Prempro FAQs - Hormone Replacement Therapy Attorneys, Estrogen, Progestin, Menopause, Dangers

What are the different types of hormone therapies?

How many postmenopausal women take estrogen alone or
    estrogen plus progestin therapy?

What is the important information about Premarin and Prempro
    and all estrogens and estrogens plus progestins drug products?

What are the dangers associated with Prempro?

Are Premarin and Prempro safer in lower doses?

Is it dangerous to abruptly stop HRT? Should Prempro be
    stopped gradually? Will I bleed if I stop taking Prempro?

Are there alternatives to HRT?

Are the estrogens and progestins in birth control pills (oral
    contraceptives) the same as those in Prempro and Premarin? Do
    they have the same risks?

What are the different types of hormone therapies?
There are a wide range of different hormone therapies – patches and pills, natural and synthetic, combinations of estrogen and progesterones, and individual estrogen and progesterones. Prempro, Premarin, Provera, Estrogen therapy... and each has its own risks and potential benefits. Informing yourself of the possible dangers is important, and only you and your doctor can determine the most effective and safe method of treatment.

Therapy	Terminology	Newer Terminology
Using estrogen with or without progestin	Hormone replacement therapy (HRT)	Hormone therapy (HT)
Using estrogen alone	Estrogen replacement therapy (ERT)	Estrogen therapy (ET)
Using estrogen with a progestin	Hormone replacement therapy (HRT)	Estrogen-progestin therapy (EPT)

How many postmenopausal women take estrogen alone or estrogen plus progestin therapy?
Wyeth estimates that approximately 5 million U.S. women are taking Premarin and 1.5 million are taking Prempro. Approximately 10 million postmenopausal women are taking some form of estrogen, either alone or in combination with a progestin.

What is the important information about Premarin and Prempro and all estrogens and estrogens plus progestins drug products?
Premarin and Prempro, as well as other estrogen and estrogen plus progestin drug products have associated risks that may outweigh the benefits for women. A major HRT study released by the Womens Health Initiative shows (read study):

Postmenopausal women should not take estrogen and progestin to protect the heart.
Estrogens and progestins may increase the risk of heart attack, stroke, blood clots and breast cancer.
Although other doses of Prempro and other estrogens and progestins were not studied, postmenopausal women who take estrogens and progestins should also be warned about potential risks, which must be presumed to be the same.
When these drugs are being prescribed only to prevent osteoporosis, other treatments should be considered before prescribing estrogen or estrogen with progestin.
Estrogens and estrogens with progestins should be used at the lowest dose for the shortest duration.

What are the dangers associated with Prempro?
Study results show that for every 10,000 healthy, postmenopausal women taking PremPro for a year, there would be eight additional cases of breast cancer, seven heart attacks, eight strokes and eight blood clots in the lungs. At first glance, those numbers don’t seem significant. However, in 2002, more than 6 million women were taking PremPro. Statistically, that translates into:

480,000 additional breast cancer cases.
420,000 more heart attacks.
480,000 more strokes.
480,000 more blood clot cases.

Study results on the effects of Prempro also show:

26 percent increase in breast cancer.
41 percent increase in strokes.
29 percent increase in heart attacks.
100 percent increase of blood clots in legs and lungs.

Raising more red flags is the reported increase in the incidence of ovarian cancer in WHI study participants. Women who took estrogen HRTs for long periods of time had a higher risk of developing the rare form of cancer, and researchers noted a 7 percent increase in risk associated with every extra year of estrogen HRT use. Researchers called the trend “worrisome.”

Are Premarin and Prempro safer in lower doses?
The dose of Prempro used in the WHI study was 0.625 mg, which is the same as 0.625 mg Premarin (conjugated estrogens) plus 2.5 mg medroxyprogesterone acetate (progestin). It is not known whether Premarin and Prempro are safer in lower doses. Generally, medicines should be used at the lowest effective dose. The FDA cannot make further recommendations until studies are performed using lower doses.

Is it dangerous to abruptly stop HRT? Should Prempro be stopped gradually? Will I bleed if I stop taking Prempro?
It is not dangerous to just stop your HRT. You may get some minimal bleeding if you stop HRT, but that is not dangerous. Your menopausal symptoms such as hot flashes may return if you stop HRT.

Are there alternatives to HRT?
Absolutely, but it depends on what symptoms you are treating or what diseases you are trying to prevent. There are multiple herbal supplements that have been found to help against hot flashes, such as black cohash. There are excellent medications for the prevention and treatment of osteoporosis. There are estrogen medications that can be applied just to the vagina that help treat vaginal dryness. Exercise and diet can also go along way to prevent the side effects of menopause. You should talk to your doctor about your symptoms and the options available to you. Learn more about Prempro alternatives.

Are the estrogens and progestins in birth control pills (oral contraceptives) the same as those in Prempro and Premarin? Do they have the same risks?
Oral contraceptives also contain estrogens and progestins, but different types and doses. All estrogens have similar side effects. However, the risks of particular side effects may differ since oral contraceptives are used in younger women with different health status compared to postmenopausal women.

As with all estrogens, the use of oral contraceptives is also associated with increased risks of several serious conditions including heart attack, blood clots, stroke, liver tumors, and gallbladder disease. These risks are higher in women with underlying risk factors such as high blood pressure, high cholesterol, and diabetes, and in those who smoke cigarettes.

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