What is Premarin?
Premarin in its oral form is a medication containing conjugated estrogens that are sustained in a slow-release tablet. Premarin is used to treat atrophic vaginitis, dyspareunia, and kraurosis vulvae.
They have a number of uses, including:
- As a treatment of menopausal and postmenopausal vasomotor symptoms (hot flashes and night sweats)
- To help prevent osteoporosis caused by low estrogen levels, for those at risk of developing this condition
- As a treatment for abnormal uterine bleeding, caused by hormone imbalances
- As a treatment for vulvar or vaginal atrophy associated with menopause
For more resources, including a full list of the risks and benefits of Premarin tablets, please review the product monograph.
How does Premarin work?
As women enter the natural menopausal transition and move into the menopause life cycle, their bodies begin to produce less estrogen.
Premarin tablets work by providing their bodies with estrogen to replace the hormones that their bodies are no longer producing.
In turn, this can help reduce the severity of certain menopause-related symptoms. It also reduces the chances of experiencing certain conditions (i.e., osteoporosis, vulva or vaginal atrophy, etc.), which are also associated with the menopause life cycle.
Premarin dosage strength varies, depending on what symptoms you’re treating and the severity of those symptoms. Practitioners can prescribe Premarin tablets in 0.3mg, 0.625mg, and 1.25mg, depending on what they believe will best serve your individual needs.
What is Premarin used to treat?
There are a number of different uses that oral Premarin treatments are used for. These include:
As a treatment for menopausal and postmenopausal symptoms (specifically, vasomotor symptoms like hot flashes and night sweats)
As a preventative treatment for osteoporosis, caused by low estrogen levels. This is only for women who are already at risk of this condition occurring
To help treat abnormal uterine bleeding, when your healthcare practitioner has been unable to determine the cause of the bleeding
As a treatment for vulva or vaginal atrophy that’s associated with menopause. Specifically, this helps treat symptoms like:
- Itching
- Burning
- Vaginal dryness
- Difficulty urinating
- Burning sensation while urinating
The Premarin dosage recommended for you will depend on the recommendations of your healthcare practitioner, as well as the severity of your ongoing symptoms.
How do you take Premarin?
Premarin tablets should be taken on the dosage schedule prescribed by your healthcare practitioner.
These tablets can be taken with or without food, but they should be swallowed whole. Don’t chew, break, or dissolve these pills.
Never take more Premarin than has been prescribed by your healthcare practitioner.
Taking too much estrogen can be dangerous and lead to more severe side effects, while not following your dosage schedule (missing doses) can impact the efficacy of your medication
How long does Premarin last after you take it?
What are the common side effects of Premarin?
The most common side effects from taking Premarin tablets include:
- Breast pain
- Breakthrough bleeding
- Spotting
- Joint pain
- Hair loss
- Changes in weight
Uncommon side effects include:
- Change in menstrual flow
- Nausea; bloating
- Abdominal pain
- Dizziness
- Deadache (including migraine)
- Changes in libido
- Mood disturbances
- Rash
- Itching
- Inflammation of the vagina
There are also rare or very rare side effects that occur, appearing in less than 0.1% of people who take this medication:
- A spontaneous flow of milk from the nipple
- Painful periods
- Vomiting
- Irritability
- Hives
- Worsening of asthma
- Tender red nodules on the shins and legs
- Increase in blood pressure
- Dizziness
If any of these side effects begin to become severe, be sure to talk to your healthcare practitioner at Felix. They may be able to suggest an alternative dose of Premarin, or medication that may work better for you.
MHT is the most effective treatment for menopausal symptoms and has been shown to prevent bone loss.
In menopausal women who start appropriately-dosed MHT prior to age 60 OR within 10 years of their last period, the health benefits outweigh the risks.
Risks of MHT are considered very rare (~1 case per 1000 to 10,000 women on MHT per year) and may include:
- risks of stroke or blood clots in legs or lungs with oral estrogen (much lower risk with estrogen gel or patch)
- risks of dementia in women older than 65 years,
- risk of breast cancer (less than ~1 case per 1000 women on MHT per year)
These conditions are all rare, but they highlight the importance of having a full discussion with your healthcare practitioner; especially if you’re experiencing moderate to severe side effects.
Individualization is key, and your MHT treatment plan should be reassessed (at least) once a year to monitor your health, as well as ensure that you are on the correct dosage and formulation.
Your practitioner can help you find balance between treating your symptoms safely, and avoiding increased risks.
Who shouldn't take Premarin?
Certain people shouldn’t taken Premarin tablets, including:
- If you have or have had a history of breast cancer
- If you have a known or suspected hormone-dependent cancer
- If you have or have a history of any cancers
- If you have unexpected or unexplained vaginal bleeding
- If you have or have had blood clotting disorders
- If you have serious liver disease
- If you have or have had heart disease, heart attacks, or strokes
- If you’re pregnant or suspect you may be pregnant
- If you have vision loss of any degree, due to blood vessel disease in your eye
- If you have overgrowth of the lining of the uterus
- If you have certain types of congenital coagulation abnormalities (i.e., protein C, protein S, or antithrombin deficiency)
- If you experience migraines with or without auras
- If you’re allergic to conjugated equine estrogens or any of the other ingredients in Premarin tablets
- If you have intact uteri, unless it’s prescribed in association with progestin
It is important to note that Premarin tablets contain lactose.
In addition to these people, there are certain other conditions that you should be sure to make your healthcare practitioner aware of before starting Premarin tablets, such as:
- A history of breast disease, breast biopsies, or a family history of breast cancer
- Any unusual or undiagnosed vaginal bleeding
- A history of uterine fibroids or endometriosis
- A history of liver disease or jaundice
- A history of hypertension (high blood pressure)
- A personal or family history of blood clots
- A history of kidney disease
- A history of asthma
- A history of epilepsy
- A history of bone disease
- Having been diagnosed with diabetes
- Having been diagnosed with porphyria (a blood pigment disease)
- Having been diagnosed with otosclerosis (hearing loss due to bones in the ear)
- A history of high cholesterol or triglycerides
- Having had a hysterectomy
- Having been diagnosed with hereditary angioedema
As with many medications, there are certain other medications or dietary factors that can interact with Premarin tablets.
Be sure to let your healthcare practitioner know about any other medications that you’re currently taking. Also, avoid grapefruit juice or herbal products containing St. John’s Wort while using Premarin tablets.
Further reading
