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This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. Every woman who thinks she has an irregular menstrual bleeding pattern should think carefully about the specific characteristics of her vaginal bleeding in order to help her doctor evaluate her particular situation. Her doctor will require the details of her menstrual history. Each category of menstrual disturbance has a particular list of causes, necessary testing, and treatment. Circulating estrogens modulate the pituitary secretion of the gonadotropins, LH and follicle stimulating hormone FSH through a negative feedback mechanism. Estrogens act to reduce the elevated levels of these hormones seen in postmenopausal women.

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