519.1–899.7ROR 686.0 · χ² 34,149 / p <1e-300
356.0 EB05 298.5 · IC025 +6.6
3/3 methods agree
Not in label — unassessedserious n=90 · 100% consumernot reported in cached trials
Progesterone receptor assay positive333488.9
427.8–558.6ROR 495.9 · χ² 103,950 / p <1e-300
309.1 EB05 282.3 · IC025 +7.6
3/3 methods agree
Lab value / disease markerserious n=329 · 75% consumernot reported in cached trials
Oestrogen receptor assay positive374434.6
384.2–491.6ROR 441.6 · χ² 108,053 / p <1e-300
287.1 EB05 263.5 · IC025 +7.5
3/3 methods agree
Lab value / disease markerserious n=369 · 73% consumernot reported in cached trials
Malignant breast lump removal40374.8
259.0–542.5ROR 375.5 · χ² 10,200 / p <1e-300
233.9 EB05 179.1 · IC025 +5.4
3/3 methods agree
Not in label — unassessedserious n=40not reported in cached trials
Breast cancer in situ331310.2
273.8–351.3ROR 314.6 · χ² 75,214 / p <1e-300
226.7 EB05 206.9 · IC025 +7.2
3/3 methods agree
Not in label — unassessedserious n=328not reported in cached trials
Biopsy breast abnormal24302.0
190.0–480.0ROR 302.3 · χ² 5,140 / p <1e-300
191.1 EB05 135.2 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious n=24not reported in cached trials
Breast cancer female5,790245.7
239.4–252.2ROR 325.9 · χ² 1,104,544 / p <1e-300
192.2 EB05 188.1 · IC025 +7.5
3/3 methods agree
Not in label — unassessedserious PRR 131.5 · 90% consumernot reported in cached trials
Breast microcalcification23208.9
132.6–329.0ROR 209.1 · χ² 3,679 / p <1e-300
148.4 EB05 104.2 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=23not reported in cached trials
Breast operation103129.6
105.4–159.3ROR 130.2 · χ² 11,347 / p <1e-300
110.8 EB05 94.0 · IC025 +5.9
3/3 methods agree
Reporting / coding artifactserious n=103not reported in cached trials
Breast lump removal2292.7
59.8–143.8ROR 92.8 · χ² 1,724 / p <1e-300
78.5 EB05 54.6 · IC025 +4.2
3/3 methods agree
Not in label — unassessedserious n=22not reported in cached trials
Breast cancer7,88881.8
80.3–83.4ROR 122.7 · χ² 578,642 / p <1e-300
74.9 EB05 73.6 · IC025 +6.2
3/3 methods agree
Labeled — boxed warning
exact term
serious PRR 51.2 · 93% consumerNCT00808132: 1/445 (0.2%) on Conjugated Estrogens; 1/474 (0.2%) control (serious AE)
Inflammatory carcinoma of the breast1065.2
34.3–124.0ROR 65.3 · χ² 531 / p 1e-117
54.8 EB05 31.8 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious n=10not reported in cached trials
Mammogram abnormal3650.4
36.0–70.5ROR 50.5 · χ² 1,603 / p <1e-300
46.6 EB05 35.2 · IC025 +4.3
3/3 methods agree
Lab value / disease markerserious n=35not reported in cached trials
Mastectomy9249.7
40.3–61.3ROR 49.9 · χ² 4,109 / p <1e-300
46.7 EB05 39.2 · IC025 +4.9
3/3 methods agree
Not in label — unassessedserious n=92not reported in cached trials
Breast calcifications4249.3
36.2–67.3ROR 49.4 · χ² 1,838 / p <1e-300
45.9 EB05 35.4 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=38not reported in cached trials
Biopsy breast1647.8
28.9–79.0ROR 47.8 · χ² 651 / p 6e-144
43.2 EB05 28.2 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=16not reported in cached trials
Lymphadenectomy3432.1
22.8–45.2ROR 32.2 · χ² 960 / p 5e-211
30.6 EB05 22.9 · IC025 +3.9
3/3 methods agree
Not in label — unassessedserious n=34not reported in cached trials
Ovarian cancer30730.6
27.3–34.3ROR 31.0 · χ² 8,473 / p <1e-300
29.6 EB05 26.9 · IC025 +4.6
