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Canadian Med Center

Low Estrogen and the use of Premarin

Thursday 20 February 2020
6 minute(s) read

Table of Contents

I. What is Estrogen?

II. The Importance of Estrogen

III. Menopause Overview

IV. What to Know Before Using Premarin

V. Common Side Effects

a. Physical Changes

b. Internal Side Effects

VI. Is Hormone Therapy Right for You?

Low Estrogen and the use of Premarin

What is Estrogen?

Estrogen is a vital part of the reproductive cycle and function for women. Hormones tell specific tissues to act in a certain way, which initiates the creation of female secondary sexual characteristics in adolescence. Estrogen is not just one specific hormone but refers to a group of chemically similar hormones, including estrone, estradiol, and estriol. Medications like Premarin possess estrogen in order to help with symptoms of menopause. These estrogens circulate the bloodstream and bind to estrogen receptors on cells, affecting not only the sex organs but a woman’s bones, liver, and heart. [1]

Low estrogen most often occurs in menopausal women, but certain conditions can lead to low estrogen levels in young women. Young women experiencing eating disorders like anorexia are more likely to have lower estrogen as well as those who excessively exercise. Turner Syndrome (a genetic abnormality of the sex chromosomes) and irregularities in the pituitary gland can also lead to a decrease in estrogen. 

The Importance of Estrogen

The right amount of estrogen in the female body is vital to a healthy and functioning system. Low estrogen can cause infertility, depression, weight gain, weak bones, and irregular periods. To learn more about the effects of estrogen on the female body, read below.

Mammary Glands: Estrogen is vital in the development of breasts during adolescence and proper estrogen levels stop the flow of milk when a baby is no longer breastfeeding.

Uterus: The mucous membrane that lines the uterus is enhanced by estrogen. Estrogen is crucial in stimulating the uterine muscles to contract and develop. These contractions also help during childbirth and help expel dead tissue during a woman’s period.

Fallopian Tubes: A healthy flow of estrogen reinforces the fallopian tubes. A thick muscular wall in the fallopian tubes helps transfer egg and sperm cells.

Ovaries: The growth of egg follicles are stimulated by estrogen.

Vagina: The vaginal wall is thickened by estrogen and creates a naturally acidic environment that helps reduce bacterial infections.

Cervix: Estrogen regulates the flow of mucous secretions and helps the movement of a sperm cell as well as the fertilization of egg follicles. [2]

an illustration of the female reproductive organs

Menopause Overview

Menopause occurs when menstrual periods stop, and a woman can no longer get pregnant. On average, a woman experiences menopause in the United States at 52 years old. You have reached full menopause after 12 consecutive months without a menstrual cycle. Your body’s transition from perimenopause (around menopause) to full menopause comes with a lot of random hormonal changes, which sometimes require estrogen replacement drugs. 

As a woman ages, the ovaries release fewer and fewer hormones. When menopause comes on, the number of ovarian follicles (hormone-secreting mechanisms) decreases. Luteinising Hormone (LH) and the Follicle-Stimulating Hormone (FSH) are two of the critical hormones that become less responsive as the ovaries age. These hormones are responsible for reproduction, and their effectiveness decreases as the ovaries age. [3]

Once a woman hits menopause, LH and FSH can no longer regulate the release of estrogen, which causes undesirable menopause symptoms. The symptoms of menopause can include mood swings, painful sex, vaginal dryness, hot flashes, sleep problems, and low sex drive. These changes can make a woman feel abnormal and unlike themselves, so medications like Premarin help smooth this transition. [4]

a blonde lady

What to Know Before Using Premarin

Premarin is a medication used by menopausal and post-menopausal women. Premarin is made of conjugated estrogen hormones, putting them in the category of hormone replacement therapies (HRT). Premarin can be consumed in tablet form or a Premarin cream can be applied with an applicator. This medication can also help replace natural estrogen in women with ovarian failure or other hormonal imbalances. It helps reduce symptoms of menopause like vaginal dryness, hot flashes, and osteoporosis (bone weakening). [5]

Premarin can be useful in regulating the hormone levels of menopausal women, but knowledge of your prior medical history is essential before starting this medication. Like all medications, Premarin has a lot of active and inactive ingredients, so discussing any possible allergic reactions with your doctor is recommended. Interestingly, the drug’s active ingredient is from the urine of pregnant mares, which is the origin of the name “Premarin.”

Hormones like estrogen (the main ingredient in Premarin) interact with many medications and bodily functions. Introducing synthetic estrogen to the body can have adverse effects if you have pre-existing conditions such as:

  • Unusual vaginal bleeding
  • History of heart attacks or stroke
  • History of hormone-related cancers
  • Liver disease
  • Increased risk of blood clots

If you have had any of these diseases or disorders, tell your doctor before considering Premarin. Pre-menopausal women with low estrogen still have the possibility of pregnancy, so make sure you are not pregnant before considering this medication. Taking Premarin while pregnant has been linked to birth defects in unborn children. This drug also transfers to the baby through breastfeeding and can hinder the production of breast milk in nursing mothers. [6]

Common Side Effects

a. Physical Changes

Because estrogen affects so many parts of the body, several side effects can occur when a patient begins hormonal replacement treatments like Premarin. Loss of scalp hair is common because fluctuating estrogen levels can lead to stalled hair growth on the head but may increase hair growth on other parts of the body. Breast tenderness or swelling can also occur. [7]

Many women report changes in their skin after menopausal symptoms begin, and some medications can enhance this condition. Menopause can cause hypoestrogenism (accelerated age-related deterioration), which leads to thinner skin, increased wrinkles, and skin dryness. Skin-darkening (melasma) is also common. [8]

a before-after illustration of female balding

b. Internal Side Effects

Stomach cramps, nausea, vomiting, and bloating are common symptoms associated with hormone replacements. Estrogen is closely linked to headaches and migraines, so introducing new hormones to your system may increase these pains. Problems are likely to improve with prolonged estrogen use as the hormone levels stabilize.

Some side effects are harder to quantify but often reported with estrogen medications. Some examples include decreased sex drive, nervousness, dizziness, and lethargy. Again, these symptoms usually sort themselves out but consult your doctor if they persist. [7]

Is Hormone Therapy Right for You?

Consulting a doctor is the first step to a successful path of treatment. The balance of hormones within the body is a delicate process, so your doctor will determine the proper dosage for you. Estrogen therapies and other hormone therapies will continue to be re-evaluated as time goes on, and symptom severity fluctuates. Premarin is a therapy for menopausal women, but hormone therapies can be used in both men and women to treat certain illnesses. 

Estrogen therapies have their pros and cons, but if you are an overall healthy person with a clean family medical history, these treatments could work to improve your daily life. There are several types of hormone therapies, including systemic and low-dose vaginal products. If you want to learn more about the different types of hormone therapies, please visit.[9]

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.