Estrogen Series Premarin and Prempro
Estrogen’s benefits discussed to date.
- Protects women from getting respiratory viruses including Covid. May also be beneficial as a treatment of respiratory viruses especially with lung involvement because of stimulation of the Estrogen Receptor (ER) https://regenerativemc.com/fearofcovid/
Estrogen’s fears discussed to date.
- None
Prempro Benefits discussed to date.
- Decrease in colorectal cancer and osteoporosis
Prempro Fears discussed to date.
- Preliminary results from 16,608 women in the Prempro-only arm of the Women’s Health Initiative (WHI) 2002 was stopped due to increased breast cancer risk and lack of overall benefit. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5792205/ https://regenerativemc.com/estrogen/
- Prempro also showed a slight increase in heart disease, stroke, blood clots and urinary incontinence
Medications Studied In Women’s Health Initiative (WHI): Premarin and Prempro
The Largest Women’s Health Prevention Study enrolling 160,000 post-menopausal women ages 50-79 started in 1991 and lasted for 15 years. WHI looked at two medications vs controls for the treatment of menopause. The focus was to prove these medications would have beneficial effects on the top 4 most common diseases for women:
- Cardiovascular disease, the leading cause of death in women,
- Breast cancer, the second leading cause of death in women,
- Colorectal cancer, the third leading cause of death in women,
- Osteoporosis, the leading cause of bone fracture in women
Medications studied in WHI were:
- Premarin, the’ estrogen-only arm’, is also referred to as CEE, conjugated equine estrogen.
- Prempro, a combination medication consisting of Premarin, CEE, and a synthetic progestin referred to as ’medoxyprogesterone’ or ‘medroxyprogestin’
These two medications are often referred to as estrogen and estrogen plus progesterone leading to great confusion when reading the literature.
Premarin
Premarin, made from ‘natural estrogens’ from “horse urine” first came out in 1941 as a stand alone “estrogen” HRT therapy for any post-menopausal woman. Horse estrogens are not bioidentical to human estrogens but it is thought they compete for the same estrogen receptor sites in humans. Premarin was researched extensively and given to women extensively until the Women’s Health Initiative stopped the Prempro arm of the study in 2002.
Before WHI, Premarin was one of the most prescribed medications on the market. Premarin was not why the study was stopped. Premarin is made of ‘conjugated horse estrogens’or CEEs.
Its ingredients are: “ Sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares’ urine. A mixture of sodium estrone sulfate and sodium equilin sulfates, 17α-dihydroequilin, 17α-estradiol, 17β-dihydroequilin”.***
Human estrogen is 17β-OH estradiol which converts into estriol and estrone. When you want to research effects of estrogen on the body, for example, ‘Does 17 beta OH estradiol increase blood clotting?’, you need to search 17β-OH estradiol’s effect on blood clotting. You will get different results doing this.
Prempro
Prempro, is a combination of Premarin and Medroxyprogestin, Medroxyprogestin is a synthetic equivalent of Progesterone. It is not natural progesterone. It was introduced in 1991 as an alternative HRT in women with intact uteruses, meaning no hysterectomies. Premarin alone was used only in women with hysterectomies.
The reasoning WHI used to differentiate HRT treatment to those women with and without uteruses is the belief progesterone is only needed to protect a uterus from estrogen dominance. Therefore, if you don’t have a uterus you don’t need progesterone protection. This belief is taught and prevails today even though Progesterone receptors are located throughout the body and is needed for other body functions such as bone health, hot flashes, anxiety, sleep, mood, and depression.
Please understand, bio-identical hormones Estrogen and Progesterone made from wild yams were not studied by the Women’s Health Initiative which is why in the literature you will see written, “there is a lack of evidence” when referring to the use of bio-identical hormones.
Have an awesome day! Dr D