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Premarin Controversy Continues

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There are few drugs in modern history that have stimulated greater controversy than Premarin. Since its FDA approval in the early 1940s more than 30 billion doses have been dispensed. The estrogens in this hormone replacement therapy (HRT) are made from purified pregnant mare's urine.

By the 1960s, Premarin was widely prescribed to ease menopausal symptoms. Not only was it used to eliminate hot flashes and night sweats, doctors prescribed it to calm anxiety, slow the aging process and help women stay "Feminine Forever." That was the name of a popular book written by physician Robert A. Wilson in 1966.

Since then, Premarin has been praised and vilified by doctors, patients and consumer advocates. Even 40 years later the controversy rages on. Epidemiologists continue to argue about the risks and benefits of HRT. On March 7, 2012 an online article in The Lancet Oncology suggested that estrogen by itself (without progestin or medroxyprogesterone) does not increase the risk for breast cancer and might even lower it. The key author (Garnet Anderson) was quoted as saying, "Women who have had a hysterectomy may be reassured that taking estrogen by itself, short term, to relieve menopausal symptoms will not increase their risk of breast cancer."

Sounds convincing and very reassuring. But 25 days later on April 1, 2012 (not an April Fool's joke, we assure you), a much larger study was presented at a cancer conference in Chicago with just the opposite results. The research involved roughly 60,000 nurses who participated in The Nurses Health Study. Data was analyzed from 1980 through 2008. Women who took both estrogen and progesterone (Prempro for example) had an 88 percent higher risk of breast cancer after 10 years on the treatment. Those who took estrogen alone for at least a decade had a 22 percent increased risk of developing breast cancer. Those women who were exposed to just estrogen for more than 15 years had a 43 percent greater chance of being diagnosed with breast cancer. The lead author, Dr. Wendy Chen, is quoted as saying, "There's a continued increase in risk with longer durations of use and there does not appear to be a plateau."

With such conflicting research and dueling headlines (one month you read that "Estrogen Pills Reduce Breast Cancer Risk" and the next you see that "Long-Term Estrogen Therapy Does Up Breast Cancer Risk") it is hardly any wonder women are totally confused.

The experiences of individual women often get lost in the clamor.

Some women, like this one, strongly favor the drug: "I had a complete hysterectomy in 1974 due to endometriosis, a very painful disease involving my uterus and ovaries. I took Premarin but did not take progestin since I had no uterus. I have heard that progestin is what may increase the risk of cancer for women taking estrogen.

"Nothing terrible has happened to me all these years on Premarin. At 79, I'm healthy and play tennis and golf regularly."

Another woman had a serious side effect, but still opts for Premarin: "After I had a hysterectomy, I was put on a high dose of Premarin for menopausal symptoms. I stayed on it for 30 years. Two years ago, I was diagnosed with early breast cancer. I had a lumpectomy and 7 weeks of radiation. The cancer has not returned.

"Would I do it again? You bet! Surgery and radiation are a small price to pay for 30 years of health and happiness."

Here is a different perspective: "In the mid 1980s, my doctor talked me into taking estrogen for night sweats and lack of sleep. In 1998, after taking estrogen all that time and getting annual mammograms for 12 years, I was diagnosed with early stage breast cancer.

"I needed a lumpectomy and five weeks of radiation. The first thing I was told was to stop taking estrogen. Not long after that, the uproar started over HRT and many women stopped taking it. After 12 years, I was breast cancer waiting to happen. I took it that long because I was told it was good for my bones.

"In 2006 I found out I had uterine cancer. I'd had symptoms for only a few weeks before they performed a hysterectomy. The doctor said the cancer was about to break through the lining of the uterus. I guess I was lucky. Again, I needed five weeks of radiation. This time it was much harder.

"I have to wonder if any of this would have happened had I never agreed to take the estrogen. I guess I'll never know."

Proving that HRT was responsible for a particular woman's cancer is very difficult. The stories of these three women demonstrate why individual preferences must be part of the prescribing decisions. Weighing benefits and risks based on objective information is critical to that process. The latest data from the Nurses Health Study seems to confirm that use of hormones beyond 10 years increases the risk of breast cancer. That includes estrogen by itself or combined with progesterone. Whether so-called bio-identical hormones would be any safer remains to be determined.

For more information about treating menopausal symptoms and hot flashes without estrogen or progesterone, or a combination of the two, we suggest our Guide to Menopause or The People's Pharmacy Quick & Hand Home Remedies from National Geographic. You can find both in our People's Pharmacy Store under Guides or Books.

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My OBGYN tried to foist HRT on me for years. I argued with him at first and then just took the prescription he wrote out and threw it in the trash. I've had hot flashes for years, but they are nothing compared to the threat of cancer. I would never consider taking estrogen.

I, too, am 79 and have taken Premarin for almost 40 years. I stopped periodically after the news items came out, but always went back and felt better. When I stopped... even at this age... I had hot flashes and mood swings. Resumed and felt
fine. Only regret is that this year my Drug Insurer (Humana) stopped contributing to the cost. It is still expensive after all these years. Why?

I had a hysterectomy at age 39 (uterus, not ovaries) and went into menopause at 45. At age 48, I started Premarin ONLY and it worked great, plus made my skin so soft, few wrinkles. I already had heart trouble but after 22 years, the dr. said to stop taking it, and I did. No breast problems yet at age 75 and skin not as nice. I'm sorry some women weren't as lucky.

Are you referring to oral premarin or the premarin cream? thanks mary

What we know from the WHI study is that the use of Premarin for 10 years increases the risk of cancer. Taking estrogen, even in the form of Premarin, also increases the survivability of cancer. Whether the cancer you get from Premarin is easier to survive than the cancers you get without Premarin, or whether HRT makes you simply more able to survive any cancer, can't be determined.

