Alternatives to Premarin and Prempro

As a follow up to iFH’s patient-to-doctor letter regarding the Premarin family of drugs and the horrors they inflict on both horses and women alike, we have compiled a list of alternatives that may be safer, effective and humane.

We encourage you to go online to further acquaint yourself with the effectiveness and safety of these compounds; there is a wealth of information out there, but beware of false claims and err on the side of caution.

And, as always, please inform your doctor if you plan to use these as treatments for the relief of menopausal symptoms since some may have seriously adverse side-effects.

LIST OF ALTERNATIVES

Lifestyle Changes

Probably the simplest and most natural approach to the treatment of menopause is to adopt a healthy lifestyle in regard to diet, exercise and stress management. Not only will this help alleviate symptoms but the benefits will ensure that you remain healthy now and in the future.

1. Nutrition: It should go without saying, avoid refined and processed foods, choose more whole foods, fresh fruit, vegetables and complex carbohydrates. Avoid high fat dairy products and meats and supplement these items with healthy fats such as olive oil, nuts, seeds and lean cuts of meat or fish. Additionally, practice portion control and avoid empty calorie foods.
2. Exercise: Exercise is vital to keeping symptoms in check. Exercise directly affects hormonal activities in the body by raising the level of endorphins, for example, to maintain emotional stability and suppress anxiety. Moreover, the benefits are unsurpassed: maintenance of muscle and joint strength, increased metabolism, reduced weight, improved cardiovascular health, increased cognitive function, maintenance of bone integrity, and the list goes on.
3. Stress Management: It is a well known fact that stress induces more severe hot flashes. There are many stress-reduction techniques available to manage the burden of everyday anxiety – rest, relaxation, varied leisure activities, and most importantly self-affirming thoughts to maintain self-image and confidence.

Bio-identical Hormones

Bio-identical hormones are synthesized in the lab from plant sources and as the term implies are pharmaceuticals that closely mimic natural hormones produced in the body since they possess the same molecular structure. There are many indications that bio-identical hormones pose far less risk for the human species than conventional therapies such as Premarin.

Dietary Phytoestrogens

Dietary phytoestrogens are naturally occurring substances (e.g. Isoflavins) found in fruits, vegetables, and whole grains such as soybeans, alfalfa sprouts, and oilseeds (such as flaxseed). There is some evidence that they have a weak estrogen-like effect that may reduce the intensity and frequency of hot flashes.
Eating natural foods that contain these compounds is safe but there are also non-prescription supplements on the market for which there is no long-term safety data.

Natural Hormones

1. Estriol: Can be used to treat hot flashes and other symptoms and helps in maintaining bone density. However, two studies have recently shown that estriol causes stimulation endometrial cells.
2. Natural Progesterone: There is some evidence that natural progesterone is useful in the treatment of hot flashes but no evidence that it benefits bone density. Examples include: topical progesterone creams and oral progestins.
3. DHEA:  Dehydroepiandrosterone (DHEA) is an estrogen precursor meaning it is converted to estrogen and possibly some testosterone in the body. This may or may not increase levels of estrogen in the body naturally.

Prescription Drugs

There is also convincing evidence that some prescription drugs such as SSRIs, SNRIs, Gabapentin and Clonadine, which are not licensed for treating menopausal symptoms do in fact alleviate hot flashes and night sweats. These are powerful drugs yet in severe cases some doctors may be willing to prescribe one of these treatments, with the patient’s consent.

Herbal Medicines

Herbal medicines are readily available however caution is advised since they can contain powerful ingredients that may contraindicate other prescription drugs and/or may have adverse effects on certain individuals.

Some examples include: Black Cohosh for hot flashes and sweating, Kava to reduce anxiety, Ginko to decrease the risk of onset of dementia and St. John’s Wort as an anti-depressant. No substantiated medical studies are available for these medicines and most do not have to comply with the stringent safety, quality and manufacturing regulations that govern conventional medicines.

In the News

As time progresses many women – and doctors – are looking for safer and more humane alternatives to conventional HRT. Recently in the news a non-hormonal supplement called Amberen, manufactured by Lunada Biomedical, has been touted as the next cure-all for relief of menopausal symptoms. Claiming to have a double-blind, placebo-controlled clinical study to back its effectiveness, it contains 100% natural ingredients, all on the FDA’s approved Generally Recognized As Safe (GRAS) list. Only time will tell as to the authenticity.

