Premarin

Premarin

Premarin is a Hormone Replacement Therapy to help you with the symptoms of menopause. It contains the hormone oestrogen. When you are going through the menopause oestrogen levels in your blood drop as you stop having your periods. More information

A doctor will review your order and write you a prescription, if appropriate. This prescription is then forwarded to a pharmacy. The pharmacy will have your medicine delivered to you within one to three working days. Read more about this process here.

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Menopause is a natural reaction in your body when your ovaries stop producing eggs. When working during child-bearing years, your ovaries produce the hormone oestrogen, as your ovaries stop working, so the levels of oestrogen in your blood drop. This is not something that happens suddenly overnight, in fact, it can take years, lasting anything from 6 months to 13 years. Sadly, if you experience unpleasant symptoms as you are going through the menopause you may suffer for some time. 

Menopause usually happens sometime between the ages of 45 and 55. In the UK the average age to reach menopause is 51. It can happen much earlier though and this is known as premature menopause. Premature menopause can happen at any age and there is no clear cause as to why it happens. Sometimes it can be caused by surgery to remove the ovaries, but in other cases, it’s simply unexplained. 

There are three stages of menopause: 

  • Perimenopause: the time when your periods are becoming less frequent and lighter, lasts on average 4 years
  • Menopause: Once your last period finishes, the average age in the UK is 51
  • Postmenopause: menopause ends one full year after your last period but it usually takes 2 to 5 years for symptoms to stop

This drop in oestrogen levels can leave you more susceptible to certain types of disease, like osteoporosis. This is why it’s really important to take care of your health during the menopause, stay active, eat a healthy varied diet, lose any excess weight, stop smoking and limit your alcohol intake. 

The changes in your hormones during all of these various stages of menopause can cause some unpleasant symptoms including: 

  • Hot flushes 
  • Vaginal dryness 
  • Lower sex drive 
  • Night sweats 
  • Difficulty sleeping 
  • Headaches 
  • Anxiety 
  • Mood changes 
  • Palpitations 
  • Joint pain or stiffness 
  • Frequent urinary tract infections 
  • Reduced muscle mass 
  • Weak bones or osteoporosis 

There are plenty of things you can do at home to help ease the symptoms of menopause, for example, maintaining an active, healthy lifestyle. Regular exercise (30 minutes of moderate exercise, 5 times a week) can help you to sleep better and improve your mood. Pelvic floor exercise can help with bladder control as you strengthen the muscles required. If you are suffering from hot flushes take steps to help prevent these like avoiding possible triggers: spicy foods, caffeine, alcohol etc. Try to keep as cool as possible and dress in layers so you can remove some clothing if you start to feel too warm.  If you aren’t coping well at home then you may wish to speak to a doctor about medical treatments. The main treatment for menopause is Hormone Replacement Therapy, which restores the normal levels of oestrogen and progesterone in your blood. There are other remedies out there, such as complementary and herbal medicines or bioidentical hormone therapy, but it is unclear how effective or safe these are, as they are not tested in the same way as conventional medicines. 

You can also look at topical treatments for vaginal dryness or cognitive behavioural therapy to help with low mood. 

Hormone Replacement Therapy comes in different guises, you can take a combination of oestrogen and progesterone or just oestrogen. Getting the right type for you can be a process of trial and error. Hormone Replacement Therapy also comes in different forms: tables, patches, vaginal creams, gels, pessaries and rings. Not all HRT treatments are taken the same way, some are taken continuously others alter along with your menstrual cycle. One option you can consider it Premarin, a Hormone Replacement Therapy which contains only oestrogen, see below for more information. 

What is Premarin? 

Premarin is a Hormone Replacement Therapy to help you with the symptoms of menopause. It contains the hormone oestrogen. When you are going through the menopause oestrogen levels in your blood drop as you stop having your periods. This drop can cause some unpleasant symptoms like hot flushes, lower sex drive, vaginal dryness, mood swings and difficulty sleeping. 

Many women cope with these symptoms on their own, but when they are severe HRT can help to ease them so you can get back to enjoying life: the levels of oestrogen are balanced by the therapy. Premarin contains only oestrogen. Lower levels of oestrogen also put you at risk for diseases like osteoporosis. 

When is Premarin used? 

Premarin is prescribed for women going through the menopause who are experiencing severe symptoms. Premarin is usually only prescribed to women who no longer have a womb as it contains only oestrogen. However, women who have not had their womb removed can still be prescribed Premarin. There may be circumstances where it is prescribed alongside another treatment which contain progesterone. 

Premarin is used to: 

  • Combat moderate to severe hot flushes 
  • Treat menopausal changes in and around the vagina
  • Ward off osteoporosis

Premarin can also be used to treat conditions where a woman’s ovaries do not produce enough oestrogen naturally and to treat the symptoms of certain cancers in both men and women. 

How do you use Premarin? 

When it comes to taking medication, you should always follow the instructions given to you by your doctor or pharmacist. Premarin comes in tablet form and should be swallowed whole. If you crush or split the tablet it may affect the way Premarin works. You can take Premarin with or without food. 

What are the dosages? 

The usual dose to treat menopausal symptoms is one tablet a day. There are different doses available and you should take the lowest dose to control your symptoms. The lowest dose is 0.3mg and this should be your starting dose the first time you use Premarin. If after time this does not seem to control your symptoms then you may need a larger dose. 

