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Premarin® Vaginal Cream: Ingredients, Benefits, and Alternatives

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Highlights from this article

Premarin® Vaginal Cream is a hormonal medication that treats vaginal atrophy (or the genitourinary syndrome of menopause).

If you’re 40 or older, you’ve probably experienced symptoms like vaginal dryness , painful sex , overactive bladder, or frequent UTIs . Symptoms can start in your thirties in the perimenopause years, and get progressively worse with time. Up to 85% of postmenopausal women have one or more symptoms of vaginal atrophy.

To alleviate these common symptoms, a doctor can prescribe Premarin® Vaginal Cream. According to the manufacturer’s website, symptoms like painful sex can resolve after 12 weeks.

So, what’s the key information to know about Premarin® Vaginal Cream? We’re here to help explain what this medication can do, what it can’t do, and how to get professional guidance on managing vaginal atrophy symptoms.

It contains conjugated equine estrogens

Premarin® Vaginal Cream contains conjugated equine estrogen, a form of estrogen that’s derived from the urine of pregnant mares, hence the name "Premarin".

Premarin® vaginal cream can help with symptoms such as vaginal dryness, painful sex, overactive bladder, and frequent UTIs. It won’t help with hot flashes or night sweats.

Approved by the FDA

Premarin® Vaginal Cream is one of several FDA-approved formulations to treat vaginal atrophy or the genitourinary syndrome of menopause.

In addition to Premarin® Vaginal Cream, the FDA has approved other vaginal estrogen products, as well as vaginal DHEA and ospemifene. Studies have shown that all forms of vaginal estrogen are similarly effective, so Premarin is no different from other vaginal estrogen products in terms of effectiveness.(1)

Restores the health of the vaginal skin

Premarin® Vaginal Cream works by restoring dry and irritated skin in the vaginal and vulvar area. The medication replenishes the lack of estrogen due to menopause and helps rebuild the tissues.(2) As a result, the vagina, bladder, and urethra, can function like they used to.

It’s expensive, but there are ways to save

The price of Premarin® Vaginal Cream is not listed on the manufacturer’s website, but according to GoodRx, it can cost over $500 per tube. The manufacturer offers a savings program to help you save on your medication, but make sure you’re eligible for the savings.

Animal-free, bio-identical, and non-hormonal alternatives

Because Premarin is derived from animal products, many women might prefer to use an alternative with ingredients that are not derived from animals. Hormone-free alternatives are available as well.

Bio-identical FDA-approved vaginal estradiol

Vaginal estradiol products contain estrogen derived from non-animal sources. Vaginal estradiol is just as effective as Premarin® Vaginal Cream. Estradiol is an estrogen that’s considered bio-identical or body-identical, meaning it’s chemically identical to the estrogen produced by our bodies.

Vaginal estradiol is available by prescription in FDA-approved formulations as a cream, suppository, or ring. At Interlude, you can connect with a board-certified doctor and get a prescription for vaginal estradiol cream or vaginal estradiol suppositories. We offer FDA-approved formulations that ship from US-regulated pharmacies.

Bio-identical compounded vaginal estradiol

Vaginal estradiol can be obtained by prescription through a compounding pharmacy. When getting a prescription through a compounding pharmacy, keep in mind that these formulations are not FDA-approved. So the quality and purity of the medication can vary.

Estrogen-free vaginal DHEA

Vaginal DHEA is available by prescription in an FDA-approved formulation known as Intrarosa. Although this medication does not contain estrogen, the body converts the active ingredient into estrogen. So if you’re uncomfortable with even a small amount of estrogen, this medication may not be for you.

Non-hormonal treatments

Vaginal moisturizers like hyaluronic acid and vaginal lubricants are available over-the-counter and can also help alleviate the symptoms of vaginal atrophy.

Read more: 9 Hormone Replacement Therapy Alternatives for Perimenopause and Menopause

Frequently asked questions

How long does Premarin® Vaginal Cream stay in your system?

Research shows that vaginal estrogen medications like Premarin® are not absorbed throughout the body.(3) Unlike oral hormone medications that travel through your body, vaginal estrogen is prescribed in low doses to treat only the vaginal area. As a result, there’s minimal absorption in the rest of the body.

How long should I wait to have intercourse after using Premarin® Vaginal Cream?

Vaginal estrogen creams like Premarin are not a lubricant, and should not be used before sexual intercourse. The impact of male partners potentially absorbing estrogen medication is unknown. In any event, the medication needs time to absorb. Ideally, you can apply the medication before you go to sleep.

Next steps

Need help switching from Premarin to a more affordable or animal-friendly solution? Interlude is here to help. Not only can a board-certified doctor prescribe vaginal estradiol if it’s appropriate for you, you can ask them any questions you may have. When you sign up for a prescription for vaginal estrogen, a board-certified doctor will review your health profile within hours. Your treatment ships straight to your door.

Disclaimer: This information isn't a substitute for professional medical advice, diagnosis, or treatment. You should never rely upon this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.
References
1) Lethaby A, Ayeleke RO, Roberts H. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev 2016;CD001500.
2) Premarin [package insert]. Philadelphia, PA: Pfizer; 2015.
3) Lee JS, Ettinger B, Stanczyk FZ, et al. Comparison of methods to measure low serum estradiol levels in postmenopausal women. J Clin Endocrinol Metab 2006;91:3791-3797.
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