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[1] [12] The equine estrogens differ from human estrogens in that they have additional double bonds in the B ring of the steroid nucleus. [1] [12] CEEs contain both 17β-estrogens like estradiol and 17β-dihydroequilin and the C17α epimers like 17α-estradiol and 17α-dihydroequilin. [1] [12
Atypical (dual estrogen and nitrogen mustard alkylating antineoplastic): Estramustine phosphate sodium (Emcyt) – 140 mg; Oral estradiol valerate (except in combination with dienogest as an oral contraceptive) is not available in the U.S. and is used primarily in Europe. [2]
Conjugated estrogens/medroxyprogesterone acetate (CEs/MPA), sold under the brand names Prempro and Premphase, is a combination product of conjugated equine estrogens (Premarin), an estrogen collected from horse urine, and medroxyprogesterone acetate (Provera), a progestogen, which is used in menopausal hormone therapy for the treatment of menopausal symptoms.
8,9-Dehydroestradiol, or Δ 8-17β-estradiol, also known as estra-1,3,5(10),8-tetraen-17β-ol-3-one, is a naturally occurring steroidal estrogen found in horses which is closely related to equilin, equilenin, and estradiol, and, as the 3-sulfate ester sodium salt, is a minor constituent of conjugated estrogens (Premarin). [1]
However, the FDA does have authority over the compounded product. [2] In 2001 the FDA surveyed a limited number of compounded preparations, including eight hormone compounds. All three estradiol products passed every test; however, two out of five progesterone products failed at least one test of potency, content or uniformity. [2]
Conjugated estrogens (brand name Premarin), an estrogen product manufactured from the urine of pregnant mares and commonly used in menopausal hormone therapy, is a mixture of natural estrogens including estrone sulfate and equine estrogens such as equilin sulfate and 17β-dihydroequilin sulfate. [1]
Estradiol 17β-chloral hemiacetal ether O,O-diacetate Estradiol sulfate: Estradiol 3-sulfate – Estrapronicate: Estradiol 3-propionate 17β-nicotinate Orestrate: Estradiol 3-propionate 17β-(1-cyclohexenyl) ether – Polyestradiol phosphate: Estradiol 17β-phosphate polymer Promestriene: Estradiol 3-propyl 17β-methyl diether
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