What Is Estrogens, Esterified/Methyltestosterone?

Estrogens, Esterified/Methyltestosterone is a combination hormone therapy that pairs an estrogen (Esterified Estrogens) with a synthetic testosterone (Methyltestosterone) in a single oral tablet, used to treat moderate to severe menopausal hot flashes and night sweats when estrogen alone hasn't been enough. It's a prescription medication commonly known by the abbreviation EEMT, and it has been used for decades to help postmenopausal women manage symptoms that significantly affect their quality of life.

Brand Names, Generic, and Drug Class

Over the years, this combination has been sold under several brand names, including Estratest, Estratest H.S., Covaryx, Covaryx HS, Essian, Menogen, and Syntest. Most of these brands have been discontinued, and today the medication is primarily available as a generic — labeled as EEMT or EEMT HS.

It belongs to the drug class of sex hormone combinations — specifically, an estrogen-androgen combination. Because it contains Methyltestosterone, an anabolic steroid, some formulations are classified as Schedule III controlled substances under DEA regulations.

The product is marketed under older regulatory provisions and has not been approved through the modern FDA New Drug Application (NDA) pathway, though it remains legally available by prescription.

What Is It Used For?

FDA-Approved Use

Esterified Estrogens/Methyltestosterone is FDA-approved for:

• Treatment of moderate to severe vasomotor symptoms (hot flashes and night sweats) associated with menopause, specifically in patients who have not responded adequately to estrogen-alone therapy

This is an important distinction: it's not a first-line treatment. It's intended for women whose menopausal symptoms persist despite trying estrogen-only options like Premarin, Estradiol, or Estrace.

Off-Label Uses

Some doctors also prescribe it off-label for:

• Low libido (hypoactive sexual desire disorder) in postmenopausal women — the Methyltestosterone component can help restore sex drive
• Menopausal mood changes and fatigue that haven't responded to estrogen alone

How Is It Taken?

Esterified Estrogens/Methyltestosterone comes as an oral tablet in two strengths:

• Full strength: 1.25 mg Esterified Estrogens / 2.5 mg Methyltestosterone
• Half strength (H.S.): 0.625 mg Esterified Estrogens / 1.25 mg Methyltestosterone

The typical dosing regimen is:

• One tablet daily, taken at the same time each day
• Cyclic dosing: 3 weeks on, 1 week off
• Duration: Usually prescribed for 3 to 6 months at a time
• Take with or without food. Swallow the tablet whole — do not crush or chew.

Your doctor will start you on the lowest effective dose and may adjust based on your response. Most women start with the half-strength formulation and move to full strength only if needed.

Who Should Not Take It?

This medication is not safe for everyone. You should not take Esterified Estrogens/Methyltestosterone if you have:

• Known or suspected pregnancy (Category X — can cause birth defects)
• Undiagnosed abnormal vaginal bleeding
• Known or suspected breast cancer or other estrogen-dependent cancers
• A history of blood clots (deep vein thrombosis or pulmonary embolism)
• Active or recent stroke or heart attack (within the past year)
• Severe liver disease
• Known clotting disorders (protein C, protein S, or antithrombin deficiency)
• Allergy to any component of the medication

Women who are breastfeeding should also avoid this medication, as both hormones can pass into breast milk. Women over 65 should use it with extra caution due to increased risk of dementia identified in the WHIMS study.

For a detailed look at risks and side effects, see our side effects guide.

How Much Does It Cost?

Here's what you can expect to pay in 2026:

• Retail price (without insurance): $140 to $150 for a 30-day supply of the generic
• With a discount coupon: As low as $34 to $39 with GoodRx
• Per 100 tablets: Approximately $259 at retail for the 0.625 mg/1.25 mg strength

Most brand names are discontinued, so generic EEMT is the standard. Insurance coverage varies — many Medicare Part D and commercial plans cover it, though some require prior authorization or step therapy (trying estrogen alone first). The generic is typically placed on Tier 2 or Tier 3 of insurance formularies.

For tips on reducing your out-of-pocket cost, check our savings and coupon guide.

How Does It Compare to Other Hormone Therapies?

If you're exploring your options, here's how Esterified Estrogens/Methyltestosterone stacks up against common alternatives:

• Premarin (Conjugated Estrogens): Estrogen-only therapy. More widely prescribed but lacks the testosterone component. A common first-line treatment.
• Prempro (Conjugated Estrogens/Medroxyprogesterone): Estrogen-progestin combination. Protects the uterine lining but doesn't address testosterone-related symptoms like low libido.
• Estradiol (Estrace, patches, gels): Bioidentical estrogen available in multiple forms. Transdermal options may carry lower cardiovascular risk.
• Bijuva (Estradiol/Progesterone): FDA-approved bioidentical combination in a single capsule.

For a complete comparison, read our alternatives guide.

Final Thoughts

Esterified Estrogens/Methyltestosterone is a well-established combination hormone therapy for women whose menopausal symptoms — particularly hot flashes and night sweats — haven't been adequately managed by estrogen alone. The addition of Methyltestosterone can also help with low libido and fatigue. It's taken as a daily tablet on a cyclic schedule, typically for 3 to 6 months, at the lowest effective dose.

Because it carries a boxed warning about cardiovascular and cancer risks, and because it contains a controlled substance, it requires careful monitoring by your healthcare provider. But for the right patient, it can be an effective tool for improving quality of life during menopause.

Need help finding this medication or a provider who prescribes it? Medfinder can connect you with pharmacies and doctors near you. You can also learn how to find a prescriber or check pharmacy stock using our other guides.