a happy older couple

Q. My doctor recently prescribed Premarin Vaginal Cream. It has improved my life dramatically, reducing dryness and easing other symptoms of menopause. Are there any negative effects? Is it absorbed into my body?

A. Premarin Vaginal Cream contains conjugated estrogens just like Premarin pills. It has been approved by the FDA to correct vaginal dryness that leads to painful intercourse.

Risks

Over three decades ago there was evidence that vaginal estrogen cream (Premarin) could be absorbed rapidly and efficiently into the bloodstream (JAMA, Dec. 14, 1979). More recent studies have confirmed that estrogen in vaginal creams or tablets (Vagifem) is readily absorbed into the body (Annals of Oncology, April 2006; Menopause, Jan., 2009). There are concerns that vaginal exposure to estrogen might increase the risk of uterine or breast cancer in susceptible women.

Please discuss the benefits and risks with your physician. According to The Medical Letter on Drugs and Therapeutics, the long-term safety of vaginal estrogen creams remains unclear (Feb. 23, 2009).

The Estring also provides estrogen to the vaginal area to combat vaginal dryness but the dose is lower.

Alternatives

You can find out more about this and other ways to manage vaginal dryness in our Guide to Menopause. Many women find that lubricating with an edible oil such as almond, coconut or olive oil, is helpful. We are not aware of side effects so long as the woman is not allergic to the oil.

Others prefer water-based lubricants such as Sylk, containing a kiwi vine extract, especially for lubrication during sexual relations.

The FDA has approved a prescription medication, ospemifene (Osphena), to treat this problem. Rather than a vaginal cream or tablet, it is a pill to be taken by mouth. Although ospemifene is not estrogen, it does carry some of the same dangers. The manufacturer warns that there is a possibility that Osphena might increase the risk for endometrial cancer (cancer of the lining of the uterus) or strokes and blood clots deep within the veins. It recommends that women with breast cancer or liver impairment not take Osphena.

Join Over 70,000 Subscribers at The People's Pharmacy

Each week we send two free email newsletters with breaking health news, prescription drug information, home remedies and a preview of our award-winning radio show. Join our mailing list and get the information you need to make confident choices about your health.

  1. Bonstern
    Florida
    Reply

    Just started using a today.. I have dysplasia in my vagina. I had a total hysterectomy about 7 yrs ago.. I’m 50 now.. pap smears are still required even though you don’t have a uterus… that’s how they found the dysplasia.

  2. E
    FL
    Reply

    The applicator and medicine tube are so poorly designed. Cream is lost in the applicator as all of it doesn’t come out. Cream continues to come out of the tube even when you are not pushing the tube. You are wasting plenty of the cream, many of my friends have complained and The manufacturer needs to correct this. One tube is supposed to be a 90 day supply with the waste involved I always run short. My insurance company will not dispense more than one tube as a 90 day supply. Really a consumer rip off!

    • Rebecca
      Washington,Pa
      Reply

      I have same problem. Medicine is expensive n much is wasted! It keeps coming out of tube even when ur not even holding it at end!!!

What Do You Think?

We invite you to share your thoughts with others, but remember that our comment section is a public forum. Please do not use your full first and last name if you want to keep details of your medical history anonymous. A first name and last initial or a pseudonym is acceptable. Advice from other commenters on this website is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. Stopping medication suddenly could result in serious harm. We expect comments to be civil in tone and language. By commenting, you agree to abide by our commenting policy and website terms & conditions. Comments that do not follow these policies will not be posted.