Bijuva (estradiol/progesterone) is a prescription drug that’s used to treat symptoms of menopause. Bijuva can cause side effects that range from mild to serious. Examples include breast tenderness and headache.

Specifically, Bijuva is used to treat hot flashes related to menopause in females* who have a uterus.

The active ingredients in Bijuva are the hormones estradiol and progesterone. (An active ingredient is what makes a drug work.) The drug comes as a capsule that you’ll swallow.

Keep reading to learn about the common, mild, and serious side effects that Bijuva can cause. For a general overview of the drug, including details about its uses, see this article.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Some people may experience mild to serious side effects during their Bijuva treatment. Examples of the drug’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

Mild side effects have been reported with Bijuva. These include:

  • breast tenderness*
  • headache
  • nausea
  • unexpected vaginal bleeding, such as irregular bleeding or spotting
  • vaginal discharge
  • pelvic pain
  • edema
  • mild allergic reaction†

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist.

Bijuva may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after taking Bijuva, but this side effect wasn’t reported in studies.

Serious side effects have been reported with Bijuva. These include:

If you develop serious side effects while taking Bijuva, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after taking Bijuva, but this side effect wasn’t reported in studies.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Bijuva, visit MedWatch.

Get answers to some frequently asked questions about Bijuva’s side effects.

Will I experience certain side effects from stopping Bijuva?

No, you’re unlikely to experience side effects from stopping Bijuva. But suddenly stopping Bijuva could lead to your menopause symptoms coming back.

If you and your doctor decide that you should stop taking Bijuva, it’s usually best to do this gradually. Slowly stopping treatment can help prevent your menopause symptoms from coming back.

If you have questions or concerns about stopping Bijuva, talk with your doctor.

Can Bijuva cause weight loss or hair loss?

No, Bijuva isn’t known to cause weight loss or hair loss. These side effects weren’t reported in studies of Bijuva.

Keep in mind that weight gain and hair loss can occur during menopause. Bijuva is used to treat certain symptoms of menopause, but it’s not known to help with weight gain or hair loss.

If you’re concerned about hair loss or weight changes that may occur during menopause, talk with your doctor.

Learn more about some of the side effects Bijuva may cause.

Boxed warnings

Bijuva has boxed warnings about the risks of cardiovascular problems, dementia, breast cancer, and endometrial cancer. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). They alert doctors and patients about drug effects that may be dangerous.

Risk of cardiovascular problems

Bijuva has a boxed warning about the risk of cardiovascular (heart and blood vessel) problems. You should not take Bijuva to prevent heart disease or stroke.

Bijuva is a form of combined hormone replacement therapy (HRT). It contains estrogen and progesterone.

Older studies found that taking combined HRT can increase the risk of cardiovascular problems. These include heart attack, stroke, and blood clots such as deep vein thrombosis (DVT) and pulmonary embolism (PE). These side effects were rare in these studies.

Bijuva contains a different type and dose of estrogen and progesterone than that used in these studies. It’s not known how often these side effects can occur with Bijuva. They’re likely rare.

Heart attack may cause symptoms such as:

  • chest pain, tightness, or pressure that may spread to your neck, jaw, or back
  • shortness of breath
  • dizziness

Stroke may cause symptoms such as:

  • sudden weakness or numbness on one side of your face or body
  • trouble speaking, seeing, or walking

Blood clots may cause symptoms such as:

  • pain, swelling, or warmth in your leg or arm
  • trouble breathing
  • chest pain

You may have a higher risk of cardiovascular problems with Bijuva if you’re more than 60 years old or more than 10 years past menopause when you start taking it. Other factors that can increase the risk of cardiovascular problems when taking this drug include having heart disease or a past heart attack, stroke, or blood clot. The risk also increases the longer you take Bijuva.

What might help

Before starting Bijuva, talk with your doctor about the possible risks and benefits of taking this drug. This is especially important if you’re more than 60 years old or more than 10 years past menopause. Your doctor can help you decide whether Bijuva is a good option for you.

You can also ask your doctor about lifestyle factors that could help lower your risk of cardiovascular problems. These include maintaining a moderate weight and exercising regularly.

If you have symptoms of heart attack, stroke, or blood clots while taking Bijuva, call 911 or your local emergency number right away.

If you have questions or concerns about the risk of cardiovascular problems with Bijuva, talk with your doctor.

Risk of dementia

Bijuva has a boxed warning about the risk of dementia. You should not take Bijuva to prevent dementia.

Bijuva is a form of combined HRT. It contains estrogen and progesterone.

Older studies found that combined HRT increased the risk of dementia when used in people ages 65 years or older. This side effect was rare in these studies.

Bijuva contains a different type and dose of estrogen and progesterone than that used in these studies. It’s not known how often dementia can occur with Bijuva. It’s likely rare. It’s also not known whether Bijuva can increase the risk of dementia if it’s taken by people younger than 65 years.

Dementia may cause symptoms such as:

  • memory loss
  • trouble thinking or communicating
  • confusion
  • mood or personality changes

You may have a higher risk of dementia with Bijuva if you’re older than 60 years old or more than 10 years past menopause when you start taking it. The risk also increases the longer you take Bijuva.

What might help

Before starting Bijuva, you should talk with your doctor about the possible risks and benefits of taking this drug. This is especially important if you’re older than 60 years old or more than 10 years past menopause.

If you have symptoms of dementia while taking Bijuva, talk with your doctor.

If you have questions or concerns about the risk of dementia with Bijuva, talk with your doctor.

Risk of breast cancer

Bijuva has a boxed warning about the risk of breast cancer.

Bijuva is a type of HRT that contains estrogen and progesterone. Studies show that taking this type of HRT can slightly increase your risk of developing breast cancer.

