- currently receiving estrogen based hormonal therapy - abnormal genital bleeding - protein c or protein s deficiency - pre-existing liver impairment (e.g. hepatitis c, cirrhosis) - history of anaphylactic reaction or angioedema with climara - receiving lamotrigine therapy - subjects with known past diagnosis of estrogen receptor positive breast cancer or endometrial cancer - subjects with severe hypoxia at risk for acute intubation in ed - history of stroke - any history of thromboembolic event including deep vein thrombosis or pulmonary emboli - current use of st. john's wort - males on testosterone - history of myocardial infarction, cardiac stents, or active angina

- currently receiving estrogen based hormonal therapy - abnormal genital bleeding - protein c or protein s deficiency - pre-existing liver impairment (e.g. hepatitis c, cirrhosis) - history of anaphylactic reaction or angioedema with climara - receiving lamotrigine therapy - subjects with known past diagnosis of estrogen receptor positive breast cancer or endometrial cancer - subjects with severe hypoxia at risk for acute intubation in ed - history of stroke - any history of thromboembolic event including deep vein thrombosis or pulmonary emboli - current use of st. john's wort - males on testosterone - history of myocardial infarction, cardiac stents, or active angina