Below is a list of the various dosages available for Premarin tablets, each tablet strength is colour coded to help you recognise it easily: 

  • 0.3mg: green coloured tablet 
  • 0.45mg: blue coloured tablet 
  • 0.625mg: maroon coloured tablet 
  • 0.9mg: white coloured tablet 
  • 1.25mg: yellow coloured tablet 

Take your tablet at the same time every day. You take Premarin every single day, unlike some HRTs, there are no tablet-free days when taking Premarin. 

If you are not already taking some kind of HRT or you are taking an HRT that does not give you a monthly bleed you can start your course of Premarin at any time. If you are already taking an HRT that gives you a monthly bleed then you will need to wait until you finish the course of the treatment you are already on and start with Premarin the day after. For osteoporosis, the recommended dose is 0.625 mg a day, but you may be prescribed up to 1.25mg a day. If you forget to take a tablet, take the missed tablet as soon as possible but don’t take a double dose. If you miss a tablet you may experience light bleeding. If you do take a double dose you may feel sick or have tender breasts and be dizzy but it is unlikely to cause any serious harm. 

What are the side effects of Premarin? 

As with all medicines, Premarin can cause some side effects although not everyone taking Premarin will get them. 

Common side effects include: 

  • Headaches 
  • Nausea and vomiting 
  • Breast pain 
  • Irregular bleeding or spotting 
  • Stomach cramps 
  • Fluid retention 
  • Hair loss 
  • Joint pain 
  • Changes to your libido 
  • Weight changes 
  • Vaginal yeast infection 
  • Rashes and itching 
  • Dizziness 

These side effects should improve with time More serious side effects include: 

  • Increased problems with asthma 
  • High blood pressure 
  • High blood sugar 
  • Liver problems 
  • Fibroids 
  • Severe allergic reaction 

There are some diseases that are reported more often in women using HRT compared to women who aren’t using HRT, these include: 

  • Breast cancer 
  • Abnormal growth or cancer of the lining of the womb 
  • Ovarian cancer 
  • Blood clots in the leg veins or lungs 
  • Memory loss (dementia) 
  • Heart disease 
  • Stroke 

If any of your side effects are serious or hard to cope with, discuss your treatment with your doctor. 

When shouldn’t you use Premarin? 

Do not take Premarin if any of the following apply to you: 

  • You are allergic to conjugated oestrogens or any of the other ingredients listed on the pack
  • You have ever had breast cancer or cancer of the lining of the womb
  • You have excessive thickening of the womb lining
  • You have unexplained vaginal bleeding
  • You’ve ever had blood clots on the leg veins or lungs
  • You have angina
  • You’ve had a stroke
  • You have or have had liver disease
  • You are pregnant or breastfeeding

If you have ever had any of the following you should talk to your doctor before taking Premarin as it can make things worse or cause a recurrence so you will need more frequent check-ups: 

  • Fibroids 
  • Growth of womb lining outside your womb or excessive growth in the womb lining 
  • High blood pressure 
  • Kidney disease 
  • Fluid retention 
  • Gallbladder disease 
  • Severe headaches 
  • Epilepsy 
  • Asthma 
  • Low blood calcium levels 
  • High levels of fat in your blood 
  • A disease which affects your immune system 

Premarin tablets contain the colouring agent E111 (sunset yellow) which can cause allergic reactions. 

Does Premarin interact with other medications? 

Always discuss any other medication you are taking with your doctor, including herbal medicines or supplements as some of these may prevent Premarin from working effectively or vice versa. 

It is particularly important you mention any of the following: 

  • Anticonvulsants (used for epilepsy) 
  • Anti-infective (used to treat tuberculosis) 
  • Antibiotics or antifungal medicines 
  • St. John’s Wort or other similar herbal remedies 
  • Metyrapone 
  • Cimetidine (used for stomach ulcers) 
  • Dexamethasone 

Drinking grapefruit juice may also affect the way Premarin works. 

Where can you buy Premarin? 

You can buy Premarin from pharmacies nationwide, including online pharmacies, supermarket pharmacies etc. 

Can I get Premarin without a prescription? 

Premarin is a prescription only medication, you will need a consultation with a doctor in order to get a prescription for Premarin. This could be your family doctor or any other doctor who will go through a checklist with you to make sure the drug is the right choice for you and your symptoms. You cannot buy Premarin over the counter without a prescription. 

 

 

References

Brazier, Yvette What you need to know about HRT (May 2017) Retrieved from https://www.medicalnewstoday.com/articles/181726.php 

Irani, Shirin Consultant Gynaecologist Menopause (2019) Retrieved from https://www.bupa.co.uk/health-information/womens-health/menopause 

NHS UK Hormone Replacement Therapy (July 2016) Retrieved from https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/ 

NHS UK Menopause Treatment (August 2018) Retrieved from https://www.nhs.uk/conditions/menopause/treatment/ 

Pfizer Pharmaceuticals Premarin (September 2018) Retrieved from http://labeling.pfizer.com/showlabeling.aspx?id=131#PI 

Pfizer pharmaceuticals Premarin Package Leaflet (September 2016) Retrieved from https://www.medicines.org.uk/emc/files/pil.2900.pdf