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 20.2 · 92% consumernot reported in cached trials
Endometrial hypertrophy1329.7
17.1–51.5ROR 29.7 · χ² 321 / p 4e-72
27.7 EB05 17.1 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious n=11NCT00242710: 4/179 (2.2%) on Conjugated Estrogens; 1/172 (0.6%) control
Breast cancer recurrent9929.0
23.7–35.4ROR 29.1 · χ² 2,560 / p <1e-300
27.9 EB05 23.6 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=99 · 96% consumernot reported in cached trials
Wrong strength1027.9
14.9–52.3ROR 27.9 · χ² 226 / p 3e-51
25.7 EB05 14.7 · IC025 +2.5
3/3 methods agree
Reporting / coding artifact–not reported in cached trials
Breast reconstruction1126.8
14.7–48.9ROR 26.9 · χ² 241 / p 1e-54
24.9 EB05 14.6 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious n=11not reported in cached trials
Endometrial cancer6025.0
19.3–32.3ROR 25.0 · χ² 1,319 / p 4e-289
24.1 EB05 19.4 · IC025 +3.9
3/3 methods agree
Labeled — boxed warning
exact term
serious n=60not reported in cached trials
Atrophic vulvovaginitis1923.9
15.2–37.7ROR 23.9 · χ² 384 / p 8e-86
22.8 EB05 15.4 · IC025 +3.1
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=17not reported in cached trials
Fracture nonunion2919.2
13.3–27.8ROR 19.2 · χ² 473 / p 4e-105
18.6 EB05 13.5 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=29not reported in cached trials
Intramedullary rod insertion4318.8
13.9–25.5ROR 18.9 · χ² 694 / p 3e-153
18.3 EB05 14.1 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=43not reported in cached trials
Radiotherapy3717.6
12.7–24.3ROR 17.6 · χ² 551 / p 3e-122
17.1 EB05 12.9 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=37not reported in cached trials
Open reduction of fracture2217.3
11.3–26.3ROR 17.3 · χ² 315 / p 1e-70
16.6 EB05 11.3 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious n=22not reported in cached trials
Smear cervix abnormal2415.2
10.2–22.8ROR 15.2 · χ² 300 / p 2e-67
14.6 EB05 10.0 · IC025 +2.9
3/3 methods agree
Not in label — unassessedserious n=20not reported in cached trials
Benign breast neoplasm1715.0
9.3–24.3ROR 15.0 · χ² 205 / p 7e-47
14.1 EB05 8.7 · IC025 +2.6
3/3 methods agree
Not in label — unassessedserious n=16not reported in cached trials
Bunion1215.0
8.5–26.4ROR 15.0 · χ² 140 / p 1e-32
13.4 EB05 7.3 · IC025 +2.3
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
Breast mass10213.7
11.3–16.7ROR 13.8 · χ² 1,174 / p 1e-257
13.5 EB05 11.4 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=91not reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Conjugated Estrogens as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (4 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Breast cancer7,88881.8
80.3–83.4ROR 122.7 · χ² 578,642 / p <1e-300
74.9 EB05 73.6 · IC025 +6.2
3/3 methods agree
Labeled — boxed warning
exact term
serious PRR 51.2 · 93% consumerNCT00808132: 1/445 (0.2%) on Conjugated Estrogens; 1/474 (0.2%) control (serious AE)
Breast cancer female5,790245.7
239.4–252.2ROR 325.9 · χ² 1,104,544 / p <1e-300
192.2 EB05 188.1 · IC025 +7.5
3/3 methods agree
Not in label — unassessedserious PRR 131.5 · 90% consumernot reported in cached trials
Drug ineffective (drug did not work)7330.5
0.5–0.5ROR 0.5 · χ² 397 / p 1e-88
0.5 EB05 0.5 · IC025 -1.1
PRR-only: not supported by EBGM or IC
Reporting / coding artifactserious PRR 0.3 · 72% consumernot reported in cached trials
