Jane Allin and I, together with you, have been championing the cause of PMU horses for over a decade.
PMU horses are mares kept continually pregnant in order to collect their estrogen rich urine to make drugs like Prempro, Premarin and Duavee for the easing of menopausal symptoms. A tragic offshoot of this process are of course the mares’ byproduct foals. As Allin points out:
Sadly, foals born to these mares are usually worth less than the urine their mothers produce. They are considered to be nothing more than a living byproduct of Premarin. To the PMU farmers, they are often worth more dead than alive.
Joining us in the battle to save PMU horses are two awesome new friends.
First, there’s a lovely lady called Rebecca who has gone to live in China with her husband sent to work there by his company.
Rebecca has been looking for a way to help PMU horses in a really big way and now she has it. Not only is Rebecca a professional photographer used to covering very difficult assignments, but also very well versed on the issue.
Inspired by the work of Jane Allin who uncovered that there are PMU horses in China, Rebecca is determined to locate some of these farms and document them. She is donating 100% of her time and we are helping her with her expenses. We are moved by her generosity and courage.
We couldn’t be more delighted and grateful.
• Dr. Greene
An eminent women’s health care physician contacted us and offered to help in any way he can.
In particular, he likes the way we are alerting doctors to the true potential and significant dangers to patients treated with Premarin, Prempro and Duavee. He is for educating them more than ever.
We pointed out that we still have doctors responding to our Dear Physician Letter arguing that conjugated estrogens (how they are listed on the label) are not necessarily dangerous.
We responded that the estrogens in question are conjugated equine estrogens, a known carcinogen as declared by the World Health Organization.
Some doctors are shocked. Some doctors continue to argue that we are wrong because the the word equine is nowhere on the label.
Indeed it is not.
We point out that the word “equine” was omitted from packaging years ago and the FDA has done nothing about it.
Dr. Greene concurs with our plan to press the FDA to make the labeling of drugs reflect the true nature of these drugs — that they are made with conjugated equine estrogens. But will they listen to us, or anybody else for that matter?
He has a plan.
Dr. Green is writing a paper on the dangers of conjugated equine estrogens and drugs associated with them. He will use his paper to rally doctors on his side to make a strong case to outlaw the use of this ingredient. Full stop.
He justly observes that drugs made with conjugated equine estrogens are outmoded, outdated, totally unnecessary and most importantly of all a great potential danger to the health, safety and welfare of women and horses.
As his own work on this issue unfolds, Dr. Greene supports our work – especially this golden opportunity to expose PMU farms in China.
There have been significant side effects to the work we are doing on behalf of the horses affected by the making of the Premarin family of drugs — Premarin (cream and tablet), Prempro, Premphase and Duavee.
We placed these warning billboards near women’s hospitals. Horse lovers leafleted and talked to thousands of women and medical staff about the making of Premarin and how it impacts the lives of the pregnant mares it uses and what happens to so many of their foals.
Staff from these medical centers began telling our volunteers how Premarin is used in ways other than for the treatment of menopausal symptoms. It is a long list but here are two such examples:
Premarin is given to patients prior to and post hysterectomy surgery. Another example is using Premarin in conjunction with surgical procedures for patients who are deemed at risk of hemorrhaging — Premarin clots the blood.
There are many more. We will cover that soon in a separate post. If you have encountered any please let us know.
Social media advocates contributed too. You helped by sharing our post about our billboard. It reached well beyond the 10K+ notification for Facebook alone.
Our Dear Doctor Letter has done more than just alert the medical personnel we sent it to. It has helped in all sorts of unforeseen ways.
For instance, we had physicians and even their family members contacting us telling us we were giving out misinformation concerning Premarin. They said that Premarin contained conjugated estrogens that were not dangerous. We stated that Premarin is made with conjugated equine estrogens – which are listed by the World Health Organization as known carcinogens – and the FDA allowed the producers of the Premarin family of drugs to omit the word “equine” some years ago.
A number of these doctors (or their relatives who called us to defend them) flat out refused to believe us, or so they said. Surely it’s not a big leap to see where the makers of these drugs got the name Premarin (Pregnant Mare’s Urine).
One doctor who at last acknowledged that the Premarin family of drugs are made with conjugated equine estrogens with the use of pregnant mare’s urine blurted out at the moment of awareness, “that means contain carcinogens and we shouldn’t be prescribing them”. He then concluded for himsef that in his mind at least there is no doubt to why these drugs no longer have the word equine in the labeling.
So what do we do with this information? We lobby the FDA to change the labeling to accurately reflect the drugs’ true nature. That is the plan. It is a steep mountain to climb but we are willing to climb it. But we may not be alone and will have some very important help. More on that later.
To those of who have sent this letter and to all the volunteers who printed and sent thousands more, we thank you.
Thanks to your reporting, we have contacted television stations across the country for more than a year regarding the airing of Premarin cream commercials. They have, except in a few stubborn cases, either removed them and/or refused to renew them. We have also had a major impact regarding magazine and newspaper ads — print and online — via Twitter and Facebook.
