Businesswoman in Menopause fanning herself, HRT, hormone replacement therapy, menopausal women

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 Premarin 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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  1. Molly

    I still do not understand why this drug is legal after all the obvious pain and suffering it has caused. I certainly do not understand the person who thought up this barbaric idea. Torturing other animals and taking their lives from them is not an appropriate trade-off for women’s comfort.

  2. BC

    I had an episode in Dec 2016, at age 62. I had taken a vacation day for my husband’s birthday and knew what he expected. So the night before, I used Premarin cream, a full 1 mm. The prescribed dose was .05 mm. I hadn’t been using it regularly due to the costs and ick factor. (Menopause made sex difficult, and Premarin seemed to make it easier.) I woke up 4:00 AM Wednesday, the usual time, and felt a headache so drank my 2 cups of coffee and felt better. I stayed on the computer for several hours (with no big headache) because my husband wakes up at 9:00 AM. At 7:45-8:15, I took a very hot bath. After all it was winter, and after that I went to my closet to put on stretchy pajamas with the intention of climbing into bed with my husband. At ~8:30 am, I remember bending over in my closet and putting on my stretchy pants. The next thing I knew it was 2:10 pm that afternoon, and I was in a hospital bed in the ER with a terrible headache. They all thought I had a stroke.

    My husband claimed we were having great sex with multiple orgasms when I began asking him why I was not at work. He answered that it was his birthday, and I’d taken vacation. I would answer “It’s your birthday?” He laughed and said YES, that’s why you took vacation. “I took vacation?” Yes, because it’s my birthday. “It’s your birthday?” He said he answered my same questions 100 times (exaggeration probably), and thought I had a stroke so took me to the hospital. He said I dressed myself, and mobility was normal. (Funny that I put on my work clothes).

    We got in his car about 9:45 a.m.,and I proceeded to call my supervisor and coworkers multiple times, which I have no memory of doing. Everyone thought I’d gone insane. My supervisor came to the ER to see if I was OK (~2:00?) by then I was waking up. I had mentioned my terrible headache and told my husband to get me coffee because I hadn’t drunk my coffee that morning so that’s why I had the headache. Of course, that wasn’t true because I had drunk my coffee that morning, but I had no conception of how the day had progressed. At the same time, the nurse gave me intravenous pain meds for the headache. My husband brought me a coffee, and it tasted fantastic.

    They’d already ran a CT scan, which I totally missed; but I had “come to” when they took me for the MRI. I remember being wheeled and sleeping dreamily through it. We returned to the room, and the doctors started coming in to examine me and discuss. My ex-husband and grown kids also showed up and the room was full of people. I suddenly realized that I was not in an “in-network” hospital. The doctor said he saw no signs of stroke, but they were going to keep me overnight, and a neurologist would examine my scans tomorrow. I refused, saying the insurance would put the full costs on me because that hospital was out of network. (which actually ER visits are covered with a reasonable copay) I assured them I was OK, no signs of stroke, so had to leave for financial reasons. We checked out about 7:00 PM. The whole day passed like seconds. I must have been coming in and out of consciousness?

    When I got home, my head seemed dreamy and fuzzy so took a sick day the following day to fully recover. When I returned to work, the doctors I worked with were skeptical of my mental state. One linked me with a neurologist. My husband and I went to an appointment the following week to describe the episode and took my DVDs of my MRI and cat scan. After about 25 minutes of providing details and the neurologist examining the scans, he said he had no doubt whatsoever that it was Transient Global Amnesia. He said it happens about once in a lifetime and probably would never happen again. I googled it on the Mayo Clinic site, and it mentioned 3 factors I had that day: migraines, intercourse, and hot bath. Yet I still wondered if it was the hormonal cream overdose.

    Although I’ve limited its use for vaginal dryness, this year 2018, my husband was returning from a trip and mentioned he had ideas from the time when he got home. So I used the Premarin on Sunday, and then again on Tuesday night, using the prescribed .05 dose each time. Yet that was pretty close together because I typically use .05 about every 10 days because it’s expensive.

    Tuesday night I woke up about 1:30 with a headache on one side mainly. It didn’t register that it might be a migraine. Finally I got up and took 2 OTC pain meds. I tend to throw up the meds when I have a migraine so have to be careful to catch it early and stick with black coffee. I texted my coworkers saying I would take a sick day because of the headache. I suddenly begin to worry that it was the Premarin that caused that GTA episode 2 years prior. My system is very sensitive to meds so I take few if any medications.

