The Premarin family of HRT drugs is made from the urine of pregnant mares.
Updated: 1:50 pm
MORE and more doctors who prescribe Premarin® are arguing with us that the menopausal drug no longer contains conjugated equine estrogens derived from pregnant mare’s urine. Huh?
The idea doctors most often cite in support of this belief is what it says on the drugs’ packaging, that Premarin® is made from “conjugated estrogens” where it used to say “conjugated equine estrogens”. Removing the word equine is something Pfizer pressed the FDA to do shortly we believe after they merged with or acquired Wyeth pharamaceuticals, adding these drugs to their portfolio. The removal of the word equine is obviously having its desired effect.
Premarin sample package with words “conjugated estrogens”. Google search result. Unattributed image.
Well dear doctors. A quick check on the internet should assure you that the Premarin® family of drugs including Duavee (originally called Aprela) which we don’t hear much of, has and assuredly always will be made with CEE’s — conjugated equine estrogens.
Wikipedia
Conjugated estrogens (CEs), or conjugated equine estrogens (CEEs), sold under the brand name Premarin (a contraction of “pregnant mares’ urine”) among others, is an estrogen medication which is used in menopausal hormone therapy and for various other indications. Read more »
RxList
PREMARIN® (conjugated estrogens tablets, USP) for oral administration contains a mixture of conjugated estrogens purified from pregnant mares’ urine and consists of the sodium salts of water-soluble estrogen sulfates blended to represent the average composition of material derived from pregnant mares’ urine. Be sure to check out the side effects. They include endometrial cancer, cardiovascular disorders, breast cancer and probably dementia. Read more »
DrugBank
Conjugated Equine Estrogens (CEEs) are derived from the urine of pregnant mares and contain a blend of at least 10 estrogen derivatives. Marketed under the brand name Premarin, CEEs are the most frequently used form of conjugated estrogens.
All estrogen products mimic the effects of endogenous estrogens in the body which are responsible for the development and maintenance of the female reproductive system and secondary sexual characteristics.
Conjugated estrogens, or Conjugated Equine Estrogens (CEEs) are composed of a mixture of the water-soluble salts of sulfate esters from estrone, equilin, 17 α-dihydroequilin, and other related steroids that are purified from pregnant horse urine. Available as the product Premarin (FDA), this combination of equine-derived estrogenic compounds is indicated for the following conditions: treatment of moderate to severe vasomotor symptoms and vulvovaginal atrophy associated with menopause; hypoestrogenism due to hypogonadism, castration or primary ovarian failure; palliation of metastatic breast cancer; palliation of advanced androgen-dependent carcinoma of the prostate; and for prevention of postmenopausal osteoporosis. Read more »
PubChem
Premarin is a pharmaceutical preparation containing a mixture of water-soluble, conjugated estrogens derived wholly or in part from URINE of pregnant mares or synthetically from ESTRONE and EQUILIN. It contains a sodium-salt mixture of estrone sulfate (52-62%) and equilin sulfate (22-30%) with a total of the two between 80-88%. Other concomitant conjugates include 17-alpha-dihydroequilin, 17-alpha-estradiol, and 17-beta-dihydroequilin. The potency of the preparation is expressed in terms of an equivalent quantity of sodium estrone sulfate. Read more »
Send this letter whether you are male or female. Doctors are known to use Premarin® intervenously to prevent bleeding during surgery. So you may be treated with Premarin® without even knowing it or giving your permission. More to come on that so stay tuned here.
In the meantime, share far and wide. Save the horses!
China
The biggest challenge outside of the US is educating the Chinese who produce more pregnant mare’s urine and prescribe it more than anyone else in the world according to a recent source in China. And the Chinese love horse meat. So the two — Premarin® and horse slaughter — continues to go hand in hand.
Premarin tables. If you look closely you can see a legend in Chinese. Google image.Chinese version of Premarin cream.
In the meantime, doctors in the US are still prescribing and using the Premarin® family drugs at an alarming rate and seemingly unaware of the history and multiple dangers associated with this despicable drug.
“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
The Kentucky Derby this Saturday marks the tenth anniversary of the catastrophic breakdown of Eight Belles. Racing with the boys, she crossed the wire 4 ¾ lengths behind Big Brown, finishing second – the first filly since 1999 to run in the Derby — only to collapse with two shattered ankles and be euthanized on the track.