Broken bones, for very old women, can be at least as lethal as cancer, if not more so.

Problem is, no-one's going to pay for a similar study for bio-identical hormones because they don't have patent protection.

I went to a Naturopath who suggested I take Estriol. Any information about the safety of this?

Thank you for a fair and balanced look at HRT. Little has bee published re the study out years ago, stating that HRT was also bad for the heart, neglecting to point out that the study involved many older women 60 + years + who had never taken HRT. At this point, damage to the cardiovascular system -- without HRT post menopause -- would already have occurred, HRT at this later point would only exacerbate it. In other words, HRT actually was good for the heart if taken immediately post menopause.

I do take HRT, half doses, from the beginning, less times per week as the years progress. I understand the concern, I never miss an annual mammogram and self exam. But I am also concerned that there really is not good research into individual needs. One size fits all -- either with all on HRT or all nor taking HRT will ever work.

I've also seen the medication prescribed to "aid" women suffering from the debilitating effect of hot flashes: anti-depressants, xanex for anxiety, ambien to sleep. Is this a great alternative? And, so many so called natural alternatives really don't do the job. We need the research, testing to find better alternatives for women. Let's just pretend it's men that have this problem. There will soon be a "viagra" solution!!!

It would be helpful to see the absolute risks.

Many years ago, I was on premarin. When I heard that it was made from pregnant mare's urine, I stopped. I also wondered how in the world did the scientists think of the urine?? Please tell me.
Thanks,Angelafg22

I've been on Estrogen (12.5 per week) for 35 years, since having a complete hysterectomy, back in 1977. I have "Mamos" yearly and to date no cancer also no heart problems. I asked my GYN what would happen if at age 32 I did not take Estrogen and he said I could be a person that would have heart problems and strokes. All these years any he never stated any cancer problems and I have questioned him about it.

My mom started having heart attacks and stokes within 2 years of not taking Estrogen when she had her complete hysterectomy. 4 years later she was told she had breast cancer and went through all the require treatments. One year later she died with cancer throughout her body.

I fully feel some folks are marked for cancer and other are not.

I would like to hear more about this.

I took premarin with progesterone and had cancer of the entrometrium and had a complete hysterectomy followed by a radium implant. Would I take the premarin again - NO>

These are the same old data marched out again and waved in the air to intimidate and confuse women about their best health options. While some Peoples' Pharmacy writers are bright and respectable thinkers, it is misleading to cite increased cancer rates up to "88 percent." While the statistics are likely correct, it's the actual number of cancer cases that matters. The incidence of cancers and heart attacks were low to begin with, even though that low number did increase w/ HRT use, according to their study. Thus the actual number of ADDITIONAL cases is still very low. When I read the study on nurses' health, I determined there might be an added 8 cases per 10,000 women using the medications.

While one unnecessary case of cancer is "not acceptable," still it is in our best interest to consider our own health status individually. And calmly. For me, there is no breast cancer (nor any fatal cancers) on either side of my family for the generations whose health histories are available to me. Nor heart attacks. My blood type is not predisposed to cancers. However, I do have osteoporosis running thru both sides of the family. And estrogen is known to assist in the uptake of oxygen to brain cells (and other cells.) Because I need oxygen in my brain, and any help I can get for bones (albeit questionable that estrogen has helped my bones,) I choose to take a small dose, with progestins, daily.

Others with different health histories should not be bombarded w scary emails from Peoples' Pharmacy. They need helpful, thought-out information to make their own best health decisions.

Thanks for considering the actual numbers of cases, and not just the percentages.

Have these studies addressed the use of Premarin used vaginally (for dryness)?

I had hysterectomy with bilateral ovary removal in 1984. I was 33 yrs old. tried Premarin had headaches, water retention, sore breasts. Luckily, a new internist said try Estrace instead. Never could take Provera, as headaches came every time.. gave it up. Now, in 2012 still take Estrace 1 mgm daily. Mammograms have been negative, and this is the least amt I can take to control insomnia, hot flashes, irritability. Studies are never done with women who have no ovaries!

It is like hitting the wall at 90 mph after a week. Symptoms are harsh with no replacement at all. My physician and I agree on quality of life, sleep, bone health, general well being. I believe Estrace is bio identical med. What do you think of this life decision. thank you. mary w

I have taken estrogen patch "Estradiol" for many years, and would not want to stop as I feel great on it. I check with my Dr regularly, who view is that he is a 100% for it and sees no reason for me to stop. I have regular mammograms.

I wonder what studies have been done on Premarin vaginal cream. My doctor prescribed an initial course of 1 gram a day for two weeks, followed by 1 gram twice a week indefinitely (or, as she put it "As long as you want to have sexual intercourse"). This was about 3 years ago. It has worked very well, in that intercourse had become unbearably painful, and now I can fully enjoy sex with my partner. My doctor assured me the Premarin cream is safe, even for women who have had breast cancer. Do you know anything about this? Thanks.

It is one thing to discuss the merits vs dangers of premarin on womens health. It is quite another to look at how it is made and the conditions that the mares are forced to live in. If anyone were to research premarin I venture to say you could not take it with a clear conscious. I understand there are plant based and maybe synthetic alternatives that are even more bio compatible for women/humans. That information should be included in any discussion of hormone replacement therapy.

It makes me crazy that the bio-identical hormones have not been studied. I know, there is no money to be made by pharmaceutical companies but quality of life should also count! As I write this I am in pain from a urinary tract infection which might have been prevented by having more estrogen in my system. These seem so common for us post-menopausal women. Maybe when a woman wins the lottery?

I was diagnosed with early stage estrogen receptor positive breast cancer at the age of 41. I was told I should never take estrogen. When menopause hit five years later the hot flashes were so intense, frequent and painful (yes really) that I couldn't sleep and was generally quite miserable all the time. My doctor said the research wasn't clear at that point and that I could decide to take Premarin for quality of life reasons.