  3. Janice

    I was on premarin for a couple of years before the first study showed a large percentage of women were developing breast cancer. Doctor then put me on Estrogen for over 10 years. I was diagnosed with stage 1 breast cancer in June 2017. I had a lumpectomy and 5 weeks of radiation, and now my Oncologist wants me to take an oral chemotherapy drug for the next 5 years. Even though I had many years of comfort now I will have the rest of my years under medical supervision. I personally wish I had never taken either one of those drugs.

    • Carolee

      My story is quite similar. Having had endometriosis in the early 90’s, I too had a complete hysterectomy. Afterwards I was automatically placed on a high dose of Premarin. /estrogen for ten years. I was 40. A new doctor took me off the drug. Now in my late 60’s, I have developed breast cancer stage one, having had a lumpectomy , followed by radiation and then placed on Letrozole. Tomoxifen caused too many side effects for me. But It has left me with joint problems. An older sister refused estrogen therapy and has not developed breast cancer and is in her late 70’s already.

  4. Anita B

    Premarin is pregnant mares urine. How many horses does it take so that the powerful drug company phizer can make a billion dollars a year? The powerful drug company Pfizer is behind the heavy promotion of Premarin as the only remedy for ERT.

    Premarin is a “cash cow” based on the abuse and torture of female horses. The horses are mechanically impregnated. They spend their entire lives standing in a tight narrow cagel; they cannot turn or walk. The mare is pregnant for 11 months and has a baby every year of her life, about 12 years. (normal horse can live to 30)

    If you love animals, if you have a dog or a cat, please look for alternatives to Premarin, prempro. Drugs that do not start with “Prem.”
    there are alternatives to pregnant mares urine.

  5. Marilyn

    I had a complete hysterectomy about 42 years ago. I am now 76 years old and have been on Premarin ever since that time. My doctor retired and when I went to see the new doctor she said she would not give me a perscription for it and I should start taking every other day and then every 3 days.

    I have never had any problems of any kind on Premarin and look and act younger than my age. I have tried to see other doctors but they either do not take medicare or they are not seeing new patients. I have no relatives that have had breast cancer and my latest bone scan was good. I am very depressed about this and the only good benefit I can hope for is that my hair would grow a little thicker off the drug.

  6. Cathy

    I just received literature on how pregnant mares and their babies are tortured and killed for the manufacturing of this drug. I find this to be absolutely appalling that we abuse horses this way and make them suffer just to make the drug premarin, which isn’t even a lifesaving drug. I will NEVER use Premarin. I would urge others to do the same. I’ll choose to go through menopause the natural way. We don’t need this product for osteoporosis, either. Good old fashioned exercise and healthy diet is all I need.

  7. John

    Mom just died at 82. Was on Premarin for 40 years for hot flashes. She was always energetic till the end. But in the end had a massive upper and lower artery dissection. Doctors said no way on surgery. She should have never made it to the hospital. I have to wonder if the rx was to blame. Still, a long great life. Hmm.

  8. Valerie A.

    I would love to take HRT but I had breast cancer nearly 3 years ago, it was grade 1 and very small, I’m nearly 60 and I don’t sleep have aching joints etc. has anyone tried safer HRT, ie progesterone plus estriol after breast cancer and not had a reoccurrence?

    • Terry Graedon

      We haven’t seen research showing progesterone and estriol are safe after breast cancer. Is the sleep problem due to night sweats? Have you tried Pycnogenol?

  9. donna
    Quincy, il

    I am an active 74 yr old female, been on prempro for like 35 yrs. Tried stopping many times. I never had children so I have atrophy problems and vaginal dryness, irritation, burning a lot as it is. but, it is so much worse without prempro. My ins. company has denied paying for it starting jan. 1st. this is so silly. I exercise, drive a motorhome across the country and have a small business. I stoppe a few years ago, and I got yeast infections and a very bad red, irritated vulva that required special meds. and ice and laying on bed for days. Went back on prempro and problem solved. I am considering a Canadian pharmacy if it is safe? If the ob dr. I am seeing this week tells me she will give me a prescription. Somehow I have to stay on this drug. I get irritable, cry a lot, and full of anxiety as well. worried and with my stomach problems this is not good.