Memories of Barbaro’s anguishing ordeal, fresh in the minds of racing fans and the death of another horse on Kentucky Oaks day, cast a pall over North America’s most celebrated racing event and raised questions about the safety of horse racing.
Immediately the racing industry responded with the notion that more uniform regulations regarding equine health standards and drug use should be a top priority.
Ten long years and what has improved? Nothing.
Year after year, the industry holds conference after conference claiming that they are moving towards improved safety standards. Sadly, the efforts of the few that do care and want change, are lost to the greed of the rest.
These innocent souls are sacrificed to casino profits, allowance races, graded and graded stakes races and when they fail, relegated to claiming races and the slaughterhouse. It is estimated that 20% of slaughtered horses in North America are thoroughbreds — some picked up by the meat man at the track and sold by unscrupulous trainers and owners after a bad race, without a hope of finding a home. Disposed as garbage. Just throw-away items.
In fact, it seems the opposite to what the racing industry claims has happened.
The transparency, if there ever was any, is gone.
The doping continues, the trainers and veterinarians are one step ahead of the newest drug testing, the records available about trainer infractions are incomplete where serious penalties are hidden from the public, statistics only report deaths if a horse dies during a race, and horses, despite what the industry claims, continue to die in record numbers, all hidden from the public’s view.
All of this is a cover up, blatant lies, to attempt to convince everyone that the industry is above board.
Horse racing is a cruel, predatory business. You bet, they die.
QUOTES
Eight Belles
“She ran with the heart of a locomotive, on champagne-glass ankles.” Blaming the breeders and investors, sports writer Sally Jenkins claimed,”thoroughbred racing is in a moral crisis, and everyone now knows it.”
Thoroughbred Racehorses
“Our horses are sick. Our thoroughbreds are thoroughly inbred. They are locomotives sitting atop toothpicks. They are fragile and friable, designed to run but not to recover from running. And each time they break down or wear out, we chalk it up to an individual horse’s shortcomings, rather than the decades-long decline of the entire breeding industry”. — Barry Petchesky (Deadspin)
Insightful Perspective
“What he liked about horse racing was the minimal investment and the high returns. He didn’t mind horses at all; they were easy on the eyes and exciting to watch.”
“The horse industry in general was a zero-waste proposition: this was one animal you could take from birth, exploit all its qualities – speed, strength, tractability – through breeding, racing, eventing, caléche or companion service, and then profit from its flesh when it had outlived its usefulness.”
Another new study published September 12, 2017 in the Journal of the American Medical Society (JAMA) has made headlines claiming that HRT is not the villain it was once thought to be.
Per the investigators, a statistical review of the results of the damning 2002 WHI study showed that the women taking the hormones did not die earlier or have higher incidence of chronic illness than those taking a placebo.
In fact, to the contrary, this new study asserts that these women experienced a profusion of benefits as a result of taking the HRT – improving the quality of life, preventing osteoporosis, heart disease and Alzheimer’s, and of course a satisfying sex life among other advantages.
An author who penned an article in the Huffington Post by Erika Schwartz MD, self-described as a physician who is a hormones and prevention expert, even goes so far as to tout them as miracle drugs. Laughable at best.
“Hormones are great for you. You are better off with any kind of HRT (bioidentical estradiol, testosterone, conjugated equine estrogen, etc.) than nothing. The WHI study was a most horrific insult to women’s health in recent history. It hurt and still does millions of women. Women are suffering because money was more important than pure science and honest medical discourse.” [1]
Pfizer World Headquarters. Reuters.
How was money more important than science and honest medical discourse? If anything, the WHI resulted in huge losses in profits for Big Pharma, notably Wyeth, now a wholly owned subsidiary of pharmaceutical giant Pfizer.
Moreover, Wyeth was guilty of covering up the truth about HRT and its link to increased incidences of cancer, heart disease and other life-threatening ailments in pursuit of higher profits at the expense of women. A classic example was the use of ghostwriters hired by Wyeth for this very reason.
