Estrogens
Tapering Guidance
If used daily for more than 1-2 months
- Reduce dose by a maximum of 25% every week initially (i.e. week 1 75%-50%-25%) and this can be extended if needed
- If intolerable withdrawal symptoms occur (usually 1-3 days after a dose change), go back to the previously tolerated dose until symptoms resolve and plan for a more gradual taper with the patient
- Dose reduction may need to slow down as one gets to smaller doses (i.e. 25% of the original dose)
- Overall, the rate of discontinuation needs to be controlled by the person taking the medication
Withdrawal Symptoms and Monitoring Guidance
- Hot flashes, weight gain, insomnia, anxiety