Alternatives to Premarin

Q I had my yearly checkup with my OB/GYN who highly recommended that I use the Climara® Patch or start using Premarin. In 1993, I had a full hysterectomy. I tried using the Premarin; however I suffered more hot flashes and weight gain.

I DO NOT want to use the Climara Patch nor go back to the Premarin tablets. Since discontinuing the Premarin in 1993, I have not had any side effects. Please advise if you carry any products that can be used in place of Premarin or the Climara patch.

I did read the book by Dr Jonathan Wright, Natural Hormone Replacement For Women Over 45. Do you carry any products which he recommended?

DM
A Dear DM, 
As you are probably aware, Premarin is a drug with synthetic conjugated estrogens. The Climara Patch is a transdermal estrogen composed of estradiol 0.05%. Although it is a natural estrogen, it is five times more potent than the prescription Estrace® patch which contains 0.01% estradiol. Dr. John Lee, an expert on natural progesterone replacement, talks in detail about the "Estrogen Dominance Syndrome" in his book, What Your Doctor May Not Tell You about Menopause.1 To very briefly summarize, he states that too much estrogen or synthetic estrogens can be dominating and thus cause undesirable symptoms.

He also states that adequate levels of Natural Progesterone can alleviate or significantly improve most of the problem symptoms. Plus, appropriate levels of progesterone can help prevent and even help reverse osteoporosis, can help prevent heart disease, and can lessen PMS and postmenopausal symptoms of hot flashes, bloating, and swelling. When progesterone levels are adequate, there can also be positive effects on migraines, fibrocystic breasts, high blood pressure, skin problems, and more. Dr. Lee's book is one of my favorites on women's health care.

To answer one of your questions, yes, Life Enhancement does offer a Natural Progesterone cream which, by the way, meets Dr. John Lee's standards for quality, concentration and effectiveness.

Whether estrogen replacement is appropriate for you, or whether Natural Progesterone, or both are for you, will depend on your own individual preferences and body chemistry. However, there is a lot of research available worth considering that substantiates the benefits of these hormones in the areas of osteoporosis and heart disease prevention, among others.

Additionally, neither of these transdermal patches contain all three of the naturally occuring estrogens in the body, the ones Dr. Jonathan Wright speaks about in his book, Natural Hormone Replacement For Women Over 45. Estrogen replacement, whether it is natural or not, is by prescription only. However, Natural Progesterone does not require a prescription.You may want to see a nutritionally-educated physician, or one who is familiar with natural hormone replacement. You can also help educate your own doctor. Best of all, you can become an expert for yourself. Regardless of what you choose, you will need to obtain a prescription. There are compounding pharmacies that can mix together the three natural estrogens in appropriate concentrations in cream or that have different combinations available in oral form. Dr. Wright's recommendation of estrogen combination, in the form of Tri-Est, available from compounding pharmacies,2makes the most sense to me.

Good luck. Let me know what you decide and how things work for you.

Dr V
References 
1. Available from Life Enhancement (see order sheet). 
2. List of compounding pharmacies and offshore sources available through Life Enhancement.