“The articles, published in medical journals between 1998 and 2005, emphasized the benefits and de-emphasized the risks of taking hormones to protect against maladies like aging skin, heart disease and dementia. That supposed medical consensus benefited Wyeth, the pharmaceutical company that paid a medical communications firm to draft the papers, as sales of its hormone drugs, called Premarin and Prempro, soared to nearly $2 billion in 2001.” [2]
In any case, the study: “Menopausal Hormone Therapy and Long- term All-cause and Cause Specific Mortality; The Women’s Health Initiative Randomized Trials” in its entirety is available here and a brief overview and summary of results can be found here.
The study was an observational follow-up of more than 27,000 postmenopausal women aged 50 to 79 years who were enrolled in the 2 WHI randomized clinical trials between 1993 and 1998 and followed up through December 31, 2014 – a cumulative total of 18 years.
These two trials — the original WHI study, and a second WHI study published two years later — found that taking estrogen plus progestin (Prempro) HRT increased a woman’s risk of heart disease and breast cancer while taking estrogen alone (Premarin) increased the risk of stroke, dementia, and other health dangers including endometrial cancer.
Trio of Rescued Premarin Foals. Photo: Vivian Grant Farrell.
The new study published in JAMA on September 12, 2017 strongly supports the claim that hormone therapy with CEEs (conjugated equine estrogens) in combination with progesterone (e.g. PremPro) and CEEs alone (Premarin) are not associated with “all-cause” mortality. In other words, they are trying to convince women that HRT therapy is not harmful, will not kill you nor shorten your life – those women who took the drugs to alleviate the symptoms of menopause were no more likely to be dead after 18 years than those who didn’t.
“Among postmenopausal women, hormone therapy with CEE plus Progestin (PremPro) for a median of 5.6 years or with CEE alone Premarin for a median of 7.2 years was not associated with risk of all-cause, cardiovascular, or cancer mortality during a cumulative follow-up of 18 years.” [3]
Specifically, HRT taken for 5 to 7 years was not associated with risk of long-term “all-cause” mortality.
So they say.
Yet in the same breath, they continue to advise restrictions on its use based on the age of onset of menopause, the lowest dose possible, for the shortest duration possible, not to be taken with existing risk of cancer and heart disease, blah, blah, blah . . .
“Although these findings lend support to practice guidelines endorsing use of hormone therapy for recently menopausal women with moderate-to-severe symptoms, in the absence of contraindications, the attenuation of age differences with longer follow-up and potential health risks of treatment would not support use of hormone therapy for reducing chronic disease or mortality. Moreover, it is unclear whether benefits would outweigh risks with longer duration of treatment.” [4]
As with other prescription medications and the plethora of warnings, contraindications and precautions, how safe are these drugs, particularly given past studies other than the WHI trials have also shown them to be harbingers of heart disease, cancers and other maladies?
As a matter of fact, according to their analysis, the researchers found that there was indeed a “statistically significant” increase in breast cancer incidence in women who took the combination CEE and Progestin HRT (Prempro) – the same findings as the WHI and other independent studies of which there are many.
“Total cancer mortality did not differ significantly between intervention and placebo groups in either trial despite the increased incidence of breast cancer with CEE plus MPA34 and concerns about an increased risk of hormone-sensitive cancers with both regimens”. [5]
Yet this “critical finding” is obscured in the blanket statements in the many articles circulating the Internet that extol the benefits of HRT as a direct result of this study.
Sadly, often these warnings are not passed on to the unsuspecting patient and are glossed over, even by their physicians. One need only listen to the sweeping comments made by Erika Schwartz, MD, the hormone expert who authored the paper referred to above; “Principal Investigators of 2002 WHI Study Reverse Findings — HRT vindicated in new JAMA article”.
Not only does she recommend all forms of HRT to her patients, as well as making the ridiculous statement that women are suffering because money was more important than science when in fact, money had nothing to do with it — sales of Premarin and its derivatives plunged after the results were released — she has this little rant to add:
“Now oddly media coverage hasn’t really done this report justice. It has been casually covered as a ray of hope but not as the wake-up call it MUST be. While in 2002 the media frenzy killed HRT, the JAMA report was interpreted as light reassurance for HRT. That’s just not right. There is no doubt here. HORMONES DO NOT HARM WOMEN, the medical establishment dogma does.” [6]
Seriously?
The researchers themselves have underscored the limitations of the study, caution the interpretation of the results and warn that cause-specific mortality analyses should be considered exploratory. If that isn’t from the horse’s mouth what is?
