/* Milonic DHTML Website Navigation Menu Version 5, license number 187760 Written by Andy Woolley - Copyright 2003 (c) Milonic Solutions Limited. All Rights Reserved. Please visit http://www.milonic.com/ for more information. */









Premarin and Hormone Replacement Therapy

By Murry J. Cohen, MD





Psychological Experiments


Pharmaceuticals & Biological Agents

Premarin & HRT

Premarin Update



Abuse & Rescue







Facts About Estrogen

Where Does Premarin Come From?

Alternatives to Premarin

Should Every Menopausal Woman Take Estrogen?

What You Can Do


Produced by Wyeth-Ayerst, Premarin is the most widely prescribed drug in the United States. It is also used by many women in Israel, where it is sold under the name Premaril. The active ingredient, pregnant mare's urine, is collected on farms in the United States and Canada under extremely inhumane circumstances from tens of thousands of horses. These docile animals spend most of their lives tethered until their health fails and they are slaughtered, as are most of their foals. More modern, non-animal based substitutes for the treatment of menopause and osteoporosis are widely available.


Facts About Estrogen

Many gynecologists prescribe Premarin for women going through menopause; however, there are much healthier, more humane alternatives. This drug is derived from very cruel treatment of horses.


Where Does Premarin Come From?

Premarin is derived from pregnant mare's urine, obtained by impregnating a mare, fitting her with a rubber collection cup joined to a hose, and forcing her to stand for over 5 months on a concrete floor in stalls so small she cannot take more than one step, turn around, or lie down properly. After her foal is born, she is allowed out to pasture with the foal for only up to five months, after which time she is reimpregnated, separated from her baby, and returned to the estrogen production line. Sometimes, to increase profits, the mare's urine is concentrated by water restriction, potentially leading to disease in the animals which could be transmitted to humans. There is also some evidence that the equine estrogen contained in Premarin may cause cancer.





What Are the Alternatives to Premarin?

There are several equally effective drugs derived from plants like soybeans and Mexican yams, including:

  • Activella

  • Cenestin

  • Estrace

  • Ogen

  • Ortho-Est

When smaller amounts of estrogen are needed, natural estrogenic substances (plant-derived estrogen-like chemicals called phytoestrogens, consisting of lignans and isoflavones) should be considered. These compounds are 1/400 as potent as estrogen itself and serve to balance estrogen levels. If estrogen levels are low, ingestion of these foods can result in an increase in overall estrogen activity. If estrogen levels are high — as in some cases of PMS — they can bind to estrogen receptor sites and decrease estrogenic activity. In either case, they can balance estrogenic activity. These compounds can also lower cholesterol.


Foods containing estrogen-like substances include:

  • Soybean Products (soy milk; soy burgers and hot dogs; tofu; tempeh; soy nuts and beans; soy flour; miso)

  • Split Peas

  • Whole Wheat

  • Rye

  • Oats

  • Barley

  • Chickpeas

  • Sesame Seeds

  • Pomegranates

  • Apples

  • Spinach

  • Flaxseeds

  • Lima Beans

  • Alfalfa Sprouts

One combination would include flaxseed cereal and soy milk (1 bowl) for breakfast and 4 oz. tofu at another meal.


Some supplements that can stimulate estrogen production by the ovaries include:

  • Flaxseed Oil
  • Licorice Root
  • Unicorn Root
  • False Unicorn Root
  • Black Cohosh
  • Fennel
  • Evening Primrose Oil
  • Vitamin E (400 U)
  • Dong Quai

A recent study in the American Journal of Epidemiology from the Cancer Research Center in Hawaii showed that women whose diets are rich in soy foods are less than half as likely to develop uterine cancer. Ask your gynecologist about raloxifene, a new drug that is not an estrogen but acts on estrogen receptors to increase bone density without increasing cancer risk (New England Journal of Medicine 337:1641, 1997).





Should Every Menopausal Woman Take Estrogen?

Estrogen deficiency may occur during or after menopause, and estrogen excess or imbalance may cause PMS. There are instances, therefore, when the amount of estrogen activity in the body should be increased, decreased, or balanced. This should be discussed with your gynecologist.


Estrogen supplementation should be considered with caution in women with:

  • History of breast cancer

  • Liver disease

  • Thrombosis

  • Hypertension

  • Fibrocystic breasts

  • Elevated cholesterol

  • Migraine headaches

  • Endometriosis

A 1997 review published in Lancet (350:1047) of 51 studies in 21 countries shows a 35% increased risk of breast cancer in women who have used hormones for 5 years or longer. Estrogen can also increase uterine cancer risk (Lancet 349:458, 1997). In addition, estrogen may have the following side effects: headache, nausea, anxiety, and insomnia.

RISKS:  See Recent Studies — HRT Update


What You Can Do

  • Learn more about Premarin and Estrogen Replacement Therapy

  • Discuss alternatives with your doctor

  • Discuss alternatives with your friends

  • Try a vegan diet

  • Boycott Wyeth-Ayerst

Note: The vitamin company Solgar has been bought by Wyeth-Ayerst. If you have been buying Solgar vitamins, please find an alternative.


Dr. Murry Cohen is the former Co-Chairman of the Medical Research Modernization Committee and was a medical consultant to the Washington, DC-based Physicians Committee for Responsible Medicine. He is a member of CHAI's Advisory Board.