I elected to do so at the higher dose as that was the only thing that controlled the hot flashes. I tried several times to go off, and the hot flashes came back full strength very quickly each time. Twenty six years after the initial diagnosis the cancer had metastasized to my liver and the surface of one lung. I was immediately put on Arimidex which blocks estrogen, and the hot flashes returned. After trying several different remedies, my doctor finally suggested a clonidine patch. That is working. Now I might have 0-3 per day and not nearly as intense.

I have no idea whether the estrogen replacement therapy caused my cancer to return. But even if it did, I would make the same decision all over again. I just wish the clonidine patch had been available much earlier. If it works now that my body is getting no estrogen, surely it would have worked earlier. I wonder if any doctors are using it to treat menopausal symptoms in the absence of breast cancer. I am very fortunate. My response to Arimidex was slow but sure, and my oncologist thinks that is an indication that it will work for a long time.

Premarin is still expensive, because no other drug companies have entered the market with a generic version.

Even though if found this article interesting, I would have liked to know the dosage of Premarin that these women took. I have been on Premarin since 1975 at .625 mg ever since. I was 35 when I had my surgery. My doctor put me on it to help with my night sweats and hot flashes. I am healthy, work out 3 days a week at the gym, lifting 90 lbs with my legs and 70 with my arms and work my abs with 85 lbs. I might end up eventually having problems, but I am willing to take the risk. I am told all the time that I look to be in my 50's. Thank you for the information.

I have been using a Premarin vaginal cream....is there anything in the latest report that would negatively impact on such usage, twice each month? Would appreciate hearing from any others who might also use this medication.

How little they knew about Premarin when they began marketing and selling it is shown even by the dosage. Over the next 35 years or so, they kept lowering the dose when more news came of how harmful it was to women. It's shocking that a drug was recommended so persistently to women by drug makers and doctors who had no understanding of its dangers or even how much to take.

I am 70 yrs. old, healthy, work out at gym everyday - eat heathy, but losing my hair - what would be wrong with taking hormones for next 10 yrs.? Feel great, but hate the loss of hair and wrinkled, damaged skin, as well as dryness everywhere, must I get old without feeling old? Would hormones be helpful? Married 50 yrs.., sex still good but I get infections every time , who wants THAT? Want to continue our life as good as it is now, much better then when we were so young - can or should I use hormones?

It feels that there are many unanswered questions in this. The first article cited discusses the use of Premarin in women who had a hysterectomy. The second one seems to be more focused on women in general. My doctor recently told me that women with hysterectomies were less likely to have problems with Premarin. Does it make any difference in terms of likelihood of cancer, bone loss, etc?

I have had doctors who have lied to me about all kinds of drugs including Premarin. Each time a doctor encouraged me to take a new prescription, I would come home and research that drug on several websites and found that the very drugs they tried to get me to take were very dangerous.

So I made a long study of vitamins, minerals and herbs and I am doing very well with those and I will NEVER take another prescription drug as long as I live.

Well, here's my 2 cents: I am currently 67+ years old. I had a hysterectomy (one ovary was left in as it was still "working' at the time) in 1989 and about 6 months later was put on Premarin for the hot flashes, etc. that ensued.

Each year at the time of my annual physical, the doctor and I would discuss the benefits of staying on the Premarin: helps your bones, helps prevent heart attacks and strokes, etc., etc. She said all the survey results showed it would be best to keep taking it.

In 2002 I was diagnosed with estrogen positive breast cancer and my surgeon told to me to stop taking Premarin immediately - as in Right Now!

Did it cause my breast cancer? Who knows? But had I to do it over there's no way I would have taken it. There are other alternatives to hot flashes and night sweats. If the cancer hadn't been caught through a routine mammogram, I might not be writing this comment right now! Everyone is free to make their own decision, but I know what mine would have been.

My doctors More than one touted the wonders of HRT and it sure kept those menopausal symptoms at bay. Then after 8 years of taking this wonderful panacea I was diagnosed with stage 3 breast cancer. No history of cancer in even our extended families. 8 chemo and 37 radiations later and of course a modified radical rt breast mastectomy in 1999 I am cancer free still.

Of course no doctor will now prescribe any kind of HRT therapy for me even though today it is offered at a much lighter dose. I now do still suffer many of the post menopausal symptoms especially sleep problems and night time flashes. I am thankful to be alive. By the way I had fibrocystic breasts a big no no for estrogen therapy. I am a strong advocate against HRT. If one person reads this and decides to go without I have succeeded in getting the word out.

There is another reason to refuse Premarin, and it has to do with the way the pregnant mare urine is collected. Not only are the mares confined and made pregnant as often as possible, but the number of foals resulting from the pregnancies are too many for the market and horse rescues to save, so many of them go to slaughter.
We need to know more about the source of drugs we use.

I couldn't image being without my hormones. I believe it depends on the person how they respond in taking HRTs. I have been taking HRTs for years soon after going through menopause taking Prometrium (extracted from a variety of wild yam) in pill form for hot flashes, cold flashes and now I am on a cream (compound) bio-identical hormones. I still have my uterus and ovaries, with a normal weight, no high blood pressure. I never took Premarin. My sister, who is younger than me, never took HRTs and got breast cancer...thankfully, she doesn't have it anymore.

I took Premarin for many years. I was my sole support, and the menopausal night sweats were making me a wreck--barely able to function at work. I don't know what I would have done without it.

I was still on Premarin when that flawed study threw so many in a tizzy some years ago. Sometime after that I decided to try life without Premarin. My GYN suggested a several month's term of stepping down and finally off it. I have not had side-effects from taking it or now, and I am so glad that medication was available for me.

Like other commenters above, I have not had any repercussions, and I come from a family whose females have had breast cancer. I just make sure I have a good mammogram each year.