So, what to make of this? What prompted these original researchers to revisit this 25 years after the fact? To right a perceived wrong in the hope that the whole debacle of the HRT debate goes away once and for all? To help lessen the stigma so that there will be a resurgence of sales of the Premarin family of drugs?
Your guess is as good as mine, but I am betting it has everything to do with Pfizer’s bottom line.
There is no reason to think that a new study is right and all the previous studies are wrong. But if they are profit driven this is exactly what the drug companies want people to believe.
Class Action Lawsuits
And what about all those class-action lawsuits? Are they suddenly moot? These were massive suits involving thousands and thousands of women, some surviving and others dying. If these drugs don’t cause cancer why on earth did Wyeth/Pfizer lose these lawsuits, many of which were unlawful death suits? Do people really think that companies such as Wyeth and Pfizer have no leverage? Money talks.
The science is there but it seems that there is always some new study funded by these mammoth pharmaceutical companies to cast doubt on the findings if they are not in support of pushing their drugs that make lucrative profits — money before patient safety. In fact, for this study, Pfizer was paid for consultancy and review activities.
Conflict of interest? You be the judge.
As Peter Gotzsche M.D., Director of The Nordic Cochrane Centre and author of “Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Health Care” points out:
“Much of what the drug industry does fulfills the criteria for organized crime in US law,” Dr. Gotzsche said in a recent interview. “And they behave in many ways like the mafia does, they corrupt everyone they can corrupt, they have bought every type of person, even including ministers of health in some countries . . . The drug industry buys the professors first, then chiefs of departments, then other chief physicians and so on, they don’t buy junior doctors.” [7]
Unattributed Google search result.
Lies, Damn Lies and Statistics
The approach to this study is not new and similar studies have been made in the past — for example, one in 2013:
One of the key points is that in these studies the results of the WHI are broken down by age groups, rather than individuals treated as a single cohort. The other principal factor is that the statistical analysis used in both the current and 2013 study was hypothesis testing (statistical significance) using “P values”. And in each case, the conclusions were the same — HRT is safe (with some restrictions).
While this age-stratified analysis is a good approach, what of the actual statistical method used to arrive at the conclusions?
Without going into detail about hypothesis testing and the use of “P values” to predict the significance of an event, this statistical method and its applicability to medical research has been shown repeatedly that conclusions based on calculating “P values” are frequently false. Just as statistical significance does not always mean a result is real, lack of statistical significance (which they are using in this study) does not mean that there is no effect.
In fact, observant experts have been pointing out serious flaws in standard statistical testing for decades. In recent years, the depth of the problem has become more apparent and better documented, yet the medical community continues to employ these methods simply because these methods have been embedded in the scientific process. In effect, it is not just medical research, but all research fields, that often draw erroneous conclusions.
Even the researchers warn of caution when interpreting these results:
“Finally, the nominal P values presented here should be interpreted cautiously, as multiple outcomes and subgroups were examined. Thus, cause-specific mortality analyses should be considered exploratory.” [8]
And yet, this new study is being promoted as leading-edge “feel-good” news for menopausal women across the globe via social media without recognition of the caveats associated with the results. Reckless endangerment at its best.
Yes, ladies, you can breathe a sigh of relief. Or not.
“The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.” [9]
In truth, the best solution to determine the safety of HRT on the health of menopausal women would be to repeat the experiment without the flaws that existed in the original WHI studies. Unfortunately, often studies are too complicated, lengthy or expensive to repeat.
Or, as in this case perhaps, the drug company does not want to pursue a wholly comprehensive study as it will further affect sales if found to negatively impact the health of patients, just as it did originally – why take the time and money if only to find that HRT does in fact cause heart disease, cancer and the like.
That is both a financial risk and a precarious risk where damning results could leave a stain on the brand name and negatively affect profits if the results are published. However, drug companies publish only a fraction of the studies they fund — the ones that promote their drugs. Unwanted results are not published.
Sadly, doctors must rely on academic peer-reviewed medical journals to learn about prescription drugs and pass these findings onto their patients in the way of prescription medications. What choice do they have?
