PREMARIN, Everything else has failed Options

[sloane]

I've been trying to solve my menopausal hormone problems for a while now(3 years) and have tried most things except premarin. Even though my E2 levels are high(250, though have been lower/higher to no avail) on the gel/patch/pill/cream, you name it, I'm still symptomatic and feel lousy. Before all this I was a pill user(ovcon 35) and was a happy camper with good head of hair, full breasts, no chin hairs etc. etc.
I'm going to give Premarin a try, to see if that might help. It seems sufficiently different from the bioidenticals that it just might work. I had a hysterectomy last year, so no need for P.
Does anyone have any guidelines as to what dose to start with and does this story sound familiar to anyone else?

[Meryl]

Personally, I wouldn't take Premarin. It's made from horse pee. I don't understand why you think it might work when other estrogens haven't worked for you. You just need to alter your dosage, I would think. Whatever you do, good luck! We're all in this together, and I hope you can find your solution soon!

[Duch]

Hi

If you're talking about premarin (vaginal) cream, the manufacturer (Wyeth) recommends trying a regime of using 2 grams per day, 2 to 3 days apart, three times, then reducing the amount of cream about 0.05 grams (ie, 1.5 gms, 2 to 3 days apart, 3 time etc.) by the time the tube is exhausted, the theory is your body will have been 'kick started' into producing estriol. This will eliminate vaginal dryness and nasty infections. It didn't for me, and I wound up using 2 grams a day daily. Thank God for Blue Cross. Incidently, there's another product, Estring, that inserts and is good for 90 days before needing to be changed.

If you're talking about estrogen tablets (beta-17estrogen) the patches run from 0.025 to 0.1mg, the tablets are stronger: .625, .9, l.25 and 2mg. Different manufactures make them in different strengths. Start with the lowest, and increase as needed.

If that doesn't work, try adding testosterone.

Hope that helps.

[Duch]

I should add: My friend had a full hysterectomy a few years ago, that would have thrown her into meno overnight, but she didn't suffer much because she was using anti-deressants for depression. ADs can curb the meno symptoms.

She went off the ADs about 18 months ago, and is really suffering withmeno. I was suprised to learn her doctor had monkey'd about with the estrogen levels, and after that failed to help, recently she added progesterone, saying it wouldn't hurt and it might help. I don't know what the results of that are at this point.

[sloane]

I'm actually talking about premarin tablets, not cream(v dryness not an issue). And i mean premarin, not E2 patches pills etc. (been there, done that, didn't work).
The reason the premarin might just work is that it's stronger, isn't eliminated so quickly and is different in composition from everything else that HASN'T worked. Make sense?
BTW, I'm on Zoloft already, and still symptomatic.

[skiergirl]

Sloane,
If the bioidenticals didn't work for me, I think I'd first try a synthetic estrogen other than Premarin; I think there are several on the market. At least it wouldn't be made from horse urine. Best of luck and I hope you find something that works.

[sloane]

Well, the only ones I know available in the US are Cenestin--same as Premarin, and FEMHRT--ethinyl estradiol and Norethindrone. I don't need/want the progestin, so that just leaves the premarin, unless you're aware of another synthetic. If you are, please let me know!!

[skiergirl]

Yikes Sloane I think you are right--almost everything besides Premarin is in a combination form. I have to say that it seems strange that your estrogen level was so high on the bioidenticals but you still felt lousy. Have you considered that you could have something else going on?

[jasminetea]

Yikes Sloane I think you are right--almost everything besides Premarin is in a combination form. I have to say that it seems strange that your estrogen level was so high on the bioidenticals but you still felt lousy. Have you considered that you could have something else going on?

I'm wondering about this, too. You didn't mention exactly what menopausal symptoms you're having ... are they typical low estrogen symptoms like hot flashes and vaginal dryness, or something else?

[sloane]

Hot flashes, night sweats, brain fog, anxiety, depression, oily skin, chin hair, breast deflation--but no v dryness!
All pretty much go away if on BCP's--go figure. It could be the progestin that is the key, but doctors these days are very leery about any progestin. Bioident progesterone knocks me out.

[jasminetea]

It sure sounds like symptoms of not enough E to me ... I saw an old (2 years old!) post of yours about high SHBG making the estrogen unavailable (I know little about this) ... is that still the case I wonder?

Good luck with Premarin, I hope it works for you!

[sloane]

Probably still the case, but have since learned that even 'bound' E can be considered available--guess it's not so tightly bound as T. But enough theory. I'll give it a try and see what happens!!