Premarin was certainly the right solution for me.

During my late thirties it was necessary for me to have complete hysterectomy (1976). My doctor told me to take Premarin for the remainder of my life if I didn't want to go through the change. I am so very glad I followed his advice. I have had and still have to fight to get it. For me, taking it is better than the alternative.

Is there evidence of increased cancer in women who use Premarin vaginal cream and and no oral HRT?

I was in today to see my doctor about Estradiol. I have been on it about 15 yrs with the lowest dosage. I tried to get off of it for 3 weeks this past month but couldn't take the night sweats and hot flashes so I started back on it. My doc said as long as I know the side effects and they the Estradiol makes me feel better and helps me, plus out weighs the risks, I should take it. I google ESTRADIOL and got all kinds of scary information, but it also said it is used to fight some cancers so who knows what to do. I am 70 yrs old, had a hysterectomy years ago I thought hot flashes would be long gone by now. I also have tried Black Cohosh, sweet potatoes, etc etc to no avail. Anybody have a good substitute?

I had a hysterectomy (complete) in 1992. I will be 60 this year. I am now having thyroid problems and my Dr. told me Premarin was a very strong tri-estrogen and could cause thyroid problems. I am not taking a compound (I use vaginally for my bladder prolapse) and it is amazing. He suggested just using one estrogen (estrace) the safest of the three that premarine has. I never felt better. Hope this might help someone.

Gosh. In the seventies we moved to VT and not long after I was told I had to have a hysterectomy due to endometriosis and I did. I believe it was within a year hence I remember my husband and I driving to Boston for a conference and I had very strong feelings that I wanted to get off this Premarin I was taking. The feelings I had were so powerful that I did stop. That's it. Our marital life has been wonderful and we will have been married 49 yrs in a few weeks. I must add that I am so glad we were able to have our two children prior to the surgery. To this day, the only med I take is a mild one for high blood pressure.

Ps. I must add that Z and I (after moving to VT in 1971 with our two young children) began, slowly at first, eating in a much healthier fashion. Local farm milk, fresh eggs from local folks (and then our own chickens), fresh vegetables and all sorts of wonderful new recipes appreciated by family, friends, et al, were on our table at mealtime. We also believed in a glass of wine as part of the picture.

One more thing. Adele Davis, Rodale Press and Diet For A Small Planet were eye openers for us and were our guides toward teaching ourselves to help ourselves. What an amazing time that was. And now we have found you, Graedons and are fascinated by your weekly radio show on NPR. You are most appreciated in this household and I know we are just two out of many other listener's from all over this country who don't want to miss even one of your broadcasts. You are the best! Thank you, Jean. GO BLACKSTRAP MOLASSAS. After taking a teaspoonful twice a day and now only three days later no more bleeding nor hemorrhoids. This followed years with the problem? WOW!

I am 84 years old and had taken Premarin from age 50 to 72 which at that time was diagnosed with endometrial cancer, caught very early. After this surgery, doctor put me on Evista..still taking it daily. All of this after smoking for 40 years. Consider myself very fortunate to still be alive.

A couple of us have asked about Estrace. I am hoping someone has some insight on this. Thanks

Hello~ I had my total hysterectomy at age 33 for endometriosis and went on premarin the next day..1.25 mg /day.... I tried every other alternative imaginable and came back to premarin even though I hate the fact that it is derived from horses. So I switched to the synthetic version called Cenestin...same dosage...and nearly identical. No problem. I get a mammogram every year. At this point I am more afraid of all the radiation from 24 years of mammos. ( I am 57). Recently the price of Cenestin went so high and I couldn't even find it at the pharmacy so I have recently switched to that company's alternative called Enjuvia..which is even closer to the Premarin formula...only synthetic...and by synthetic I mean made in the lab..I believe they use some plant sources for much of it.

A doctor I once saw put me on Progesterone cream made up by the pharmacist..he read a book that made him think it would help the breasts resist tumors which may be encouraged by the estrogen. Sometimes I use it ..sometimes I forget..I don't notice any difference either way. I have lowered my dose of estrogen to 0.9mg/day..and sometimes when my breasts start to hurt a little (I have those nasty benign cystic thingies) I do one day on and one day only half. I just had my cardiac screening today and except for some mitral valve proplapse I am 100% normal...low blood pressure and no cholesterol....on the border for osteopenia..which I think is normal for my age.

So..I believe lifestyle and family history are the real determining factors here for cancer and heart disease. If you have an organ..like your uterus and ovaries, tubes and cervix removed..the estrogen you are taking is not in addition or surplus..it is making up for what the body can no longer produce. I don't feel I am SUPER Feminine......It's not like having a normal thyroid and taking more thyroid for some weird reason. Then of course the body would freak out.

I have tried 3 months without my estrogen and had depression for the first time in my life. It was AWFUL!!! I intend to take estrogen forever..though it is ridiculously expensive. Women get the raw deal all the time, yes? Hope this helps...

I think estrogen unopposed by progesterone can cause cancer. You need your hormones to be balanced. I also think the high fat diet is the cause of most breast and prostate cancers. Recently I read an article that talked about how we can expect to live longer and healthier than any human beings in history. It discussed how, for the first time, humans are living longer than 50 years and, for the first time in history, we are seeing diseases of old age that were never seen previously ... yes
Alzheimer’s disease, prostate cancer, osteoporotic hip fractures are just a few of the medical problems that were never really seen until the last 100 years.

I thought ‘yes, that has got to be true’ and it is a fact that as we get older our bodies will start to break down ... we will need treatment for various bothersome aches and pains as well as some serious illnesses ... but, this does not mean that we should
not look for ways to optimize our health and extend our lives.