“Pharmaceutical companies know this and have worked hard to sway the leadership. Now the question comes up if we can trust the data that the leadership relies on. One wonders how deep the deception goes. In fact, the heavy influence of pharmaceutical dollars inspired the former editor-in-chief of the New England Journal of Medicine, Dr. Marcia Angell, to conclude, “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.” [10]
In the News
It is always tempting for journalists and scientists alike to report a finding that is contrary to popular belief. This is no exception.
For years after the damning result of the WHI study, and to this day forward, HRT has been a controversial subject. When a study emerges that defies previous findings, often the magnitude of the effect is overstated and the less likely the research findings are to be true.
Then there is the enticing phrase “Contrary to previous scientific belief . . .”.
“Ordinarily, “contrary to previous belief” should be a warning flag that the result being reported is likely to be wrong. Instead it is usually a green light to go with the story. So the general criteria of newsworthiness—a first report, in a hot field, producing findings contrary to previous belief—seem designed specifically to select the scientific papers most likely to be bogus.” [11]
Add to this, the HRT media campaigns by Pfizer and others that underplay the dangers of cancer and heart disease. These types of studies that shine a positive light on the use of HRT to control symptoms of menopause clearly add more arsenal to their strategy. Billions are spent on direct-to-consumer ads promoting drugs that Big Pharma say are intended to raise awareness of treatment options.
The truth is, direct-to-consumer advertising is used to drive choice rather than inform it – the ‘driving’ typically in the direction of expensive brand-name drugs. [12]
The only two countries in the world that allow direct-to-consumer advertising are the U.S. and New Zealand.
Survey’s carried out in both countries have shown that when a patient asks for a specific drug their family physician is likely to prescribe that drug over others such as generics or alternatives, for example.
But it is more insidious than this since the ugly truth is that doctors are being enticed by pharmaceutical companies to prescribe their drugs.
In a gullible nation that has been brainwashed by Big Pharma, and their physicians who receive 95% of their information from this very source, there is little difficulty persuading the masses that drugs are the answer to any “condition” although many of these so-called illnesses are treatable by lifestyle changes or, in effect, are not diseases at all. [13]
Such is the case for the ubiquitous Premarin family of drugs.
“The medical profession is being bought by the pharmaceutical industry, not only in terms of practice of medicine but also in terms of teaching and research.” Arnold Seymour Relman. Image Source: True Activist.
So, I leave you with this.
“The medical profession is being bought by the pharmaceutical industry, not only in terms of the practice of medicine, but also in terms of teaching and research. The academic institutions of this country are allowing themselves to be the paid agents of the pharmaceutical industry. I think it’s disgraceful.” – Arnold Seymour Relman (1923-2014), Harvard Professor of Medicine and former Editor-in-Chief of the New England Medical Journal [14]
The Women’s Health Initiative (WHI) was initiated by the U.S. National Institutes of Health (NIH) in 1991. The Women’s Health Initiative, which consisted of three clinical trials (CT) and an observational study (OS), was conducted to address major health issues causing morbidity and mortality in postmenopausal women.
Related Reading
Further reading on the use of “P values” and other sources of statistical error:
Pfizer’s Premarin family of HRT drugs is made from the urine of pregnant mares.
The Premarin family of drugs is made from the estrogen rich urine of pregnant mares. Hence the name Pregnant Mare’s Urine.
The conjugated equine estrogens produced from the urine of pregnant mares to make these drugs have been declared known carcinogens by the World Health Organization.
Learn how more about how these horses are used and what happens to cast off mares and byproduct foals at Premstoppers at http://horsefund.org/premstoppers-home.php.
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Please share far and wide, on behalf of women and horses.
MARCH AGAINST HORSE SLAUGHTER — The top 10 countries with the highest horse meat export value are responsible for about 90% of the world’s total value in 1000’s of USD as shown in Table 6 and the accompanying bar chart.
This represents almost a half billion USD ($478,729,000).
Table 6 – Top 10 horse meat export value (1000’s of USD) by country – 2013
The top 10 countries with the highest horse meat import value are responsible for about 96% of the world’s total value in 1000’s of USD as shown in Table 7 and the accompanying bar chart. This represents almost a half billion USD ($491,588,000), similar to the value of the global exports.
Table 7 – Top 10 horse meat import value (1000’s of USD) by country – 2013
To be continued with a summary of all the horse slaughter and horse meat statistics and numbers we have published here, provided by Jane Allin.