Cerebrovascular accident (stroke)5022.6
2.4–2.9ROR 2.7 · χ² 514 / p 5e-114
2.6 EB05 2.4 · IC025 +1.2
3/3 methods agree
Labeled — boxed warning
synonym match
serious PRR 1.8NCT00808132: 1/474 (0.2%) on Conjugated Estrogens (serious AE)
Depression4781.9
1.7–2.0ROR 1.9 · χ² 195 / p 2e-44
1.9 EB05 1.7 · IC025 +0.8Labeled adverse reaction
exact term
serious PRR 1.4NCT00808132: 1/474 (0.2%) on Conjugated Estrogens (serious AE)
Headache4230.6
0.5–0.7ROR 0.6 · χ² 113 / p 1e-26
0.6 EB05 0.6 · IC025 -0.9
PRR-only: not supported by EBGM or IC
Labeled adverse reaction
exact term
serious PRR 0.4NCT00808132: 54/220 (24.5%) on Conjugated Estrogens; 122/474 (25.7%) control
Anxiety4181.3
1.2–1.4ROR 1.3 · χ² 31 / p 2e-8
1.3 EB05 1.2 · IC025 +0.2Not in label — unassessedserious PRR 1.0NCT00808132: 1/474 (0.2%) on Conjugated Estrogens (serious AE)
Nausea4130.5
0.4–0.5ROR 0.5 · χ² 260 / p 1e-58
0.5 EB05 0.4 · IC025 -1.3
PRR-only: not supported by EBGM or IC
Labeled adverse reaction
exact term
serious PRR 0.3NCT00808132: 11/220 (5.0%) on Conjugated Estrogens; 26/474 (5.5%) control
Deep vein thrombosis (leg blood clot)3975.5
4.9–6.0ROR 5.5 · χ² 1,437 / p <1e-300
5.4 EB05 5.0 · IC025 +2.3
3/3 methods agree
Labeled — boxed warning
exact term
serious PRR 3.8NCT00808132: 1/220 (0.5%) on Conjugated Estrogens (serious AE)
Fatigue (tiredness)3930.5
0.4–0.5ROR 0.4 · χ² 271 / p 4e-61
0.5 EB05 0.4 · IC025 -1.3
PRR-only: not supported by EBGM or IC
Not in label — unassessedserious PRR 0.3NCT00808132: 4/220 (1.8%) on Conjugated Estrogens; 12/474 (2.5%) control
Hot flush (hot flashes)3884.6
4.2–5.1ROR 4.7 · χ² 1,094 / p 3e-240
4.6 EB05 4.2 · IC025 +2.0
3/3 methods agree
Not in label — unassessedserious PRR 2.7 · 75% consumerNCT00808132: 11/220 (5.0%) on Conjugated Estrogens; 40/474 (8.4%) control
Pain3830.6
0.5–0.6ROR 0.5 · χ² 139 / p 2e-32
0.6 EB05 0.5 · IC025 -1.0
PRR-only: not supported by EBGM or IC
Labeled adverse reaction
exact term
serious PRR 0.4NCT00808132: 1/445 (0.2%) on Conjugated Estrogens; 1/474 (0.2%) control (serious AE)
Insomnia (trouble sleeping)3801.3
1.2–1.4ROR 1.3 · χ² 22 / p 1e-6
1.3 EB05 1.2 · IC025 +0.2Not in label — unassessedserious PRR 0.7 · 71% consumerNCT00808132: 12/220 (5.5%) on Conjugated Estrogens; 32/474 (6.8%) control
Myocardial infarction (heart attack)3781.9
1.7–2.1ROR 1.9 · χ² 168 / p 1e-38
1.9 EB05 1.8 · IC025 +0.8Labeled — boxed warning
exact term
serious PRR 1.3NCT00808132: 1/445 (0.2%) on Conjugated Estrogens; 1/474 (0.2%) control (serious AE)

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Medroxyprogesterone acetate ↔ Meningioma.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Conjugated Estrogens?

In FDA FAERS, the most frequently co-reported reaction terms for Conjugated Estrogens are breast cancer, breast cancer female, breast cancer metastatic, cerebrovascular accident, depression, headache. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Conjugated Estrogens have an FDA boxed warning?

Yes. The current FDA label carries a boxed warning: ENDOMETRIAL CANCER, CARDIOVASCULAR DISORDERS, BREAST CANCER and PROBABLE DEMENTIA Estrogen-Alone Therapy Endometrial Cancer There is an increased risk of endometrial cancer in a woman with a uterus who uses unopposed estrogens.

Do FAERS signals prove that Conjugated Estrogens causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.