Breast cancer may cause symptoms such as:

  • lump or swelling in your breast or armpit
  • change in the size or shape of your breast
  • breast or nipple pain
  • dimpling of the skin on your breast, like orange peel
  • flakiness or discoloration of the skin on your breast or nipple
  • nipple discharge
  • pulling inwards of your nipple

Factors that can increase the risk of breast cancer when taking Bijuva include older age and having a past history of breast cancer. The risk also increases the longer you take Bijuva. If you’ve ever had breast cancer, your doctor likely won’t prescribe Bijuva.

What might help

While taking Bijuva, you should regularly check your breasts for any changes. See this article for how to do a breast self-exam. You can also ask your doctor or another healthcare professional for advice on how to self-examine your breasts. If you notice any changes, be sure to consult your doctor as soon as possible.

You can also ask your doctor about lifestyle factors that could help lower your risk of breast cancer. These include maintaining a moderate weight and exercising regularly.

While taking Bijuva, it’s recommended that you have a yearly mammogram to check for signs of breast cancer.

If you have questions or concerns about the risk of breast cancer with Bijuva, talk with your doctor.

Risk of endometrial cancer

Bijuva has a boxed warning about the risk of endometrial cancer.

If you have a uterus, taking HRT with estrogen alone can increase your risk of endometrial cancer. This type of cancer affects the lining of your uterus, which is called the endometrium.

Bijuva is a type of HRT that contains estrogen and progesterone. The progesterone in this type of HRT lowers the risk of endometrial cancer related to taking estrogen. If you have a uterus, the risk of endometrial cancer while taking this type of HRT is similar to the risk in people who don’t use HRT. However, it’s still important to be aware of possible symptoms.

Symptoms of endometrial cancer include unexpected vaginal bleeding, such as:

  • spotting
  • irregular bleeding
  • heavy bleeding
  • bleeding after your periods have stopped

What might help

Keep in mind that when you first start taking Bijuva, you may have some unexpected vaginal bleeding. This typically settles down after a few months. If it doesn’t, consult your doctor. They may adjust your Bijuva dosage. Or they may recommend switching to a different type of HRT.

However, if you have unexpected vaginal bleeding that starts after you’ve been taking Bijuva for more than 6 months, consult your doctor. Your doctor may want to do tests to check for endometrial cancer.

If you have questions or concerns about the risk of endometrial cancer with Bijuva, talk with your doctor.

Breast tenderness

Breast tenderness was a common side effect reported in studies of Bijuva. This side effect occurs more often in people taking higher doses of Bijuva.

Breast tenderness typically gets better after you’ve been taking Bijuva for a few weeks.

What might help

If you have breast tenderness while taking Bijuva, this will usually settle with continued treatment. If it doesn’t, talk with your doctor. They may recommend reducing your Bijuva dosage.

However, if you have breast pain or tenderness that starts after you’ve been taking Bijuva for at least 6 months, consult your doctor. This could be a symptom of breast cancer, which is a rare side effect of Bijuva. See “Risk of breast cancer” just above to learn more about this.

Allergic reaction

Like most drugs, Bijuva can cause an allergic reaction in some people. But this side effect wasn’t reported in studies.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin (usually in your eyelids, lips, hands, or feet)
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an oral antihistamine, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Bijuva, they’ll decide whether you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Bijuva, they may have you switch to a different treatment.

Keeping track of side effects

During your Bijuva treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Bijuva affects you. They can then use this information to adjust your treatment plan if needed.

Below is important information you should consider before taking Bijuva.

Boxed warnings

Bijuva has boxed warnings about the following risks. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

Risk of cardiovascular problems: In some people, Bijuva can increase the risk of heart attack, stroke, and blood clots such as deep vein thrombosis (DVT) and pulmonary embolism (PE). Bijuva should not be used to prevent heart disease.

Risk of dementia: In certain people, Bijuva may increase the risk of dementia. Bijuva should not be used to prevent dementia.

Risk of breast cancer: Bijuva can increase your risk of developing breast cancer. Consult your doctor right away if you have any changes in your breasts while taking Bijuva.

Risk of endometrial cancer: Hormone replacement therapy (HRT) containing estrogen alone can increase the risk of endometrial cancer in females* with a uterus. Bijuva is a type of HRT that contains estrogen and progesterone. The progesterone in this type of HRT lowers the risk of endometrial cancer related to taking estrogen.

To learn more, see the “Side effects explained” section above.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Other warnings

Bijuva can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Bijuva is a good treatment option for you.

Talk with your doctor about your health history before you take Bijuva. Be sure to tell them if any of the following factors apply to you:

Alcohol and Bijuva

There are no known interactions between alcohol and Bijuva.

If you have questions about consuming alcohol during Bijuva treatment, talk with your doctor or pharmacist.

Pregnancy and breastfeeding with Bijuva

Before starting Bijuva treatment, it’s important to talk with your doctor if you’re pregnant, breastfeeding, or planning to become pregnant or to breastfeed.

Pregnancy

It’s not known whether it’s safe to take Bijuva during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor before starting treatment with Bijuva.

Breastfeeding

It isn’t known whether Bijuva is safe to take while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before starting this medication.

Like most drugs, Bijuva can cause a number of side effects that range from mild to serious. However, most are temporary and go away after a few days to weeks. If you have questions about side effects that Bijuva can cause, talk with your doctor.

Examples of questions to help get you started include:

  • Does my age or health history increase my risk of side effects with Bijuva?
  • Will the Bijuva dosage I take affect my risk of side effects?
  • Does Bijuva have different risks than other forms of HRT?

To learn more about Bijuva, see these articles:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.