Premarin (conjugated estrogens) is an estrogen-only treatment which can be used by itself or along with a progestin in hormone replacement therapy for women. The medication, with or without a progestin, helps reduce menopausal symptoms of hot flashes, dry an itchy skin, night sweats, vaginal dryness and so forth.

Premarin may also be used for:

• Prevention of osteoporosis
• Estrogen deficiency from other causes (such as ovarian failure or hysterectomy)
• Treatment for certain types of breast cancer (along with other medications) in men and women
• Treatment for prostate cancer (along with other medications) in men

Effective Use of Premarin

It's important to understand the difference between estrogen-only therapy and combination therapy, in which both estrogen and a progestin are taken. If a woman has a uterus, combination therapy should be utilized--failure to take a progestin during estrogen therapy may significantly increase a woman's risk of developing uterine cancer. Women who have had a hysterectomy do not need to take a progestin.

While Premarin is an estrogen-only treatment, it can be supplemented with progestin for combination therapy:

• Progestins may be purchased separately and taken in addition to Premarin.
• Combination products such as Prempro, which contains both estrogen and a progestin, will deliver both hormones at the same time.

Treatment with Premarin for menopausal symptoms may also vary somewhat according to the particular symptoms being experienced. If disruptive symptoms are vaginal only, Premarin cream may be preferable; it will reduce dryness and irritation with much less risk of side effects.

For most conditions Premarin is administered via tablet. In all cases the lowest effective dose should be used for the shortest amount of time. With the exception of use in certain cancer treatments, dosage and administration is surprisingly similar in all cases:

• Women are usually started on 0.3 mg per day.
• Dosage may be increased to 0.625 mg per day if 0.3 is insufficient.
• Younger women who have had a hysterectomy or ovarian failure may take up to 1.25 mg per day.
• Treatment is often cyclical; Premarin is taken for 3 weeks continuously with a 1 week break, or 25 days continuously with a 5 day break.

Hormone therapy may last a few months to decades. Women who enter menopause naturally typically take an estrogen supplement for under 5 years, while women who have a hysterectomy or otherwise stop producing estrogen while relatively young may undergo hormone replacement for much longer.

For the duration of treatment, doctor exams should take place periodically to ensure the hormone is working properly and to monitor for developing adverse effects. It is not unusual for dosage to be periodically adjusted.

Precautions & Side Effects

Hormone therapy is highly individual; women take estrogen supplements like Premarin for different reasons, at different ages, and for different lengths of time. All of these factors may influence the frequency and severity of side effects.

A general rule is that the younger a woman is when beginning hormone therapy, ideally 50 years or less, and the closer to menopause therapy is started, the lower the risk of adverse effects. Women who initiate therapy more than 5 years after menopause, or who who start treatment over 60 years of age, are more likely to experience serious side effects.

Most side effects are relatively mild, including cold-like symptoms, spotting, stomach upset, and so forth. These effects often disappear as treatment continues, and are not cause for concern unless severe.

Major side effects can be negative or positive, depending on when treatment was started and individual patient response:

• Reduced risk of osteoporosis
• Decreased risk of colon cancer
• Increased or decreased risk of heart disease
• Increased or decreased risk of dementia
• Increased or decreased risk of memory loss

The risk of blood clots and stroke is a concern in older women and women who start therapy years after menopause. In younger women there does not appear to be an increased risk, but neither is the risk decreased.

Women who have a family or personal history of breast cancer should never take estrogen without explicit doctor instruction and frequent medical exams.

Manufactuered by Pfizer, shipped from India with tracking.

Premarin Cream contains conjugated estrogens, a mix of estrogen hormones. It is predominantly used in menopausal women who are experiencing vaginal symptoms of menopause---such as dryness or irritation---when other menopausal symptoms are not present, or not severe enough to warrant treatment.

Note that Premarin Cream does not contain a progestin; it is an estrogen-only medication. Women taking estrogen therapy who have an intact uterus, regardless of menopause, are nearly always advised to also take a progestin to mitigate risk of uterine cancer. Women who have had their uterus removed do not need to worry about progestins.

Progestins and estrogens are often combined into a single treatment, though this is uncommon with vaginal creams. Women utilizing creams may need to buy progestin-only medications, which can be browsed here. Dosage should be determined by a doctor, as it will depend on a number of personal variables.

Using Premarin Cream

Premarin Cream is applied directly to the vagina to ease or eliminate relatively common symptoms of menopause, including:

• Dryness
• Burning
• Irritation
• Painful intercourse

The cream is very effective at treating the above, more so than administration of estrogen by tablet, since it is applied directly to the surface that needs it most. While it may alleviate other symptoms of menopause---hot flashes, night sweats, and so forth---to some small degree, it will not be nearly as effective as tablets.

Premarin Cream comes with an applicator to make intravaginal administration easy. The applicator contains dosing measurements. Detailed instructions for use come with each package.

Dosing usually starts low, gradually increased if needed. There are two standard treatment methods:

• Administer the cream once per day for 21 days, then take a week off before resuming treatment; or
• Administer the cream twice per week, such as Sunday and Wednesday.

Which method is used is best determined by a doctor; it will depend on what exactly is being treated and its severity.

Duration of treatment will likewise vary; hormone replacement therapy is not meant to be indefinite. Most women, given time, will adjust to menopause and no longer experience symptoms even without estrogen therapy. Vaginal symptoms, however, tend to be the most persistant. The need for continued estrogen therapy should be reevaluated every 3 to 6 months, simply by stopping use of Premarin Cream and seeing if symptoms return.

Potential Complications

Certain patients are poor candidates for Premarin Cream and shouldn't use this product, namely those who:

• Are or may be pregnant
• Have or develop undiagnosed vaginal bleeding
• Have a history, including family history, of estrogen-dependent breast or uterine cancer
• Have liver disease
• Have a history of blood clots or cardiovascular disease

Doctors and dentists should be informed prior to surgery that the medication is being taken.

Though rare, Premarin Cream can cause potentially serious side effects. Seek medical attention if experiencing:

• Moderate to severe abdominal pain
• Vaginal bleeding
• Symptoms of a blood clot---swelling and redness in the legs, sudden severe chest pain, sudden vision loss
• Memory problems
• Confusion

Other medications are fairly unlikely to interfere with Premarin Cream, but it can happen. To be on the safe side, always double-check with a doctor or pharmacist before mixing treatments, especially other vaginally-administered medications.