The conjugated estrogen formulation is one of the most commonly prescribed
medicines in the country, under the brand name Premarin.
The conjugated
estrogen formulation is one of the most commonly prescribed medicines in the
country, under the brand name Premarin. The hormones are purified from pregnant
mares' urine.
Prempro provides a tablet that combines conjugated
estrogens with medroxyprogesterone so a woman has to take only one single tablet
daily.
Premphase also provides one dose of these estrogens daily. The
pills taken on days 15 through 28 of the cycle contain medroxyprogesterone in
addition to the conjugated estrogens.
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 in postmenopausal women.
Premphase 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 the
sun, so it is wise to use sunscreen and wear protective clothing (including a
hat and sunglasses) if you will be out.
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.
Report any
suspected side effects to the physician promptly.
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.
Premphase may
interact with several other medications, such as theophylline
or beta blocker blood pressure pills.
The activity of the anticoagulant
Coumadin
and that of certain antidepressants may be altered.
Adequate intake of
calcium and vitamins B6 and folic acid is important.
Other estrogens
interact with alcohol and with grapefruit; it is not known if the conjugated
estrogens in Premphase do.
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 Premphase.
There are a number of situations where Premphase 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 Prempro.
Prolonged use of postmenopausal estrogen has been controversial because it increases the risk of endometrial carcinoma or cancer of the uterine lining.
Medroxyprogesterone, as supplied in Premphase, counteracts this danger to a large extent.
Vaginal bleeding could be an early warning sign of cancer, however, and requires immediate medical attention.
Medroxyprogesterone does not appear to be protective against the increased risk of breast cancer. Women with a strong family history of breast cancer will want to discuss this issue with their doctor.
Premphase tablets are to be taken once a day.