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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.
More serious side effects include bone loss, blood clots, allergic reactions, and liver problems. [10] Use is not recommended during pregnancy as it may harm the baby . [ 10 ] MPA is an artificial progestogen , and as such activates the progesterone receptor , the biological target of progesterone . [ 4 ]
Conjugated estrogens was introduced for medical use under the brand name Premarin in Canada in 1941, in the United States in 1942, and in the United Kingdom in 1956. [80] The manufacturer of Premarin secretly paid gynecologist Robert A. Wilson to promote its use by menopausal women in his 1966 book, Feminine Forever, leading to increased sales ...
Other side effects of estrogens include an increased risk of blood clots, cardiovascular disease, and, when combined with most progestogens, breast cancer. [1] In men, estrogens can cause breast development , feminization , infertility , low testosterone levels , and sexual dysfunction among others.
More recently developed forms of drug delivery are alleged to have increased local effect lower dosing, fewer side effects, and constant rather than cyclical serum hormone levels. [1] [2] Transdermal and vaginal estrogen, in particular, avoid first pass metabolism through the liver. This in turn prevents an increase in clotting factors and ...
Conjugated estrogens (Premarin) – 25 mg/vial; Estradiol cypionate (Depo-Estradiol, Estradiol Cypionate) – 5 mg/mL (1 mg/mL and 3 mg/mL discontinued) Estradiol valerate (Delestrogen, Estradiol Valerate) – 10 mg/mL, 20 mg/mL, 40 mg/mL; Polyestradiol phosphate (Estradurin) was previously available in the U.S. but was discontinued.
Adverse effects can also occur in the urinary, central or peripheral nervous, or musculoskeletal systems. [35] A review of clinical trials studying bioidentical progesterone use found that it was ineffective in managing vasomotor symptoms of menopause, but had mild and self-limiting side effects. [36]
Vaginal estrogen is a form of estrogen that is delivered by intravaginal administration.Vaginally administered estrogens are thereby exerting their effects mainly in the nearby tissue, with more limited systemic effects compared to orally administered estrogens. [1]