- What is conjugated estrogens vaginal cream, and how does it work (mechanism of action)?
- What brand names are available for conjugated estrogens vaginal cream?
- Is conjugated estrogens vaginal cream available as a generic drug?
- Do I need a prescription for conjugated estrogens vaginal cream?
- What are the side effects of conjugated estrogens vaginal cream?
- What is the dosage for conjugated estrogens vaginal cream?
- Which drugs or supplements interact with conjugated estrogens vaginal cream?
- Is conjugated estrogens vaginal cream safe to take if I'm pregnant or breastfeeding?
- What else should I know about conjugated estrogens vaginal cream?
What is conjugated estrogens vaginal cream, and how does it work (mechanism of action)?
Estrogens are one of the two major classes of female hormones. (Progestins comprise the second major class). Estrogens are used primarily to treat the symptoms of menopause and states in which there is a deficiency of estrogen, for example, among women who have had their estrogen-producing ovaries removed. Conjugated estrogens are a mixture of several different estrogens (estrogen salts) that are derived from natural sources and blended to approximate the composition of estrogens in the urine of pregnant horses. The main components are sodium estrone sulphate and sodium equilin sulfate. Estrogens have widespread effects on tissues in the body. Estrogens cause growth and development of the female sexual organs and maintain female sexual characteristics such as the growth of underarm and pubic hair, body contours, and skeleton. Estrogens also increase secretions from the cervix and growth of the inner lining of the uterus (endometrium). Conjugated estrogens were first approved by the FDA in 1938.
What brand names are available for conjugated estrogens vaginal cream?
Premarin Vaginal Cream
Is conjugated estrogens vaginal cream available as a generic drug?
GENERIC AVAILABLE: No
Do I need a prescription for conjugated estrogens vaginal cream?
What are the side effects of conjugated estrogens vaginal cream?
Among the most common endocrine side effects are:
- breakthrough vaginal bleeding
- loss of periods,
- excessively prolonged periods,
- breast pain or
- breast enlargement, and
- changes in sexuality (increases or decreases in libido).
Other important side effects include:
- gallstones, and the gallstones may result in abdominal pain and require surgery.
- Migraine headaches, and
- retention of water (edema).
Melasma--tan or brown patches-- may develop on the forehead, cheeks, or temples. These may persist even after the estrogen is stopped.
Blood clots are an occasional, serious side effect of estrogen therapy and are dose-related. (The higher the dose of estrogen, the greater the risk of blood clots.) Cigarette smokers are at a higher risk than non-smokers for blood clots, and patients requiring estrogens should be encouraged to quit smoking.
Estrogens can promote thickening of the lining of the uterus (endometrial hyperplasia) and increase the risk of uterine cancer. At diagnosis, endometrial cancers in recipients of estrogens are generally at an earlier stage and are less aggressive when they are discovered. Survival from endometrial cancer also is better in women taking estrogens than in those not taking estrogens. The addition of a progestin to estrogen therapy offsets the risk of endometrial cancer. Conflicting data exists on the association between estrogens and breast cancer. There may be a small increase in risk. The effect of concomitant progestin therapy on the risk of estrogen-induced breast cancer is unclear. Conjugated estrogens are well-absorbed from the vagina and into the blood. The amount absorbed depends on the frequency of use and the amount used. Thus, more frequent use or larger amounts of vaginal estrogens can have effects throughout the body (see conjugated estrogens, Premarin). The Women's Health Initiative found that postmenopausal women (50-79 years old) taking conjugated estrogens had an increased risk of breast cancer, blood clots, and stroke. There was also an increased risk of impaired cognition and/or dementia among women over age 65.
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