This natural estrogen formulation is one of the most commonly prescribed
medicines in the country. The hormones are purified from pregnant mares' urine.
Estrogen replacement therapy is prescribed primarily to relieve
menopausal symptoms such as hot flashes. It has also become a popular measure
for preventing osteoporosis and reducing the risk of heart disease.
It
is approved for treating breast engorgement right after childbirth when a woman
does not plan to breastfeed.
Estrogen can also be helpful in various
conditions where a woman does not produce enough natural estrogen. Certain
cancers in men and women may benefit from estrogen therapy.
Premarin has a number of potential side
effects, including breakthrough menstrual bleeding, breast tenderness, bloating,
nausea, vomiting, stomach pain, headache, gallbladder problems, liver tumors,
depression, jaundice and high blood pressure.
Some women experience an
increase in blood sugar and may go on to develop diabetes.
The skin may
become more sensitive to sunburn, so it is wise to use sunscreen or wear
protective clothing (including sunglasses) if you will be out in the
sun.
Some kinds of vaginal infections may be more common in women using
estrogen. Candida or yeast overgrowth may be a problem.
Other adverse
reactions include a change in weight, fluid retention, alteration in sex drive,
hair loss, and change in the curvature of the cornea. This may make contact
lenses inappropriate.
Your doctor should be notified immediately of any
of the following symptoms: pain in the calf or groin, sudden shortness of breath
or sharp chest pain, sudden severe headache, blurred vision or speech, weakness
or numbness in an arm or leg, yellow skin or eyes or severe abdominal pain.
Let your doctor know if you suspect you may have become pregnant, if you
feel seriously depressed, if you notice lumps in your breast, or if vaginal
bleeding is abnormal.
Premarin may interact with several other
medications, such as Dilantin,
Mesantoin, rifampin, or cortisone and other steroids.
The activity of
the anticoagulant Coumadin
and that of certain antidepressants may be altered.
Adequate calcium and
vitamins B6 and folic acid are important.
Until the estrogenic activity
of hops is further studied, taking this herb in combination with medicines such
as oral contraceptives or hormone replacement therapy is an experiment best
avoided.
In general, the herb chaste tea berry
should not be combined with menopausal hormone replacement
therapies.
Saw palmetto berries, which have both estrogenic and antiestrogenic activity,
are not recommended for women using female hormones for hormone replacement
therapy.
Check with your doctor and pharmacist before taking any other
medicine or herbs while taking Premarin.
There are a number of situations where Premarin may be inappropriate. Pregnant women should not use this medication, as it could affect the fetus.
Women with a history of breast cancer or other malignant disease susceptible to estrogen are generally advised to avoid this hormone.
Blood clotting disorders such as thrombophlebitis are also a reason to be wary of Premarin.
Prolonged use of postmenopausal estrogen has been controversial because of questions about cancer.
Endometrial carcinoma or cancer of the uterine lining is more of a risk for women exposed to estrogen. This adverse reaction may be counteracted by simultaneous administration of progestins.
Vaginal bleeding could be an early warning sign of cancer and requires immediate medical attention.
The risk of breast cancer is more uncertain. Studies have provided conflicting results, and more research is needed. Women with a strong family history of breast cancer will want to discuss this issue with their doctor.
It is important to take Premarin exactly according to the doctor's instructions, since the dose
and timing are different depending on the purpose for which it is being used.
Women who
have menopausal symptoms but are still having menstrual cycles start taking Premarin on the fifth
day of menstrual bleeding. They then take one pill daily for three weeks, and no Premarin for the following week.
Doctors often prescribe a progestin compound in addition for women who have not had a hysterectomy.
Make sure you understand the schedule of when to take Premarin and when to take the progestin.