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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:
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:
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:
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:
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.
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No current Rx required
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Medicines have benefits and some have risks. Always read the label and use only as directed. If symptoms persist or you have side effects see your health professional.
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