If you’re pre or post-menopausal you may have been prescribed or even begged your GP for Hormone Replacement Therapy (HRT) to try and relieve some of the awful symptoms. Perhaps you’ve read up on the wonders of bioidentical hormones and decided you’d like to try them. But, if your experience is anything like mine, you would have been fobbed off by your doctor and told that bioidentical HRT is too difficult to take, or there’s not enough known about it, and been handed a prescription for Prempak-C or Premarin.
What is Premarin?
If you’ve been prescribed Prempak-C, Prempro, Premique, Premarin or the combined menopausal-osteoporosis drug Duavee (formerly known as Aprela), you have been prescribed a synthetic form of HRT that contains conjugated horse oestrogens.
The Premarin family of drugs contains estrogenic compounds that are made from the urine of pregnant mares. That’s where the name is derived from: PREgnant MAres’ urINe = Premarin. Any HRT with Prem in the brand name is likely to contain conjugated equine (o)estrogen (CEE).
Although it sounds disgusting, you may still be wondering what the fuss is all about. After all, we may eat gelatin or inject Botox, and most of the time we have no idea what ingredients are in our medicines or beauty products. So what’s wrong with a little pregnant mare’s urine if it’s going to get rid of your hot flushes and make you feel better?
The problem is two-fold. Firstly, drugs containing CEEs are not well tolerated by the human body and the Premarin family of HRT increases the risk of suffering from thrombosis or a heart attack or breast cancer. And secondly, treatment of the pregnant mares is very cruel.
The Women’s Health Initiative Study and Risks of Prempro Use
Back in July 2002 the Women’s Health Initiative (WHI) study into hormone therapy was stopped abruptly because it was clear that long-term risks of Prempro use clearly outweighed the benefits. Prempro was a combination pill made up of Premarin and Provera, a synthetic form of progesterone. Women in the study on Prempro were found to suffer more breast cancers, heart attacks, strokes and blood clots than the women taking the placebo.
The results of the WHI study sent shockwaves around the world and women stopped taking HRT in droves. Doctors stopped prescribing it and for over a decade there was a lot of confusion around the safety of HRT.
Unfortunately, when the results of the study were publicised, no distinction was made between synthetic conjugated horse oestrogens like Premarin and bioidentical oestrogen and progesterone.
Bioidentical hormones are synthesised in laboratories from hormone precursors found in soybeans or yams and their molecular structure is designed to be an exact replica of the hormones produced by your body. This means that they are easily recognised and produce few of the side effects and diseases associated with synthetic hormones.
The Risks Associated with Premarin
- Increased body fat
- Cardiovascular events
- Arterial sclerotic disease
- Venous thrombosis (blood clots in veins) and
- Migraine headaches.
And recent research published in JAMA Internal Medicine Journal in January 2014 found that “CEEs use was associated with a higher risk of incident venous thrombosis and possibly myocardial infarction than estradiol use.”
Premarin is the Most Commonly Prescribed HRT in the USA
Premarin is manufactured by global pharmaceutical giant Pfizer. On their website they say “PREMARIN is the #1 prescribed branded estrogen therapy for the relief of moderate to severe menopausal symptoms.”
It begs the question, if so much is known about the risks of Premarin, why are so many doctors continuing to prescribe it for their menopausal patients?
PMU Farming and Cruelty to Horses
Apart from the obvious health risks to women, there is also the issue of cruelty to horses. People for the Ethical Treatment of Animals (PETA) describe how the pregnant mares are:
“Tied in small stalls, unable to move either backwards, forwards, or sideways or lie down comfortably, they stand with sacks strapped to their groins for months on end. In order to make the urine more concentrated, their water intake is restricted, so the horses are constantly thirsty. The foals are considered “byproducts,” and most are fattened up, slaughtered, and sold for horsemeat or turned into dog food.”
Up until 2002 Pregnant Mares Urine (PMU) farming was big business in North America and Canada. Hundreds of PMU farms churned out gallons of oestrogen-rich pregnant mares’ urine on a daily basis and were handsomely rewarded by large pharmaceutical companies like Wyeth and Pfizer.
But the WHI scare saw a drop in Premarin and Prempro sales and after 2002 many PMU farms were scaled down. Now, according to equine advocacy organization The Horse Fund, most PMU farming has been relocated to countries with less regulation, like Kazakhstan and China, which has a reputation for animal rights abuses.
Just Say ‘No’
With so many safer alternatives on the market it seems unnecessary to still be manufacturing synthetic oestrogen from pregnant mare’s urine. Not only is it a cruel practice, but it is harmful to the health of the women who are prescribed it.
So, if your doctor prescribes you Prempak-C or Premarin, refuse to accept the prescription. You are under no obligation to accept it. Object on the grounds of animal cruelty and the fact that it is associated with higher risks.
Ask for bioidentical hormones (usually in the form of oestrogen patches or gel and Utrogestan progesterone capsules). If your doctor is reluctant to prescribe them, ask for a referral to a Menopause Clinic or a Gynae-Endocrine Consultant at a hospital.
If more and more women refuse to take this product, there will no longer be a commercial reason to manufacture it. And that will not only benefit the health menopausal women around the globe, but those poor suffering pregnant mares as well.
“We are not spiritually unconnected from the drugs we take, or the pain and suffering that goes into their making.” — ALICE WALKER
Read more about My Experience of Prempak-C and Weight Gain