This piece I read said that until the beginning of the 20th century human females also ovulated until death! (Of course the average life expectancy at that time was only about 50 years!) In 1900, for example, only 6% of women in the United States were post-menopausal. Now almost 35% are post-menopausal.

So, with advances in medicine, sanitation and diet, we women (just like captive laboratory and zoo animals), can expect to live a third of our life after cessation
of menses.

some captive primates will not only cease ovulation (if they live long enough) but will also stop producing estrogen. The majority of mammals, however, continue to produce estrogen until death even if they no longer ovulate. So human menopause (cessation of ovulation and estrogen production) is an UNintended consequence of living beyond age 50. The “natural state” of mammalian evolution leads to functioning
ovaries until death, and for females, maintaining circulating estrogen levels during the entire adult life is the overwhelming intention of mammalian evolution.

The risk of uterine cancer is decreased below baseline levels if HRT consists of a combination of estrogen and protesterone (i.e. HRT, if used properly in women with a uterus decreases risk of uterine cancer).”

Progesterone should always be viewed as the life-long partner of estrogen, since they balance each other out and work together to promote optimal female health.
Progesterone is the “feel good” hormone, as it acts as a “natural anti-depressant,” boosting moods and well being as well as stimulating bone growth, healthy heart function and offering protection against breast and uterine cancer.

HRT may decrease risk of colon cancer.

HANG ON TO YOUR SEXUAL STEROIDS!

if we set aside the mildly troubling symptoms of menopause we are left with the far more important fact that without estrogen, there WILL be bone loss. You can take all the calcium and vitamin D that is recommended, you can lift weights and stay active but none of this will entirely prevent bone loss. For women who weigh a lot more than I do it may not be a problem. I am 5'8" and weigh 118 pounds. I am small boned.

I tried every single thing in the book to reverse my osteoporosis and it was not until I went back on estrogen--low dose estradiaol--and natural progesterone cream to
balance it that my osteoporosis began to reverse.

There is no reason for estrogen (or birth control pills) to be so expensive. It's a total rip-off by big pharma, cause they should be the price of aspirin, the way they are in the 3rd world!

>though it is ridiculously expensive.

Shop around. I found a local compounding pharmacist who keeps me in transdermal estrogen for $35 / month. The brand-name products where $150 and $225 / month for an equivalent dose. (I needed a prescription from my doctor, but he was happy to write once I'd done the research and the pharmacist made the phone call with the details of what needed to be on the prescription.)

My mother took hrt for 15 years after menopause because her doctor told her to. She never had a hysterectomy or any reason other than all the doctors were prescribing it. She had to have a double mastectomy after cancer was discovered. My doctor wanted me to take Premarin when I was in my late 40's; no hysterectomy, menopause or reason. I tried it for about 3 months; it made me feel like I was 6 months pregnant and I quit it. When I told my doctor that I felt HRT caused my mother's breast cancer, she said she would have gotten it anyway.

I had a hysterectomy at age 49 because of fibroids that extended to my ovaries. My gynecologist prescribed 2.5 per day of Premarin and told me to take it until the day I died, that it would give me "the edge". I took the initiative to reduce my dosage to .625 x 2 about fifteen years ago with no diminution in benefits. My parents both died in their early fifties of heart disease while I, now 79 years old, am still here to tell my story. Even my extended family is plagued with heart disease.

While I look at least 20 years younger than my age; on good days 25 years younger. My mood is great, my skin, troubled until my forties, is so smooth that I often get compliments on it. The last time I had a bone density test, my bones were likened to those of a 25 year old. From a recent cardiac scoring, a test to determine presence and extent of plaque on the veins leading to the heart, my score on a scale from 0 to 400, was 1. Downside? Having to argue constantly to continue my HRT

Recently, I had hip surgery and, as a consequence, developed two small pulmonary embolisms that, thank heaven, came with severe, though somewhat confusing, symptoms that immediately sent signals to my Internist who saved my life with his brilliant diagnosis. Now I'm once again in the position of having to defend my use of Premarin despite enjoying "spectacular" (my doctor's word, not mine) health except for this brush with disaster, no doubt caused by the hip surgery.

I am currently taking Coumadin to avoid further clots, and my Hematologist is evaluating the risks of further use of Premarin. Whatever happens, I will never regret taking Premarin as long as I did because I feel there are even more benefits than those that are catalogued.

I am 54 yrs old and had a complete hysterectomy In my 30s. I have taken Premarin, estratest and lastly estradiol.

Because I had a mom and sister who died from metastatic breast cancer, my
Dr has taken me off of the 2mg of Estradiol and I have been off HRT completely for the last 4 months.

Intercourse is painful and my libido is virtually non existent and the hot flashes are getting worse. My family also has a history of heart disease. I am a young 54 and I don't know what to do but I am not ready to say goodbye to intercourse as part of my sex life. I'm also worried that now that I'm not on HRT, I might have heart problems.

I was on Estradiol .05mg for 18 yrs after a complete hysterectomy. I decided to get off. My Doctor told me to wean myself off, not just stop cold turkey so I took a pill every other day for 4 months and then stopped.
The night sweats and hot flashes came back something terrible.

I went back to the Doctor last week Nov 1, 2012 to see if he could give me something for the hot flashes as I couldn't stand them. He informed me that he had just been to a big Convention/Conference the week before and now the Doctors think that it is safe to take Estradiol for hot flashes. So, I am back on them at lowest dose .05mg again.

It's been 9 days and still having 2-5 hot flashes a night and on and off during the day. They worked excellent in the 18yrs I took them but evidently haven't kicked in yet this time. How can they now say they are safe when I read all these comments of breast cancer? Do I trust my Doctor? What to do .....what to do...what to do????

