Doctors’ Answers to “Frequently Asked Questions” – Hormone Therapy
Related Women’s Issues
These comments are made for the purpose of discussion and should NOT be used as
recommendations for or against therapies or other treatments. An individual patient is
always advised to consult their own physician.
Considering Cardiac Risks of Premarin
Use [posted 11/5/98]
Question: Is there any medical risk of cardiac or CVA problems with the long term
use of Premarin for a woman who has had a total hysterectomy? I take .625 mg per day and
have been for the past 11 years.
Answer: There may be a slightly increased risk for the first year of use, then
the risk drops. Most physicians would strongly recommend estrogen use to decrease vascular
disease.
Bellamine S tablets for Menopausal
Symptoms [posted 11/4/98]
Question: I’m taking Bellamine S tablets by amide for menopausal symptoms and find
that it is working well for me. I’m curious though about its history and where I might
find more information about it on the internet. My D.O. prescribed it for me instead of
hormone replacement therapy (HRT) and said that this was used before HRT was available.
Could you tell me more about it? How does it work? What are the main ingredients? Thank
you.
Answer: As to the history, I would contact the company, a list of numbers is in
the front of the PDR. Side effects are usually constipation and dry mouth. This class of
drugs was used extensively in the 60s and 70s;but, stopped due to law suits as I recall.
There were few actual problems, just legal ones.
Premarin Concerns [posted
11/4/98]
Question: I had a total hysterectomy in 1994 and was immediately prescribed
Premarin. I asked my doctor how long I need to take Premarin and her answer was
“forever, it keeps us young.” I dislike the idea of taking anything forever and
would like information in order to make an informed decision as to whether I need to take
Premarin “forever,” or if I can discontinue, or decrease gradually as nature
must have intended. What would be the side affects? Could I do well with one of the newly
advertized “natural” or herbal estrogens? I have listed the medication I
currently take and I will soon be starting Lipitor to control cholesterol. Thank you.
Answer: The best current drug to decrease cardiovascular disease is estrogen.
Women still die most frequently from this class of problems, not cancer or other problems.
A very good study was done on nurses which showed both an increase in longevity and an
increase in quality of life in women taking estrogen. If there is a strong family history
of breast cancer it should probably be avoided and reloxafene taken instead. For a women
who has elevated cholesterol, this would be one of the best drugs going from my
prospective. As to natural estrogens, there is no direct evidence that there is any
difference in your body’s response. Nature must have intended for us to have elevated
blood pressure and diabetes mellitus;but, we treat these with increased longevity. Your
call, but, a great drug for longevity and quality of life.
DepoLupron & Hormone Production
[posted 10/30/98]
Question: Please describe the recommendations for this drug, side effects, and how
it works in the body. I am looking up this information for a friend prescribed this drug.
Answer: DepoLupron is a synthetic nonapeptide analong of gonadotropin-releasing
hormone. It works as an LH-RH agonist inhibiting sexual hormone production. In this
manner, it effectively decreases or stops natural production of testerone(in men the usual
receptors ). Side effects center on those seen with steroid absence-similar to what women
experience in menopause. Hot flashes, decreased sexual drive, impotence, difficulty
concentrating, weakness etc.
Finding Plant Based Alternative to
the Animal Based Premarin
Question:I found your web site most interesting. However, we are looking for
Estropipate, the plant based estrogen which has been prescribed for my mother-in-law. We
think it is made by Ogen. Can you help? would like to know exactly what this is and if
there are any side effects. She is 80 years old and in very good health. she was
originally prescribed Premarin, which we are opposed to her taking.
Answer: Opposed due to what? Estropipate is made by Ortho/McNeil and is
stucturally different from other types of estrogen. However, seems to have the same
risks/benefits of the other estrogens. These include hypercoagubility, hypertension,
cancer of the breast and uterus, and fluid retention. There are no major differences in
side effects between Premarin and Estropipate.
Hormone Replacement Therapy
Question: I have been on Prempro for 6 weeks. I have had spotting daily for 4
weeks. Is this unusual and, if not, how long should it continue? Once I stop spotting,
will it reoccur? Except for enlarged breasts and tender nipples, I have no other reactions
to the drug. I am 73 years old, with severe osteoporosis, and I am also taking Fosamax.
Answer: It sounds like you have just recently started taking hormonal
replacement. Usually, Prempro will not cause spotting, one of the reasons for its
popularity. However, the spotting represents build up of your endometrium and may require
a burst of progesterone to cause a regular period. I’d give it two or three more weeks to
see if it goes away. If not, you will probably need a regular cycle or switch to an
estrogen regimen followed by a progesterone burst (causing regular periods).
Estrogen Therapy
Question: My wife has been on estrogen therapy for about 25 years. A year ago her
prescription dose was cut in half. Since then she acts like a different woman. She’s
become very easily upset. Acts like a know it all. Quick to contradict. Laughs after
making a statement which is not at all humorous. Could the reduction in her estrogen dose
have caused this pesonality change?
Answer: Sure. Double the dose and see if it vanishes. If not, get a complete
workup by a good internist.
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