This campaign, like so many, relies on the help of horse lovers like you. Congratulations on a job well done. Please continue to let us know when you see any type of ad for these products. We have a contact form here on Tuesday’s Horse specifically for this purpose. It’s in the dropdown box under Contact Us entitled Report Premarin Ads.
OUR MISSION CONTINUES
Our mission to help Premarin – or PMU – horses continues. The impact of the work we do is sometimes not immediately seen, difficult to sum up or give exact figures for. But what we are doing is having an effect.
Our campaigns have been so innovative and effective other groups and individuals have followed in our footsteps. The horses need us all.
We must continue our efforts for without us these horses have no hope, no voice and will continue to be subjected to the cruelties and death associated with the making of the Premarin family of drugs.
“Nothing has been, or ever will be, appealing or beneficial about the PMU industry and the Premarin family of drugs; they are clearly harbingers of death from both sides of the equation”.
– JANE ALLIN
Sorry we have been so long posting this. We saw this the day it came out but 2016 started off unusually busy and hasn’t let up.
Looks like it’s more than Premarin tablets Pfizer are expecting women (and in some cases men) to swallow. Check this nonsense out. And the picture filed with it is even worse. They have pregnant mares outside grazing in high grass. But if you look closely you can see a foal too which means these horses have just given birth that’s why they are not “online”. We are talking about the “pee line”.
An expected increase in contracted volumes of pregnant mare urine over the next two years is a small bit of good news for Manitoba’s long-beleaguered PMU industry.
Pfizer Canada says it will increase the amount of PMU collected from ranches in Manitoba and Saskatchewan during 2016 and 2017.
Pfizer uses estrogen from PMU to manufacture Premarin used for hormone replacement therapy in post-menopausal women.
Industry officials cautioned the announced increase in volume will probably not have a major impact on PMU production.
“From our perspective, it’s not going to be anything of any significance,” said Norm Luba, executive director of the North American Equine Ranching Information Council, a non-profit association in Louisville, Kentucky representing PMU ranchers.
“It will be a small increase over the current amount that we contract,” was all Christina Antoniou, corporate affairs manager for Pfizer Canada in Montreal, would say in an email message to the Manitoba Co-operator. “We are currently in the process of contracting for 2016-17 and therefore cannot provide any further details.”
Antoniou indicated a recent improvement in Premarin sales is responsible for the increase.
These people are unbelievable. Literally. Pfizer are making more money than ever off the Premarin family of drugs. Even with price increases there is no way so few a number could possibly supply all the pregnant mare’s urine they need. Who are they kidding? Still, it is puzzle. What are they up to? We’ll let you know when we know.
There are some well informed comments to this article so Pfizer & Co are fooling no one.
Ty Savoy quotes this:
‘In fact if one person is unkind to an animal it is considered cruelty, but where a lot of people are unkind to a lot of animals, especially in the name of commerce, the cruelty is condoned and, once large sums of money are at stake, will be defended to the last by otherwise intelligent people.’
Ruth Harrison, Animal Machines: The New Factory Farming Industry (2013)
Contrary to popular belief, the FDA has yet to approve any generic as a substitute for Premarin and its daughter products (i.e. Prempro, Premphase, Duavee).
Accordingly no prescription drugs used to treat menopausal symptoms, other than the Premarin family, contain pregnant mare’s urine.
However much confusion arises when the subject of HRT is broached, particularly in terms of the safety aspect of FDA-approved versions that are not derived from pregnant mare’s urine.
The vast majority of FDA-approved HRT prescription drugs are synthetic bioidenticals — hormones identical on a molecular level to endogenous hormones that are synthesized in the lab from natural plant sources.
These are not to be confused with the compounded bioidenticals, none of which are approved by the FDA.
Premarin and its derivatives are also synthetics but, of course, sourced from an animal by-product.
Apart from Brisdelle, the only non-hormonal FDA-approved HRT, the rest fall into three categories of hormone combinations as follows:
A good proportion of these drugs contain estradiol or esterified estrogens (non-equine) as the estrogen component (e.g. Estrace, Femtrace, Activella, Femhrt, Angeliq). However several have identical equine estrogens that are derived from plant-based sources versus pregnant mare’s urine.
That said, these drugs are not entirely identical nor are they exactly equivalent in constituents. Cenestin, Enjuvia, and Menest are three such HRTs included in this group.
Cenestin was originally developed as a generic for Premarin by Duramed/Barr but in 1997, the FDA refused to approve the abbreviated new drug applications from Duramed and Barr Laboratories for a generic version of Premarin.
In any case, all three of these drugs – Cenestin, Enjuvia, and Menest – contain similar estrogen components that are found in Premarin and its derivatives.
Premarin however is a complex mixture of numerous hormonal components, of which only some of the estrogenic components are found in the plant-based synthetics.