  10. Kay
    Huntington Beach

    I am curious about getting Premarin through a Canadian pharmacy. I will research it. I am 75 and very healthy with the exception of intense hot flashes. I had a hysterectomy about 30 years ago and was put on Premarin. I took it for all of those 30 years until last year when my doctor refused to prescribe it for me due to the chance of breast cancer. I went to an OB-GYN who prescribed it again for me until my insurance company denied it as being unsafe for women over 65. The cost was to be $155 for one month’s supply. Ridiculous. My doctor’s nurse is appealing the decision for me. However, I doubt that I will receive a favorable decision. I’ve learned that 20% of women have hot flashes their entire lives. I fall into that percentage. Ugh!!!

    • Carolyn
      The Woodlands, TX 77381

      I called my insurance company, got the number for my doctor to call to get an “exception.” The company immediately agreed to continue covering my HRT! Various doctors have done this for me regarding different drugs the insurance has initially refused to cover. Good Luck! I’ve been taking HRT since I was 48 and I’m now 72, look at least 10 years younger and don’t have osteoporosis as does my mother, two sisters and 1 brother.

      • Sharen

        I am a 72 year old nurse who had a total hysterectomy at 47 because of a non-cancerous mass on an ovary. I have been on low dose Premarin ever since. My doctor sees no reason for me to stop taking Premarin because ,if you read the statistics, there are side effects but not to the degree that should have caused thousands of women to stop taking them. The benefits far out number the risks for most women. However, older women who have taken HRT should not stop and then start taking them again, as this causes increased risk. I intend to keep taking Premarin for as long as I live. I am not recommending this choice to anyone. I suggest you do your research and speak with your doctor. I did both and made my decision based on both.

    • Judy
      Central Fl 34769

      I have been on .625 Premarin since 1982. I had a total hysterectomy, everything gone due to endometriosis . I am now 72 years old. I work 20-30 hours a week, walk my dog every day, I take care of my home inside and out. I feel great and as I an the oldest in the family I look younger and can work harder than my sisters. My insurance stopped paying for Premarin and I have done research almost all of our medications are made outside of the United States and shipped into the United States and we are charged exhorberant prices by our pharmacies. I get my Premarin from a Canadian pharmacy for 3 months at a price of 54.00 for 3 months.

      That seems a lot better than what Walgreens was going to charge me at 255.00 per month. Don’t worry about quality, it’s shipped to pharmacies directly from India, Pakistan, Canada and many other foreign countries and dispensed to you all and at higher price price. Oh yes, that 54.00 dollars for 3 months of Premarin shipped directly to me includes postage.

      • Hazel

        Please share the Canadian Pharmacy & how long does it take to receive your Premarin? Thanks

        • Sue

          Yes please share the pharmacy information from Canada. My insurance is now paying nearly nothing . My portion for a three month supply is $472.00! I do not have that kind of money. I feel terrible being off Premarin for just 1 month. I have tried alternatives, with no luck.

          Like everyone else, I suffer from hot flashes, night sweats, lack of sleep and even a drug reaction, rash! I feel absolutely awful, not like myself at all. I am so discouraged. I am have to find another way to get my prescription filled.

      • Pam
        Portage, Indiana

        Hi Judy.

        Can you tell me which Canadian pharmacy you used to obtain the Premarin? I would like to use one that is safe.

        Pam H.

  11. Anne

    Premarin should have never been prescribed without further testing because of a huge cancer risk when taking the hormone replacemen.t. I cannot understand why Premarin is being marketed despite the risks that have been documented. I find that quite outrageous.

    • The People's Pharmacy

      The cancer risk is real, but it is not huge. Still, many women would prefer not to increase their risk at all.

  12. Amber

    OK, here is my experience with Premarin. I had a complete hysterectomy w/ oopherectomy in 2008, I was 26 years old. I am now 33. For the first couple of months, I tried no HRTs, as I had heard horror stories and I wanted to try to go without. I was then put on 1.25mg/day of Premarin due to the hot flashes. It did not take long to develop a psychological need for the drug. Fast forward a few years, and I started developing issues with my body, i.e. losing hair, heart palpitations, itching/burning/tingling in my legs, sensitivity to light, migraines, etc…. but I was so psychologically dependent on the Premarin, I ignorantly never blamed the Premarin.

