Premarin

Premarin (conjugated estrogens) is a mixture of estrogens derived from natural sources, available as oral tablets (0.3 mg, 0.45 mg, 0.625 mg, 0.9 mg, 1.25 mg) and as a vaginal cream. It works by replacing estrogen that the body no longer produces in sufficient amounts after menopause or due to other causes of ovarian hormone deficiency. Oral Premarin is indicated for moderate-to-severe vasomotor symptoms (hot flashes) of menopause, treatment of moderate-to-severe vulvar and vaginal atrophy, hypoestrogenism due to hypogonadism, castration, or primary ovarian failure, and prevention of postmenopausal osteoporosis; the vaginal cream is used specifically for atrophic vaginitis and moderate-to-severe dyspareunia. Premarin carries a boxed warning: estrogens, with or without progestins, should not be used for the prevention of cardiovascular disease or dementia, as studies showed increased risks of stroke, deep vein thrombosis, myocardial infarction, and in one study, probable dementia. Unopposed estrogen in women with a uterus increases the risk of endometrial cancer, so a progestin is usually added. Common side effects include headache, breast tenderness, nausea, bloating, and irregular vaginal bleeding or spotting. Premarin should not be used in women with undiagnosed abnormal vaginal bleeding, known or suspected breast cancer, active or history of blood clots (DVT/PE), active or recent stroke or heart attack, liver disease, or known/suspected pregnancy.