[Duch]

what is/are the worst symptoms?

[Duch]

Bioidentical Estrogen

• Micronized estradiol/Estrace-Synthesized from soy and yam.*
• Estradiol/Alora-Synthetic.*
• Estradiol/Climara-Synthesized from soybeans.*
• Estradiol/Estraderm-Synthesized from Mexican yams.*
• Estradiol/Fem Patch-Synthetic.*
• Estradiol/Vivelle, Vivelle-Dot-Synthesized from Mexican yams.*
• Estradiol/Estring-Synthesized from Mexican yams.*

Non-Bioidentical Estrogen

• Conjugated estrogens/Premarin-Pregnant mares' urine.*
• Conjugated estrogens/Cenestin-Synthesized from soy and yams.*
• Esterified estrogens (estrone, equilin)/Estra Tab-both estrone and equillin are synthesized from soy and yams.*
• Esterified estrogens (estrone, equillin)/Menest-Both estrone and equillin are synthesized from soy and yams.*
• Micronized estradiol/Estrace-Synthesized from soy and yams.*
• Estropipate/Ogen-Synthesized from Mexican yams.*
• Estropipate/Ortho-Est-Synthesized from yams.*
• Ethinyl estradiol/Estinyl-Synthesized from Mexican yams.*
• Estradiol cypionate/Depo-Estradiol-Synthetic.*
• Estradiol valerate/Delestrogen-Synthetic.*

*** Administrator Note: Link has been removed.

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[skiergirl]

Sloane,
Maybe you should consider Cenestin instead of Premarin. It is biologically identical to Premarin but is plant based and not derived from animal sources (horse urine). I think, morally speaking, I would be more comfortable with that. Also, have you considered the estrogen injections? I've read that they work for some women who haven't had good results from anything else.

[dfw]

You might want to try using a femring. It's a vaginal ring that releases estradiol systemicly over three months and comes in two strengths .05 and .1mg.

[CarolH]

Sorry, I don't know anything about premarin but you said the patches, creams and gels didn't work for you. I am familiar with that problem. My skin doesn't absorb very well so Dr. gave me troche that disolves under the tongue. You might want to consider this.

[Happ1]

Ladies, I have just been perscribed Prempro .625 mg/2.5mg. I don't know much about this medication. Is this considered HRT? Should I be concerned about long term effects or side effects? Of course the doctor thinks it is a good thing for me to try to help with the hot flashes and dryness, but since all the bad press regarding this stuff the past several years, I am hesitant. The packeging says it could increase the risks of Dementia (among other things). My mother had Dementia and the thought of getting it as well is very scary to me.

I want to feel better, but not at the risk of my health in later years. I value your opinions, and would appreciate it if you would share your thoughts. Thanks so much.

[skiergirl]

Happ1,
Yes, PremPro is considered to be HRT. It's a combination of Premarin, which is composed of several different types of estrogen, including one made from horse urine, and Provera, a synthetic progestin. And yes, I think you should be concerned about the long term effects of PremPro. I've done lots of reading and reasearch and have concluded that the bioidentical hormones are safer, since they are chemically equivalent to the hormones our bodies make. Bioidentical estrogen is available in the form of patches, tablets, or transdermal creams. Bioidentical progesterone is also available in a cream or capsule (Prometrium).

[Happ1]

Happ1,
Yes, PremPro is considered to be HRT. It's a combination of Premarin, which is composed of several different types of estrogen, including one made from horse urine, and Provera, a synthetic progestin. And yes, I think you should be concerned about the long term effects of PremPro. I've done lots of reading and reasearch and have concluded that the bioidentical hormones are safer, since they are chemically equivalent to the hormones our bodies make. Bioidentical estrogen is available in the form of patches, tablets, or transdermal creams. Bioidentical progesterone is also available in a cream or capsule (Prometrium).

Thank you Skiergirl. I will ask my doctor about Prometrium when I see her again in 2 weeks. I assume it is perscription only? In the mean time I will begin the PremPro. I don't plan on staying on anything for more than 1 year. Thanks again.

[Duch]

Happ

Just for the record, there is no clinical evidence that bio-hormones are safer than non-bios.

The controversy over hrt was the result of a study by WHI. The results of this study were blown out of proportion. There is no significant difference between women using hrt and not using it. The results were reviewed with an eye to reducing the confusion the original study caused, and the results have been published in the British medical journal, The Lancet. No ones going to tell you this is perfectly safe, but not using hrt or bhrt isn't perfectly safe either.