Consult Your Doctor

In any case, it is important to separate fact from fiction and be astutely aware of the consequences of clinically unproven medications. Apart from the unmistakable benefits of lifestyle changes, before considering any of the alternatives listed please consult your doctor.

By JANE ALLIN

RESOURCES

— Alternatives to Premarin and Prempro in Word
http://tuesdayshorse.files.wordpress.com/2010/02/alternatives_to_premarin_ifh_update.doc

— Patient to Doctor Letter
http://tuesdayshorse.wordpress.com/2010/02/18/alert-your-doctor-not-to-prescribe-premarin-for-menopausal-symptoms/

— Articles on Premarin Horses
http://tuesdayshorse.wordpress.com/category/premarin-horses/

Alert your doctor not to prescribe Premarin for menopausal symptoms

For every 150 women who stop taking Premarin, one mare is spared from the “pee line” and seven “byproduct” foals are not be slaughtered for their meat.

We are not spiritually unconnected from the drugs we take, or from the pain and suffering that goes into their making.”

– Alice Walker

“We crush ’em and recycle ’em . . . just like aluminum cans.”

– Pat Houde, equine feed lot manager, regarding Premarin foals and mares

The Int’l Fund for Horses is working to end the use of medications derived from conjugated equine estrogen (CEE), or pregnant mare’s urine.

Mares, foals and women are all at risk. The mares and foals cannot speak for themselves, but women can, and should, for the horses and for themselves.

We ask that women please prepare the following letter and send it to their physicians.

If you are a woman not experiencing menopausal symptoms, please edit the letter to fit your circumstances (omit the last paragraph and end with a thank you).

Both men and women should share this with the horse lovers and women in their lives.

Thank you for getting involved!

PATIENT TO DOCTOR LETTER RE PREMARIN FAMILY OF DRUGS
Download Word Document of Letter Here

[Insert Date]

Dr. [Insert Name]
[Insert Address]
[Insert City, State, Zip]

Dear Dr. [Insert Name]

Re: Hormone Replacement Therapy Drugs for Treatment of Menopausal Symptoms
Premarin®, Prempro® and Aprela (awaiting approval)

Please Refuse to Prescribe these Drugs

As a concerned and knowledgeable patient regarding the use of the conjugated equine estrogen produced drugs Premarin® and Prempro®, I encourage you to stop prescribing these medications for relief of menopausal symptoms. Premarin® and other such HRT compounds are derived from the high concentration of estrogen in pregnant mare’s urine (PMU). Not only is the collection practice inhumane but the risks imparted by these drugs to unsuspecting women are objectionable and unnecessary. Many believe that the risks far outweigh any benefits offered given that these particular medications are recognized by the United Nations as potent carcinogens.

The Horses

Life for PMU mares is merciless; repeatedly impregnated for up to as many as 20 years, they spend 6 months of their 11-month pregnancy confined to stalls so small they have difficulty turning around or lying down. During this time, they are permanently connected to cumbersome rubber urine collection bags that chafe their flanks, cause infections and severely limit movement. Water intake is routinely restricted to concentrate the amount of estrogen in their urine causing life-threatening renal and liver problems. Equally disturbing is the fate of the foals – the “by-products” of the industry. Most are sold at auction to “kill buyers” and ultimately end up at the slaughterhouse.

The Women

Nationwide studies (e.g. NIH’s Women’s Health Initiative) have been published that clearly corroborate the link between HRT, cancer, heart disease, stroke and dementia. Women who take these drugs face significantly increased risks of: invasive breast cancer (26%), heart disease (29%), strokes (41%), blood clots to the lungs and legs (50%), ovarian cancer (60%), impaired cognitive function, dementia and Alzheimer’s, asthma, lung cancer, malignant melanoma, and reduced insulin resistance, among others. Most importantly, when these medications are stopped, a woman’s risk returns to the same level as those who have never used these therapies.

