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Estrogen replacement therapy is commonly prescribed for women as their natural estrogen levels decline due to a hysterectomy or after menopause. If you have questions and concerns, we're here to help. Give the registered pharmacists at Madison Pharmacy Associates a call at 800-558-7046. We'll work with you and your health professional to arrive at the prescription that will most effectively manage your menopausal symptoms and suit your lifestyle. Hormone Balance As with all of the major hormones, baseline and follow-up testing of estrogen levels is critical for maintaining hormone levels in a physiologic range and avoiding the side effects of under or overdosing. Estrogen Medications When taken alone, estrogen can cause the cells in the uterine lining to become crowded or malformed and possibly cancerous. Therefore, when you still have a uterus estrogen is often prescribed in combination with progesterone, which controls that effect and protects you from endometrial abnormalities. Testosterone, which benefits libido and bone health, may also be prescribed. Even women who do not have a uterus and use progesterone therapy along with their estrogen experience beneficial effects with mood, fluid retention, and sleep. Premarin made from a combination of estrogens, including conjugated estrogens derived from pregnant mare's urine, has been the most commonly prescribed estrogen supplement in the U.S. for the past 50 years and is the estrogen used in many well-publicized studies, including the Women's Health Initiative study (where Premarin and Prempro were used.) It is important to note that the conjugated estrogens in Premarin are not natural hormones, but must be converted by the body into active estrogens. Therefore, the results of studies using Premarin can not necessarily be applied to natural estrogens. Natural estrogens, derived from soy, are identical in chemical structure and act in the same way as the estrogen your body naturally produces. Estrogen Medications | TYPE | BRAND | FORMS | DAILY DOSAGE RANGES |
| | Estradiol | Estrace or Generic | Oral tablet | 0.5 - 2.0 mg | | Estrace 0.01% | Vaginal cream | 1 - 4 gm | | Estring | Vaginal Ring | 7.5 ug | | Alora, Estraderm, Climara, Vivelle, FemPatch | Transdermal patches | 0.025 - 0.1 mg | | Menostar | Transdermal patch | 0.014 mg | | EstroGel 0.75 mg/pump | Transdermal gel | 1 pump | | Estrasorb 4.35 mg/pouch | Transdermal emulsion | 2 pouches | | Compounded by a pharmacist | Sublingual tablet | 0.05 - 1.0 mg | | | Transdermal cream | 0.025 - 0.1 mg | | | Oral Capsule | 0.25 - 2.0 mg |
| | Conjugated estrogens - estrone combined with other estrogens, some derived from urine of mares | Premarin | Oral tablet | 0.3 - 1.25 mg | | Premarin 0.625 mg/gram | Vaginal cream | 0.5 - 2 gm | Premphase
(combination of conjugated conjugated estrogens estrogens and a synthetic progestin) | Oral tablet | Tablets contain 0.625 and 5.0 mg
medroxyprogesterone
synthetic progestin) | | Prempro (combination of conjugated estrogens and a synthetic progestin) | Oral tablet | Tablets contain
0.3 - 0.625 mg conjugated estrogens and 1.5 - 5.0 mg
medroxyprogesterone
(synthetic progestin) | Testing and Prescriptions At Madison Pharmacy Associates, our prescriptions are individually formulated and prepared just for you. Our original formulas use only natural hormones molecularly identical to the ones your body produces. Your prescribing physician can choose from many different strengths and delivery systems, from conventional to customized. Anyone using or considering estrogen therapy should also consider testing her salivary hormone levels through the Restore® Program. The Restore® Program includes testing, a comprehensive written evaluation with suggestions for individualized hormone therapy compounded by Madison Pharmacy Associates, Inc. and ongoing case management to address your questions and concerns. Use of the Restore® Program is the most effective way to determine your individualized, low-dose hormone therapy needs while avoiding over and underdosing. Please call us with your questions at 800.558.7046.
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