I am 50 yrs old 5'2" 110lbs. I had a tubal ligation at 26 and hysterectomy @ 37 kept my ovaries but have been on HRT since early 20's 1st w/injections w/B12 once a month then after my hysterectomy I've been on estratest hs 2 pills daily.0625mg estrogen + 1.25 mg testosterone that's 0.125 estrogen and 2.50 never had any problems until 8 months ago I started feeling severe fatigue, joint and muscle pain, skin is dry and itchey, I can feel the depression creeping in I'm losing my hair after washing more than normal, upper right side pain just below my ribs and it radiates to my back and shoulder blades all the time anywhere from a mild 3 to an intense 8, my sex drive has all but diminished seems like overnight. I've had several blood tests, ct scans, chiropractic, massage and nothing. Last week I went to a Gyn for the 1st time in 13 yrs she said everything is ok, she did blood tests for TSH (thyroid stimulating Hormone) and free T4) my TSH was 6.42(high) but my free T4 was 1.00 (normal) she prescribed synthroid .50mg which is to increase my T4 (I wont take this unless its last result) she told me to stop taking estratest and put me on Premarin .0625 twice weekly, not even close to enough I knew in 1 day, my mood swings are severe, hot flashes, trouble with weight gain still are not an issue.

She scheduled a trans vaginal ultrasound to check my ovaries and a mammogram. She thinks my testosterone levels are off the chart but after the blood tests it's quite low, I am iodine deficient. I have increased my own iodine intake as well as the premarin just to maintain my sanity until I get the other tests done this Friday. Does anyone know if increasing my premarin is harmful without testosterone? This post is a last act of desperation I'm so sick of feeling so crappy all the time, I'm looking for any advice or thoughts. thx

I had cervical cancer and had a radical hysterectomy over a year ago my gynecologist recently prescribed premarin but I'm not certain I want to use it because I'm not sure it's safe.

I too am 73 yrs, old. I had been on the yellow premerin for a long time. I moved to another city for a year, the doc there put me on a liquid instead of the pill, tasted bananas. I moved back to the old home town, where my doctor put me back on yellow premerin. 6 yrs. ago I moved to BC for a few years... there the doctor changed to the green pills which didn't help at all... so I asked to change them, he gave me the wine colored ones... I have been on them now for about 4 yrs. But now out of the blue they want me to stop completely ! Yet I have to reason to as far as I know. I was always healthy, now well, I'm 73 ... everybody dies of one thing or another, so why stop this now, when there's no reason to ? I am mad and will not go see him again... thanks

Have been on premarin 1.25 since 1974 when I had a complete hysterectomy for cancer.

My bone density tests come back very normal (younger than what I am now (73). Have had to have stents put in my groin this year. I think I do not get enough exercise. I am 5'3" and weigh approximately 116 pounds. I am a smoker and I think that may be the cause for some of my problems, like apparently high cholesterol which I will take care of without prescription drugs.

My original doctor that put me on the premarin said to stay on it until I was 80, so I am taking his advice as he was way ahead of a lot of things even back then.

I had a total hysterectomy in 1983 due to advanced endometriosis. I was 33 years old. I was put on a low dose of premarin. I cried for a week and the dosage was increased.. it worked well for awhile but the night sweats and hot flashes came back and my dosage was increased to 1.25. I've been at that dosage for 30 years.

My new PCP told me that women my age did not need to be taking the estrogen replacement after all this time. I tried reducing the dosage on my own by cutting them in half for about 2 weeks then stopping them all together.

Are you kidding me? Horrible! I can't sleep, skin stinging like millions of ants biting me, hot flashes, profuse sweating..I'm back on my premarin! My only side effects was weight gain. I do keep up with my mammograms to be on the safe side.

I had a total hysterectomy at age 23 in 1971. I was on Premarin for years. I am now 65. I got OFF Premarin back in 1990 and onto a safer form of estrogen - the patch + natural progesterone cream. 2 years ago I went on a gel type of estrogen. I also still use natural progesterone cream.

I had my complete hysto when I was 33 for endometriosis and I am 58..been on Premarin, then switched to Cenestin..then something cheaper..now back on Cenestin (absurdly expensive)...started with 1.25 mg..now down to 0.9 most days and half a tab for a week or so when my boobs start to hurt...I have yearly mammos..and don't smoke (quit) ... no family history of breast cancer..a lot of strokes in my family tree....I figure; many if the studies with negative results do not discriminate between healthy lean women and grossly fat cigarette smokin' babes..or ones with the breast cancer gene or family history of breast cancer....also some women I know are clueless if a lump is in their breast??..simply out of touch with their bodies!?!

When a woman has both ovaries removed it is removing a major gland in the body. If you had your thyroid taken out you would need to take thyroid hormone for the rest of your life...pancreatic problems..then you very well might need to take insulin. I figure the amount of estrogen I am taking is just making me normal..it is not enhancing anything...these boobs are still sagging and my energy is still half of what it once was...

I tried 3 month OFF estrogen and life was not worth living..It's a gamble but so is all living..Be careful..live a life of moderation in all things..lower your original dosage just a bit and listen to your body.

One doctor I saw several years ago convinced me to try the hormone creams..I use about 1/8 tsp. progesterone compound cream on my chest or arms every night but not sure why since i don't have a uterus and wonder if it makes a difference or not...but sometimes think it helps me to get to sleep?!?

Doctor's are pretty clueless, especially ones who haven't had a hysterectomy or who are in their 20's or 30's and especially men. I have stopped taking Advil to help save my liver where the estrogen is processed (substituting aspirin which is cheaper and a more effective pain reliever) and take a measly capsule of milk thistle daily...I wish I could say I don't drink..but I hope I have a healthy enough liver to handle the estrogen and an occasional glass of wine..or 2.

My Mom was placed in a long care home at the age of 82. My Mom never took any hormones in her life, had a hysterectomy in her early 40's, no history of breast cancer in her family at all. She was given premarin cream to prevent dryness and bladder infections. The dosage was supposedly .625 but was never measured. 9 months later she developed an estrogen positive tumor and had to have her breast removed. The doctor doesn't think it caused it but the timing is pretty strange. Is it safe for the elderly?