The Culprits

Noteworthy are the on-going lawsuits against Wyeth (now a Division of Pfizer), the manufacturer of the Premarin® family of drugs. Juries and Judges alike have shown that Wyeth failed to adequately warn consumers about the risks associated with these drugs and that they purposefully hid the risk of breast cancer and other diseases. Moreover, evidence has confirmed that Wyeth employed ghostwriters to write medical reports related to HRT and paid physicians to sign off as the authors. Not only did the articles overstate the benefits of HRT, but they diminished the serious risks associated with the drugs.

The Alternatives

I believe there are safer and more humane alternatives available. However, as always, before trying these alternative remedies, I would like to discuss these options with you.

Sincerely,

[Insert Patient Name]
[Insert Patient Ref Id# if applicable]
[Insert Patient Address]
[Insert Patient City, State, Zip]
[Insert Patient Telephone No.]

ALTERNATIVES TO PREMARIN AND PREMPRO
Download Word Document of Alternatives Here

For more information on the PMU industry, please read the iFH Fact Sheet >>

Read articles about Premarin and the horses on Tuesday’s Horse >>

Thank you, Jane, for your stellar work and leading our Team in this effort.

Premarin regrets

by RON WILSON

Thanks to my late father, a drug made from animal waste is the most widely prescribed drug in the world today.

My father, Dr. Robert A. Wilson, penned the influential 1960s book “Feminine Forever,” which promoted and popularized the idea of menopause as a disease. Menopause is a “living decay,” he wrote, which often destroys a woman’s “character as well as her health.” He added, “The unpalatable truth must be faced that all postmenopausal woman are castrates. A man remains a man until the very end. The situation with a woman is very different. Her ovaries become inadequate relatively early in life. She is the only mammal who cannot reproduce after middle age.”

Excerpt from ad (click to enlarge):

The physician who puts a woman on 'Premarin' when she is suffering from the menopause usually makes her pleasant to live with once again.

It is no easy thing for a man to take the stings and barbs of business life, then to come home to the turmoil of a woman 'going through the change of life'. If she is not on 'Premarin,' that is.

My father’s solution: abolish menopause altogether, through the use of estrogen drugs, and woman will stay “feminine forever.” The idea took. One hundred thousand copies of “Feminine Forever” were sold in its first seven months of publication, and in the late 1960s and early 1970s, newspapers and women’s magazines ran hundreds of articles promoting estrogen use. Doctors across the country jumped on the bandwagon, prescribing estrogen drugs for millions of women. Unfortunately, the estrogen drug that is most widely prescribed, Wyeth-Ayerst’s Premarin, has a secret ingredient that my father had no trouble accepting: animal suffering.

Premarin is made from the estrogen-rich urine of pregnant horses. To collect the urine, farmers in the United States and Canada confine some 75,000 mares to tiny stalls for six months at a stretch. Some of the horses receive exercise every few weeks, but most don’t see the light of day for months. The mares must also wear cumbersome urine-collection bags which chafe their legs and prevent them from ever lying down comfortably.

Farmers are encouraged to limit horses access to water so that their urine will yield more concentrated estrogens. A veterinarian who works on pregnant mares’ urine (PMU) farms told inspectors from the United States Department of Agriculture that this practice can cause mares to suffer from renal and liver problems.”

The 70,000 foals born on PMU farms every year fare little better than their mothers. Some are used to replace exhausted mares – many of whom are forced to stand on the “pee line” for up to 20 years! But most of the foals are sent to feedlots where they are fattened, then slaughtered for meat. Claude Bouvry, Canada’s leading horsemeat exporter, says the PMU industry is his “biggest source of supply.” Without the overseas demand for horsemeat, Bouvry says, “there would be no market for the young horses procured by [PMU] mares.”

These horses do not have to die. Synthetic and plant-based estrogen drugs are readily available, and many physicians prefer them to Premarin. Small wonder: The Food and Drug Administration cautions that “the urinary estrogen excretion by pregnant mares is widely variable.” Studies have shown that the amount of estradiol – one of the active hormones in Premarin – can vary by almost 400 percent from one batch to the next. Of even more concern, some studies suggest that long-term treatment with Premarin significantly increases breast cancer risk.

Sadly, my father’s contribution to medical science resulted in a prescription for animal cruelty. I encourage woman of all ages to learn more about Premarin and its many alternatives.
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