Why Do/did You Take Premarin, Prempro? Options

[AimeeDecorates]

I'm hoping no one takes offense at this question, because I have wondered about this for a long time. It is not criticism of any kind.

So question is, do/did you take it because your doctor recommended it over bio-identicals, like Vivelle dot, Climara, etc.? Did anyone ever ask the doctor why he/she prefers the synthetic to the bio-identical?

With other effective forms of estrogen available, do you think about why the doctor prefers the horse hormones to a human's? If that sounded sarcastic; it is not. I couldn't think of any other way to phrase it. One is an animal model, one is a human model--how else to say it? Help me out.

Or do you, yourself, believe in Premarin/Prempro? And why? Do you believe there just isn't any difference between animal/human and synthetic/bio-identical? (I'm just asking, because who knows, maybe there really isn't any difference and they'll discover that in 50 years or something.)

I figure that Premarin/Prempro reps tell the doctors that, like their ads say "It is the most studied brand of HRT" (something like that). But to me, that would be the embarassing part, because Prempro was the one the study found to be so very harmful. I guess the pharmaceutical company thinks we won't figure that out? (Not that a bio-identical would necessarily have done any better, because I don't know.)

Anyway, I should probably ask my own gyn that question, since she originally prescribed Cenestin (which I didn't take) for me, which is based on the horse hormone model. I told her, "I'm from California and was trained to go with natural whenever there is a choice" LOL.

I guess I'm trying to figure out if there is a bias against more natural vs. synthetic in the medical world, maybe.

[nights2]

I know back when I went on it you just listened to your doctor and did what ever thay said. Back then they were supposed to know best. We have learned alot since then.

[MaryO]

I didn't ever take the Premarin family of drugs for the reasons that you mentioned. My gynecologist knew my wishes very clearly and prescribed Estrace for me which is what I'd decided I wanted at the time.

I was very surprised to learn that my insurance company put a lot of pressure on my gynecologist to switch me to Premarin. It must have been cheaper or "preferred". In any event, my gyn stood up for my beliefs and told them in no uncertain terms that I would not take Premarin. Period. He was able to convince them to pay for the Estrace/Provera instead. As it turned out, I went off them soon thereafter, too.

So, it's not always the doctors pushing what the drug reps have supplied to them, but the insurance companies can be in there with their own agendas, too.

Amazing how everyone thinks that they know better than you and your doctor what you should take.

Off the topic of Premarin, but a related topic... Several months ago I was diagnosed with panhypopituitarism - my pituitary gland isn't working due to surgery I had years ago. I go to an endocrinologist who specializes in this type of problem and he prescribed a specific, expensive drug for me. Without this drug, I have a greatly shortened life expectancy because the pituitary is the "master gland". My insurance company refused to pay for it. They finally agreed to pay for a cheaper version, after 3 months of haggling back and forth. This cheaper version was just FDA approved for adults the same day that my insurance approved it for me. I hope that I'm not the test case for this drug.

Some kid behind a desk who has never been to medical school overrides a medical specialist all based on money and the bottom line for the insurance company. Maybe he figures if I die sooner, they won't have to pay as long.

This is really a hot issue with me. Drug reps... GRRRRRRRRRRRRRRRRRRRRRRR

[AimeeDecorates]

I know back when I went on it you just listened to your doctor and did what ever thay said.  Back then they were supposed to know best.  We have learned alot since then.

True. But a lot of women still use it, and I just wonder why.

[AimeeDecorates]

So, it's not always the doctors pushing what the drug reps have supplied to them, but the insurance companies can be in there with their own agendas, too.

You're right, I forgot about the insurance companies, who just want what cheapest, in the experiences I've had.

But I still think doctors are brainwashed by drug reps.

I share your feelings on these bureaucrats deciding what's best (ha!) for the patient, rather than the patient and doctor together.

[CSugarGrove]

MaryO,

I'm sorry to hear about this. Is this condition permanent? Why did the surgery cause your pituitary gland to stop? And I suppose the drug is too expensive to pay for out of pocket, and why should we have to do that, right? Is there anything natural that might do anything to start up your pituitary? Sorry so many questions. If more people had the condition, they would have to deal with the issue.

Well, it's possible that the cheaper version that was approved might work better; you have to consider this. There IS an up side to being one of the first to try it. Think of the miracle drugs in the past that were first used on people who feared the worst, only to find that they worked really well.

Please keep us posted on how you are doing on this medication.

I don't have any info on Premarin, but I did want to say that the other evening while watching TV, I was surprised to see a commercial about it. I thought they no longer prescribed it because of all the publicity about three years ago. That was the summer that I first took HRT; in fact, almost to the day that my doctor gave me the HRT prescription, that study was blasting all over the TV and radio. I thought, "Great! What am I going to do now?" So I just filled my prescription anyway. I was having too many hot flashes to care, at that time....

[MaryO]

CSugar, I don't want to hijack this great topic, but I did also want to respond.

My medical problem is strictly an insurance issue. There are quite a few people on this drug, but they take other brands like the one that my endo originally prescribed for me. I got "lucky" and my insurance company would only pay for this newer version. We did find out that our insurance company is switching prescription providers in the next couple months or so, so who knows what THEY will allow me to take.

It's very expensive. People who need it and don't have the insurance coverage can sometimes get it at a reduced rate or free, because it is necessary. I was starting the process of applying for the reduced rate meds when this other drug was FDA approved.

My condition is permanent and was caused by surgery on my pituitary gland to remove a tumor. The surgery was years ago (1987) but it was recently found to be the case that often years later the scar tissue will cause the pituitary gland to shut down. Without pituitary function, other glands don't work well, either. I'm almost entirely adrenal insufficient and I have to take drugs (much cheaper!) for that. Adrenal insufficiency is also serious and potentially life-threatening. I have to watch for an adrenal crisis, wear Medic alert bracelet and keep all medical people and family members informed of this.

Thanks for asking. Now, back to our regularly scheduled Premarin discussion!

[aprillv68]

Back in January my gyn put me on HRT to regulate me because i had been without a period since november of last year. I remember reading up on it & reasons for taking it--i could not find ammenorrhea, only for vasomotor symptoms like hot flashes, etc. also osteoporosis & for postmenopausal women- i thought the only categorie i fell under was the hot flashes....i was & am not postmenopausal (im42)...i dont have osteoporosis...i was indeed in full-blown PMS for sure.. i thought why am i taking this? My dr didnt even explain this regimen to me, she just showed me how to take them & said "If youre that misarable these will regulate you." In other words shouldnt I have been educated by her? Isnt that what a dr is for? Isnt that why shes being paid? Yes, yes & yes! Well i took the ****things & i did get a period, in February, then a very, very light one i early March.....so much it might even have been breakthrough bleeding. I started retaining water & hence putting on weight my ankle started swelling after work ( im on my feet 75% of the time), not much but enough for me to notice, I got slight pains across my chest, not bad but again enough to notice, then once again I found myself waiting again to have a period.....pms & all....nothing. I waited no longer & took myself off--that was almost a month ago & im still waiting. So ive decided, without even calling my gyn, that HRT is not for me at least for now (BTW i was on Premphase/prempro & it did relieve my hot flashes & the other symptoms i was having that was the only positive thing i can say about it, i did feel better) I am contemplating changing gyn drs in the near future, also i am going to my regular dr to have tests for other medical conditions I could possibly have, like a low thyroid which i think i may have had all along. I am currently on estroven & soy isoflavones & small doses of black cohosh, i feel somewhat better.