A naturopath told me never take estrogen 'unopposed'. It needs to be balanced by progesterone. I have taken natural progesterone and estrogen [ not premarin though ] since I had a premature menopause at age 36. I am now 65. Estriol and estradiol are the safest forms of estrogen is what I have read and what I was told.

I had a radical surgery when I was diagnosed with cervical cancer at the age of 29 my overies were left intact. however, after 6 months the cancer returned along the scar inside and i had no option other than to have a high dose of chemotherapy over 3 months and 10 weeks of radiotherapy.

It was at this point my overies were shrivelled up and my doctor explained without estrogen invmy body I would end up with brittle bone disease and probably end up in a wheel chair by my mid 40s. It took the biggest part of a year to find the right hrt and dosage for me.

I am now 54 and have been taking 2 tablets daily 25mg of premarin. I have never had any problems, I feel great and am told regularly that i look great too for my age.

My only problem now is all the drs at my local surgery are all new and I have to battle every 6 months to get my script. I have been refused them altogether by one doctor and on my last visit yesterday I was refused the usual full dose and he would only give me the script if I agreed to halve the dose. He said which would i prefer cancer or brittle bone disease, my answer to that was if I have a choice then I will choose neither.

My arguement is i have been happy and healthy for the last 24 years and who knows what it could have been like without the premerin tablets so why should I be forced into making changes , surely it being my life I shoulg get to decide if and when I stop taking them not a doctor that knows nothing about me.

I was 21 when I had a hysterectomy, and was ask if I wanted HRT, I felt really good with the Premarin .625, now I am 59 and my OB/GYN does not want to give it anymore, she said women of 59 don't need and don't have hormones anymore. Now 10 months without hormones I feel tired, my bones hurting, lost weight, cry easily, forgetful, urinate a lot, and very dry skin and vagina.

I complained to my OBGYN, and she offered anti depressions, in her waiting room are a lot of beautiful pictures of newborns, I had never a child, and felt out of place, it seemed like there was no knowledge or understanding for to listen what happened to a woman whom did take so long this drug. I believe that a lot of OB/GYN choosing there profession to help moms with delivery of their babies. I wonder is there ever a case study done about woman like me.

I look great and feel great at 72. I have taken synthetic HRT for 27 years both estrogen/progesterone daily because my hormones were out of whack after my child was born. I have always enjoyed good health.

I have a strong family history of breast cancer. The annual ultrasound showed a suspicious thing one sixth of a CM.

The mammogram showed nothing only dense breasts. I am not concerned - my physician suggested I stop HRT over the years but I refuse. I am scared of what could happen. Will keep you posted about the tiny thing...

Started HRT at 49 then a complete hysterectomy at 54. It has been 20 years and have been on estrace tablets taken under the tongue (0.5 mg; 0.25 AM and 0.25 PM). GYN wants me to get off estrace tablets now. Am very reluctant to. Tried last year; didn't work. Now, am easing off slowly. Am very ambivalent about going off. So far, so good but don't feel the best and did have some sleep issues already and have only dropped the equivalent of 1 day. What to do??

Hi -- why does your doc want you to quit? Maybe they'd feel better about so-call "bio-identical" estradiol, even comes in gel form. I was on Premarin and Aygestin for over 20 years and read the women's health initiative study in detail.

For me, the risks did not outweigh benefits.(I'm not hi risk in any category except osteoporosis, so docs are more easily swayed to let me stay on the drugs.) A new gyn recently switched me to estradiol gel and I am getting more benefits and no apparent side effects, btw.

He says research shows this formula is better to prevent bone fractures than Premarin. The actual studies of HRT show a very small number of cases leading to impairments or death, however researchers and drug companies do not want any of us to be the one who might be harmed by their products. Hope to hear more from others. And how Gillie is doing. : )

Hi there~ I have been on HRT (estrogen mainly with a tiny bit of progesterone compounded cream at bedtime…) since I was 33 when I had a complete hysterectomy… I am 59 so that makes 26 years?? I have, over time, gone from 1.25/day to 0.62 mg/day… and was using Cenestin for the past several years but had to switch back to Premarin because of cost and no insurance… buying the Premarin now from a Canadian Pharmacy online which really saves me a lot of $.

When I tried going off HRT for 3 months many years ago… I got very depressed for the only time in my life and had vaginal dryness (yeast infections), lethargy, flattened breasts… you name it. I went back on and have been ever since. I tried all the other forms of estrogen... ogen, estrace, etc etc... even the patch, available at the time 2 decades ago. Premarin was the only one I liked.

I am interested in hearing more about this Estradiol Gel?? Are you getting the same benefits that you got from the Premarin?? Does it help with your vaginal health and mood, energy issues, etc. as well as the Premarin did? Thank you for any info you can share. I know a woman who is 88 and still on HRT since her menopause... Premarin and Progesterone tabs… and the only real issue she has is macular degeneration… and a bit of foggy mind… which I attribute more to not being able to see properly and navigate in our world… I mean 88!?! No cancer... no heart attack… no stroke… The only thing that worries me about me is these yearly mammograms… Have had them since the hysterectomy!! But Doc may cut them down to every 2 years at my request. I have cystic breasts but never have had to have a biopsy. I probably glow in the dark from radiation!! ;)

Not sure whom you are asking but as for me - yes I like the Estradiol Gel. And yes I am getting the same benefits and yes it helps vaginal health and mood, energy issues, etc. as well as the Premarin did.