The table below compares the ingredients of Premarin, Cenestin and Enjuvia. I was unable to locate the same information for Menest.
However the pharmacology is similar to the others and contains a mixture of esterified estrogenic substances, principally estrone, that are of the type excreted by pregnant mares (e.g. sodium estrone sulfate, sodium equilin sulfate).
Despite the fact that these alternatives contain several of the Premarin estrogenic components, a study comparing the pharmacokinetics and relative bioavailabilities of key estrogen components of Premarin with those of synthetic plant-based equivalents concluded that these are not in fact bioequivalent to Premarin and therefore cannot be assumed to be therapeutically equivalent. Seehttp://www.ncbi.nlm.nih.gov/pubmed/10865186.
But does this mean that these and other FDA-approved synthetics are safe?
Unfortunately these alternative synthetics carry with them the same or similar warnings associated with their use.
However it is often cited in scientific literature that estrogens derived from pregnant mares urine pose a greater risk due to the complexity and concentrations of the combined hormones together with the unmistakable fact that equine estrogens are foreign to humans.
Given that alternatives such as Cenestin and Enjuvia assimilate the equine equivalents in Premarin, despite the fact they are derived from plants, it is perplexing why anyone would elect to choose these to alleviate menopausal symptoms – purely from the aspect of being equine-related and extrinsic to the human endocrine system. More likely it is a case where they are unaware of what they contain.
And what about the rest that contain estradiol (e.g. Estrace) and other esterified non-equine estrogens, or those that contain progestins and androgens extracted from plant sources?
And let’s not forget the newest addition to the Premarin family.
Duavee (CEES/bazedozifene(SERM) http://www.rxlist.com/duavee-drug.htm
• Endometrial cancer, cardiovascular disorders, and probable dementia (> 65 yrs).
• The SERM bazedoxifene is believed to inhibit the formation of breast cancer cells by binding to the estrogen receptor thus interfering with its activity.
The picture is clear.
In effect the FDA-approved hormone-containing alternatives carry with them the same risks and warnings associated with drugs derived from conjugate estrogen estrogens, whether that be estrogen alone or combinations. Albeit the risks may not be of the same significance as those associated with drugs manufactured from pregnant mare’s urine.
Nonetheless they still exist, and potentially more so for susceptible individuals.
Although the hormonal ingredients are similar or equivalent, they may or may not function identically for any single given woman. This applies to the Premarin derivatives as well.
And so, as much as it may seem that these hormones are safer than the Premarin family of drugs, there is no solid evidence to prove this.
It is important to note that some of these drugs have been approved by the FDA because data collected from trials has proven their effectiveness in relieving menopausal symptoms and reducing the risk of osteoporosis.
However there have been no long-term studies like the WHI performed to assess their safety profile.
In the absence of comparable data, the risks are generally assumed to be similar to CEEs and other forms of estrogens.
Moreover, regardless of the source and type of hormones, it is always recommended that estrogens, with or without progestins, should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment.
Brisdelle as an alternative?
As mentioned there is only one FDA-approved non-hormonal HRT. In early June of 2013 the U.S. Food and Drug Administration approved the drug “Brisdelle” (paroxetine – Paxil) manufactured by Noven Pharmaceuticals for the treatment of hot flashes due to menopause.
Brisdelle contains the selective serotonin reuptake inhibitor paroxetine mesylate, making it unique from all other FDA-approved treatment for hot flashes which contain the hormones estrogen or progestin.
Brisdelle poses none of the risks associated with estrogens or estrogen combination therapies.
However it is a selective serotonin reuptake inhibitor (SSRIs) (antidepressant), which has been shown to increase the risk of suicidal thoughts and behavior in pediatric and young adult patients when used to treat major depressive disorder and other psychiatric disorders. Seehttp://www.rxlist.com/brisdelle-drug.htm.
Whether this risk applies to menopausal women is unclear.
As with any drugs and medications there are inherent risks, the nature of which can range from mild to life-threatening. Always consult your doctor to help decide what is best for your particular situation.
As an aside and for interest’s sake here is a list of some of the more common HRTs available and the costs associated with them. The list is by no means comprehensive and includes the tablet form of the drug only.
This information was taken from http://www.goodrx.com and pertains only to the U.S. Prices are per tablet and converted to monthly costs based on a 30-day interval.
For consistency, all of the costs were taken from Walgreen’s with the discount coupons applied. Obviously prices will vary depending on store, geographic location, available coupons, etc. and are only intended to provide a relative comparison using the same base source.
PATENT EXPIRATION DATE
PRICE PER TABLET
MONTHLY COSTS (APPROX)
Prempro / Premphase
CEEs / Progestin
CEEs / SERM (bazedoxifene)
Estrogen / Progestin
CEEs — plant based
Estradiol / Progestin
CEEs — plant based
Estradiol / Progestin
CEEs — plant based
Estrogen / Progestin
Clearly, Pfizer is laughing all the way to the bank at the expense of women and horses alike.