    I change my exercise routine, reduced stress, changed my diet, changed vitamins… but the symptoms only worsened. So, about 8 months ago, I started researching Premarin, reading scientific journal articles, studies, contacting my old grad school professors, basically just building a file of any and all information I could obtain about the drug and its side effects. Once I realized the Premarin was the likely cause of my ailments, I began to experiment. I started taking a Premarin every other day for 2 weeks, then every 3 days, then once a week, and then zero. This experiment lasted about 2 months and I chronicled everything. Then, I went back on Premarin for a couple months, tapered off in the same fashion and chronicled the results again. I wanted to make sure the Premarin was the cause, so I reverted back to my education in science. What I have found, unequivocally is that Premarin caused ALL of my symptoms, and since I have stopped taking them, I feel fantastic.

    See, I didn’t realize just how many ailments I had until I quit putting Premarin into my body. My body had been trying to tell me for years that Premarin was causing damage, but I was so concerned with how I would feel without the Premarin, that I always just took it. The longer you are on this drug, the worse you feel and the worse you get. My mother has taken 1.25mg of Premarin for 25 years, and she has since stopped as well and feels great. I could write for hours here about how horrible the long term effects of this drug are. I have never had any mental illness, it doesn’t run in my family, nor have I ever had a problem with nervousness or anxiety, but with Premarin I began to experience both. My mother got so anxiety ridden – for noe reason – that she was prescribe an anti-anxiety med (which she is off of now). Premarin was causing me to have bipolar-like mood swings. Horrible mood swings. I felt anxious frequently, I was constantly irritable; VERY irritable. I was told I had restless leg syndrome – which I do not; it was the Premarin. I would bouts of confusion or muddied thinking. I would have lapses in memory; it goes on and on. I have degrees in psychology, I know what a mental disorder looks like – and I was beginning to question whether or not I had one. Even went to see someone. But the reality is – IT WAS ALL MY PREMARIN! I have been off Premarin for 3 months now (and my mother for 10 weeks) and words cannot even describe how phenomenal I feel. I am so happy I took matters into my own hands and didn’t end up on this damaging drug as long as my mother had. My hair is starting to thicken; my moods are back to normal; anxiety gone completely; my mental clarity is back in full force; I am back to my calm and patient self; my heart no longer skips a beat, I have had 1 headache in 3 months (I used to get a migraine 2-3 times a month on Premarin), my legs feel normal and strong, I haven’t had stomach/bathroom problems….the list goes on… I just encourage you women, especially those who think Premarin saved their quality of life – IT IS ONLY TEMPORARY – I once felt this too. But the longer you are on it, the more damage it will cause to you both physically and mentally. Doctors prescribe it because it is the gold standard; the oldest drug used to treat these types of issues.

    Challenge your doctors, ask hard questions, research yourself, find out the truth. And please, please, listen to your body. The only negative I have experienced since I stopped taking Premarin is hot flashed, but they are getting less intense and less frequent the more time that goes on. But for me, I’ll take the hot flashes. It is a small price to pay to have my health and my life back.

  13. Mackenzie

    Hello I am 20 years old and I was recently put on premarin alone for vaginal tearing and painful intercourse I am trying to find info on someone my age that is on premarin and its been very difficult. I am concerned if I am too young for this and if I should be worried about long term effects?

  14. Diane

    I have been taking Premarin for 20 years with a uterus and feel fine. There is no breast cancer, heart disease in my female relatives . However, my mother died in agony from osteoporosis. My bones are strong and I want to keep them that way. I really resent Medicare’s broad brush stroke that assumes all women have the same risk factors.

  15. Sue

    I have tried all kinds of hrt. Nothing compares to Premarin. It has given me my life back. Before starting it, I was having major panic attacks and depression from my dropping hormones. My choices were antidepressants and abut anxiety meds which caused other major side effects. Don’t need anything since I started the Premarin.