Hi DG -- So far so good on estradiol gel, but will need another six weeks or more to really tell. Because tomorrow I go back to be started on the needed progestrone, to balance the estradiol. (See ref to shell's note, below -- it gives me hope!) :) Fwiw, the new gyn had me go off norethindrone acetate (Aygestin) and Premarin, and switch to just estradiol gel seven weeks ago. The plan is to add in whatever he picks for a progestin and see how that goes.

Till reading shell's post, had not realized that some believe it's the progestins that are 'feel good' hormones, rather than the estrogens. (Premarin has many types of estrogens, for example.)

I did begin to wonder if I felt more "irritable" about a week ago, so reported this to gyn's office. They immediately put him on the phone (!)and he said to take a couple days off and then start back, using a diff place on body, with thicker skin (lower dose absorbed that way, I imagine.) I felt better right away, so it is also a strong placebo effect and the good feeling of finding a doc who listens and has ideas and is flexible. wow.

If I forget to post in a month or two, and you're still wondering about moods, ask again. (I get a feed for this thread of emails.) Oh, yes, did get big improvement in sexual health, more comfy after intercourse, seems better vaginal flora, natural lubrication, feeling well-protected against frequent UTI's I was getting when I had tried reducing Premarin dose (from 0.325 to half that -- admit, I was breaking pills into quarters to get this: 0.160 mg/D... approximately.) :) Will know more about energy issues after progestins are added and adjusted if needed. Good, so far.

About costs. There are generic estradiol gels on the U.S. market, but the Estrogel does not have a generic. My doc gave a big explanation about how it is not made at a compounding pharmacy. (I suspect he owns stock in Estro-gel. He gave me 2 months' supply but it will have co-pay on my very good drug insurance of $100 for 3 months' supply. I know that doesn't sound like much, considering the benefits of it, but it's a LOT higher than drugs in the formulary or generics.) The talk he gave me was about the actual dosage that the person receives, per unit or "dose." Generic concentrations can go up or down, he says, up to 10% per year, and still receive FDA approval. Because his Estro-gel has a more steady dosage, year to year, he feels it's a better drug. Frankly, I do not agree.

A gel, even w perfect "pump" dosing, can vary in absorption and even dosing, depending how much stays on your hand instead of on skin where applied. And we're supposed to wash our hands well after application (thus lose a little gel) so as not to expose other people to estradiol. (Esp. males and children.)

Sorry to ramble, but I believe a less expensive generic estradiol could be very effective for all the good reasons: bone mass, vaginal and urinary tract, oxygen to the brain (I believe estrogen may facilitate neuron cell oxygen uptake, read about it some place.)

Can't wait to see if the progestin makes me even happier than now! And hope to hear from more people, since I'm just one out of many on HRT. Gotta add that I was afraid of gaining wt. from stoping Premarin and Aygestin, but so far, not happening. I walk almost every day on a treadmill and the very very slow wt. loss I was hoping for has gone very well. I put on about 20# during menopause and managed to loose more than half of it, over past 8 years. This works for me. : ) p.s. I'll be 66 this month, on HRT since age 43. They talked me into it because of osteopenia, but still have that, even after 12 years on Fosamax. (Off it for 2 years now.)

Let me again highly recommend reading shell's entire post of April 5, 2012 (found it when skimming down posts today) which in part reads,

"Progesterone is the “feel good” hormone, as it acts as a “natural anti-depressant,” boosting moods and well being as well as stimulating bone growth, healthy heart function and offering protection against breast and uterine cancer. "

Hi,
Can anyone tell me if I absolutely need to take progesterone (prometrium) as long as I am taking premarin? I am 53 and have been taking both for 4 years to alleviate peri-menopause symptoms. I would like to continue taking premarin for another year or so but don't see the need to continue taking the progesterone. There is no family history of breast cancer.

I have taken Premarin .625mg for over 25 years after a complete hysterectomy. I have had no issues with breast cancer or heart issue. I tried take a lower dose estrogen but I was a wreck mentally and could not sleep. To me it is worth the very small risk to continue my .625mg dose and have a better quality of life.

I think a study of the effects of radiation from mammograms should be done as far as causing breast cancer.

I totally agree. Same scenario as me.

I had a complete hysterectomy at 38 years old due to endometriosis and interstitial cystitis in 1998. Even after all these years I still get horrible hot flashes and night sweats. My family has a history of heart problems and arthritis but I have had none of these since being on Premarin. I get regular mammograms and all have been negative. I will continue to take Premarin for as long as I can. Because my prescription ran out and my new gynecologist appointment isn't until next week, I have been off Premarin for a month and I am MISERABLE with intense hot flashes. I hate it. I constantly feel sweaty and have to dab at my shiny face because of the perspiration. If I couldn't get my Premarin from my doctor, I would get it illegally some way because there's no way I would put up with these hot flashes forever.

I have been taking Premarin 1.25mg since my complete hysterectomy in 2000. At my last physical, in May of this year, my doctor and I decided that I should start to wean myself off of it. She said I could cut the pills in half but since they are so hard, the pharmacist suggested I take one pill every other day. My doctor agreed. Since this time, I have been experiencing hot flashes, memory loss, disrupted sleep pattern, headaches and increased depression. Is this common? Has anyone else experienced the memory loss and depression? I already take an anti-depression medication but, as of late, it just seems to be worse.

Just between you and your doctor, why must you stop taking this now? If it is not a health-related reason, maybe my story will help. I had all the same symptoms you describe, except maybe headaches, before starting HRT. When I reduced my dose during the big HRT scare, only hot flashes (and frequent UTI's returned). Maybe the bio-identical form would prevent having to wean off? I've been on Estradiol gel for 4 months now and feel good. (Sleeping well, good memory, no hot flashes and no more night sweats that I had on 1/4 original Premarin dose.) There were several options for balancing w/ progestins. I picked the one of having a menstrual cycle every 2 months because it feels "safer" to me, so lining of uterus clears itself out. Hope you won't need to feel sad and have other symptoms much longer.

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