Premarin is the brand name for a compound drug consisting of conjugated estrogens. Isolated from mare's urine (PREgnant MARes' urINe), it is manufactured by Wyeth Pharmaceuticals and has been marketed since 1942. It is available as Premarin cream for topical application. It is also available in tablet forms - Premarin 0.3, Premarin 0.45, Premarin 0.625 and Premarin 1.25.
Premarin Cream is a treatment that can soothe tissues in and around the vagina. And it doesn't just mask symptoms temporarily. Unlike over-the-counter lubricants and moisturizers, PREMARIN Vaginal Cream actually reverses changes in the vagina that occur with menopause and can help maintain this reversal with continued use.
Picture of Premarin Cream
vaginal Premarin cream For Atrophic Vaginitis
What is atrophic vaginitis?
- Atrophy is the partial or complete wasting away of body tissue.
- Vaginitis is inflammation of the vagina.
What local genital symptoms might be associated with the menopause?
After the menopause, as a result of vaginal atrophy due to loss of estrogen, vaginal dryness and discomfort are more likely to become a problem for you. Local infection, atrophic vaginitis, becomes more common now that there is less protective lactic acid and this may result in inflammation causing soreness and discharge.
The vaginal dryness and inflammation may cause discomfort or even pain when you make love (dyspareunia). On occasion, the inflammation may cause bleeding. All postmenopausal bleeding must be investigated (17).
The peri menopause symptoms associated with atrophic vaginitis are:-
- Genital Dryness
- Itching
- Burning
- Dyspareunia - Painful Sex
- Burning leukorrhea
- Pruritis Vulvae
- Feeling of pressure
- Yellow malodorous discharge
- Urinary :-
- Dysuria
- Urinary Frequency
- Nocturia - Bladder emptying at night
- Cystitis
- Urinary tract infection
- Urinary Stress incontinence
These atrophic vaginitis symptoms can occur as pre menopause symptoms although they are more common in post menopausal women.
How can atrophic vaginitis - dry vagina at menopause - painful sex - be treated?
Topical oestrogen (creams and pessaries) are commonly used in postmenopausal women to improve the quality of the vaginal epithelium in atrophic vaginitis.
Fifteen percent of premenopausal women, 10-40% of postmenopausal women, and 10-25% of women receiving systemic hormone therapy experience urogenital atrophy.
The most common symptoms are dryness, burning, pruritus, irritation, and dyspareunia (painful sexual intercourse). Topical Estrogen or hormone replacement therapy (ERT-HRT) is the treatment of choice in postmenopausal women.0101
If genital symptoms, such as vaginal dryness, pain during lovemaking or perhaps bladder symptoms are troubling you, these could be due to reduced oestrogen levels in the tissues around the genital area. These symptoms usually respond to HRT or to topical preparations (oestrogen creams or pessaries).
On occasion, local symptoms may fail to respond to HRT anyway and additional topical oestrogen may be required.
To begin with, the creams or pessaries are introduced each night for ten days to two weeks and then reduced to a maintenance regime varying from twice weekly to perhaps no more than once each month depending on symptoms, age and response. There are a variety of topical oestrogen preparations (Table 28.1).
Estring (Pharmacia and Upjohn), a synthetic soft rubber ring which slowly releases oestradiol can be introduced into the vagina and replaced at three monthly intervals. If the uterus is still present intermittent courses of progestogen should be considered to encourage endometrial shedding (HRT and progestogen). The ring is as effective as oestrogen creams and some women find the ring more acceptable.
Table 28.1 Topical creams and pessaries that are commonly used in menopause treatment.
|
Preparation |
Oestrogen |
Company |
| Ortho-Gynest Pessaries | Oestriol 500 g | Janssen-Cilag |
| Ortho-Gynest Cream | Oestriol 0.01% | Janssen-Cilag |
| Ovestin Cream | Oestriol 0.1% | Organon |
| Ovestin Pessaries | Oestradiol 1mg | Organon |
| Premarin Cream | Conjugated oestrogens 625 mg | Wyeth |
| Vagifem Pessaries | Oestradiol 25 microg | Novo Nordisk |
| Estring Ring | Oestradiol (7.5 microg release/day) | Pharmacia and Upjohn |