    • Diane R.
      Sarasota, FL

      Wow, I never thought of menopause possibly causing my anxiety, panic attacks, and depression. I developed a serious stage of multiple sclerosis right at the same time, and I figured my increasing lack of ability to cope with even simple triggers was due to the ms. Now that I have severe vaginal atrophy, my dr. has prescribed premarin cream and I am truly looking forward to perhaps several benefits! I am excited to be in a wonderful relationship after thinking I’d probably be alone forever (with the ms disability), and hopefully Premarin will restore more of my femininity and relieve anxiety symptoms!

  16. Linda

    Does anyone have any thoughts on taking premarin that is outdated? I know we are always told that out of date medicines are not effective, however, I am skeptical. I am wondering if anyone else has the same thoughts on the subject.

  17. Bonnie Wolf

    I am 73 years old and have taken Premarin for twenty years. No issues and have enjoyed excellent health. But insurance doesn’t cover it any longer and I just paid $117 for one months supply. I now have to find an alternative,and no Estradial did not work for me. Shouldn’t it be my choice and have coverage by insurance. Living on a fixed income I cannot afford the astronomical amount charged.

  18. Rebecca
    United States

    I was off prim pro for 4 mo. It was pure hell ( I’m 72 ) my Dr. put me on Prozac..well my head was about to explode after 4 days couldn’t sleep night sweats what a mess I was..emailed my Dr. told her what was going on..she finally ok’d my prescription for prim pro. I’m so happy with my prim pro. why don’t the just leave me alone??

  19. DG

    Hello~ I have posted before about my experience of taking Premarin, then Cenestin, and recently (10 months ago) back on Premarin because the cost of non-horse-urine derived Cenestin is obscene.
    My hysterectomy was 26 years ago at age 33 and I am now 59. I have always had fibrocystic breasts but last week a small nodule was discovered in one breast and micro (the yucky kind) calcifications in the other.
    I am going in for 2 or maybe 3 biopsy/exploratory surgeries in the coming few weeks. I am nervous about what be the findings. So…even though I have lowered my dosage of estrogen over the years am not ready to go cold turkey. I once did for 3 months and I wanted to die..I had depression for the first time ever and noooo energy.
    The only recent difference in my health regimen has been going back to Premarin after using Cenestin for about 12 years with no change in my yearly mammos. I think that subconsciously, I am causing myself stress by taking the Premarin daily KNOWING full well that I oppose animal cruelty to my core and really despise the fact that I am a part of the ill treatment of horses for the selfish purpose of my own wellbeing…I believe in the total mind/body/spirit connection and therefore I have decided no matter what the findings of my biopsies…..I am going to find an alternative to Premarin once again.
    I am on Medicaid now and it doesn’t cover Cenestin…nor does the Canadian Pharmacy carry it….and I cannot rationalize or afford spending over $400 every 3 months for something that ultimately could be part of the cause of my breast situation..though I am not of that thinking at this point. Many of my women friends who have never been on HRT have had similar scares re: lumps and calcifications…..
    SO…I guess my real reason for posting is; Has anyone had to find an alternative brand and type of estrogen??? 2 of my gals are on Estrace (Estradiol) because that is what their Insurance company covers…(are our bodies being controlled by corporate america or WHAT???)…and they seem happy with it. I think I tried it early in my hormone experience and found it didn’t do much for me. I guess I will be discussing it with my Primary Health Provider on Monday when I have my yearly exam with her…maybe she has some suggestions. I would love and appreciate hearing of anyone in my particular circumstances regarding HRT..Any advice is welcome. Thanks all…….

  20. Laurie

    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.

  21. KKR

    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.

  22. GR

    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.

  23. DG

    I totally agree. Same scenario as me.

    • Lucy

      I’m 72 and still have hot flashes. Some time I feel like I’m going to die. I took my self off Premarin about 10 years ago. I never thought I would still be having them.

  24. SC

    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.

  25. Franny

    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.

    • Lydia
      Cambridge, MA

      Please look into foreign pharmacies

    • Lydia

      Yes, if you have a uterus, you MUST take progesterone if you also take estrogen.

  26. Laurie

    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. ”

  27. shell

    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.

    • Lydia

      I would like to know what you decided re the Estrogel (Oestrogel in France) v.s. other estrogen product. I have found tried both compounded estradiol and Oestrogel, and found Oestrogel to be stronger and more consistent. But that could be because the compounding pharmacy had quality control issues at the time…

  28. DG

    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!! ;)

  29. Laurie

    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. : )

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