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HealthRX.com · Printable medication review sheet

Estradiol HRT with Mounjaro: route, progestogen, clot-risk and symptom review

Use this when estradiol HRT and Mounjaro overlap. It lists your estradiol product and route, your progestogen, the clot risk factors both prescribers should know about, and a symptom log for the weeks after each Mounjaro dose change, with the warning signs from the estradiol label.

Companion to “Mounjaro and Estradiol HRT Interaction: Safety, Absorption, and Clinical Guidance” · healthrx.com/interactions-mounjaro/with-hrt-estradiol · Facts checked 2026-10-19

Your hormone therapy

Estradiol product, dose and routetablet, patch, gel, spray, vaginal
Progestogen, if you have a uterusmicronized progesterone, medroxyprogesterone, norethindrone, levonorgestrel IUD
Mounjaro dose and date of the last increase
Who prescribes each medicine

Clot risk factors to tell both prescribers

  • A past clot in a leg or lung
  • A close relative who had a clot
  • Obesity
  • Smoking
  • Lupus
  • Surgery planned, or a long spell of being immobile

Symptoms after Mounjaro dose changes

DateMounjaro dose (mg)Hot flashes per dayNight sweats or sleepBleeding or spottingNotes

What the sources say

  • In the ESTHER study, oral estrogen was linked to higher odds of a venous clot (odds ratio 4.2) and transdermal estrogen was not (0.9); norpregnane progestogens were also linked to higher odds (3.9).[1]
  • In the WHI estrogen-alone study, venous clots occurred at 30 versus 22 per 10,000 women-years with oral conjugated estrogens versus placebo; only the rise in deep vein clots (23 versus 15) was statistically significant.[2]
  • Mounjaro slows stomach emptying and may affect the absorption of medicines taken by mouth.[3]
  • The Mounjaro label's hormone study used a contraceptive pill: a first 5 mg dose cut ethinyl estradiol's peak by 59% and its total exposure by 20%.[3]

Right away, not at the next visit

  • Severe pain in your chest or legs, with or without shortness of breath; changes in vision or speech; or a sudden new severe headache: call your healthcare provider right away.[2]
  • Unusual vaginal bleeding while using estrogen: report it right away.[2]

Questions for the HRT prescriber

  1. Would a patch or gel suit me better while my Mounjaro dose is changing?
  2. Is my progestogen the best type for my clot risk?
  3. Should my estradiol dose be reviewed if I lose a lot of weight?
  4. Which symptoms mean my HRT dose needs checking?
  5. Is a blood estradiol level useful for me, and when would it be taken?
  6. How often should we review whether I still need HRT?
Sources for the facts on this sheet
  1. Canonico M, Oger E, Plu-Bureau G, et al. Hormone therapy and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration and progestogens: the ESTHER study. Circulation 2007. PMID 17309934. https://pubmed.ncbi.nlm.nih.gov/17309934/
  2. Sandoz Inc., via DailyMed. Estradiol Transdermal System: prescribing information and patient information. Effective 2026-03-04. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c714974b-766f-42f2-a846-b0c1f5a60560
  3. Eli Lilly and Company, via DailyMed. Mounjaro (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-08-27. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2d7da5d-ad07-4228-955f-cf7e355c8cc0

This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.