What Is Estratest? Uses, Dosage, and What You Need to Know in 2026

Estratest is a combination hormone medication that pairs two hormones — esterified estrogens and methyltestosterone — in a single oral tablet. If you've been prescribed it, or if you're trying to understand what it is, this guide covers everything you need to know: what it treats, how it works, how to take it, and what makes it different from other menopause therapies.

The Quick Answer: What Is Estratest?

Estratest is the brand name for esterified estrogens/methyltestosterone (commonly abbreviated as EEMT). It combines:

Esterified estrogens: A form of estrogen derived from pregnant mare urine, similar to the estrogen your ovaries produced before menopause

Methyltestosterone: A synthetic testosterone (an androgen/anabolic steroid) that may help with libido, energy, and mood in addition to menopause symptoms

It's prescribed for postmenopausal women experiencing moderate to severe hot flashes and night sweats who have not gotten adequate relief from estrogen-only therapy. This makes it a second-line treatment — typically tried after estrogen alone has been found insufficient.

Is Estratest the Same as EEMT and Covaryx?

Yes. Estratest was the original brand name, marketed by Solvay Pharmaceuticals starting in 1964. The brand was discontinued in March 2009. Since then, the same medication has been available as a generic under several names:

EEMT (esterified estrogens/methyltestosterone) — full strength (DS) or half strength (HS)

Covaryx / Covaryx HS

Essian / Syntest / Menogen (additional generics, some discontinued)

When filling your prescription in 2026, you'll almost certainly be getting a generic. The active ingredients are the same as the original Estratest.

What Conditions Does Estratest Treat?

Primary (labeled) indication: Moderate to severe vasomotor symptoms of menopause — hot flashes and night sweats — in women who did not get adequate relief from estrogen-only therapy

Off-label uses: Hypoactive sexual desire disorder (HSDD) in postmenopausal women; menopausal fatigue and mood changes unresponsive to estrogen alone

Available Strengths and How to Take It

Estratest/EEMT comes in two strengths:

Full strength (EEMT DS): 1.25 mg esterified estrogens + 2.5 mg methyltestosterone per tablet

Half strength (EEMT HS): 0.625 mg esterified estrogens + 1.25 mg methyltestosterone per tablet

Dosing instructions:

Taken orally once daily, with or without food

Prescribed in a cyclic regimen: 3 weeks of daily use followed by 1 week off

Most patients start with the half-strength formulation

Your doctor will reassess every 3–6 months to determine if continued use is needed

Is Estratest FDA Approved?

This is a nuanced question. Estratest has been marketed since 1964, before the modern FDA New Drug Application (NDA) approval system was fully implemented. It remains legally available by prescription under older regulatory provisions, but it has not been approved through the modern FDA NDA pathway.

The FDA has previously questioned whether the androgen (methyltestosterone) component contributes meaningfully to its effectiveness for menopause symptoms. This regulatory uncertainty is part of why some providers are cautious about prescribing it and why some insurance plans don't cover it.

Is Estratest a Controlled Substance?

Methyltestosterone is classified as a Schedule III controlled substance under the Anabolic Steroids Act of 1990. However, the DEA designated many specific esterified estrogens/methyltestosterone combination products as exempt anabolic steroids in June 2020, reducing the regulatory burden for those particular formulations.

The practical implication for patients: depending on the specific product your pharmacy dispenses, there may be restrictions on refills and how prescriptions can be submitted. Ask your pharmacist and prescriber about the rules that apply to your specific formulation.

What Should I Know Before Starting Estratest?

Self-exam and mammograms: Perform regular breast self-exams and stay up to date on mammograms while on this medication

Report unusual bleeding: Unexpected vaginal bleeding is a warning sign that requires prompt evaluation

Report androgenic symptoms immediately: Voice changes, excess hair growth, or acne from the methyltestosterone component should be reported to your doctor right away — some effects can be permanent if not caught early

Don't take if pregnant: Estratest is Pregnancy Category X — it can cause serious fetal harm

The Bottom Line

Estratest (EEMT) is a unique combination hormone therapy that adds testosterone to estrogen replacement for menopausal women who need more than estrogen alone. It's been around for over 60 years, has a complex regulatory history, and is increasingly difficult to find at pharmacies — but it remains an important option for a specific subset of menopausal women. For a deeper look at how it works in your body, see: How Does Estratest Work?

Having trouble finding it at your pharmacy? medfinder can call pharmacies near you to find which ones have it in stock.