"By switching from Premarin to another estrogen, women are personally empowered to change the lives of thousands of horses." - Joan Saxton, M.D.
"After changing patients from Premarin to an alternative estrogen replacement therapy, I discovered all other alternatives to be comparable to Premarin in effectiveness." - Robyn Marquez, CNP
This year as many as 50,000 horses will be made pregnant to go on a production line. For 7 months of her 11-month pregnancy, each mare will be confined to a stall probably
smaller in area than your dinner table.
What makes the pregnant mares special is their urine. On over 700 PMU (pregnant mare urine) farms in Canada and the midwestern United States, the confined mares wear a harness to collect their urine. The urine is processed into the drug, Premarin, which has dominated the estrogen replacement therapy market in the United States since 1942.
A mare will normally live 20-30 years. Lack of exercise, decreased water consumption, constant pregnancy, injury, and disease, cause most PMU horses to burn out in 5 or 6 years.
This year, in March and April, the mares will give birth to as many as 50,000 foals. Some foals will replace worn-out mares, some will be sold as companion animals, but most will go to the slaughterhouse to satisfy Japanese and European tastes. Over 50 years, this "harvest" has killed millions of foals.
It's also produced big profits. Worldwide, about 8 million women take Premarin to relieve menopausal symptoms and to help prevent osteoporosis. Premarin earns its maker, Wyeth-Ayerst, more than a billion dollars a year. Because Wyeth-Ayerst spends millions every year promoting Premarin to doctors, many doctors prescribe routinely without considering the numerous non-equine alternatives. Unfortunately, Wyeth-Ayerst is not alone; another company, Natural Biologics, is producing a "generic" pregnant mare urine product in an attempt to divert part of Premarin's dollar flow.
The continual misery suffered by the mares and foals is antiquated and unnecessary. Every woman who takes Premarin can help put an end to this shameful industry simply by considering alternatives, not only for Premarin but even for estrogen replacement therapy.
Is estrogen replacement therapy important in relieving menopausal symptoms?
When a woman reaches her forties, her estrogen level drops and her monthly menstrual periods end. Menopause or "change of life" has occurred - the average age is 51.
Menopause is notorious for sleep disturbances, impaired bladder control, vaginal dryness, mood swings, and "hot flashes" (sudden and intense episodes of heat and sweating). These symptoms are often relieved with holistic remedies or estrogen replacement therapy.
Menopausal symptoms, including hot flashes, rarely last longer than six months. In time, the body adjusts to lower estrogen levels.
Does menopause cause osteoporosis?
Bones are a living tissue constantly being rebuilt. As we grow older, new bones are built at a slower pace. When bone loss is greater than bone replacement, osteoporosis results. The bones become extremely fragile, especially at the wrist, spine, and hip.
Roughly 25 million Americans have osteoporosis, four out of five of them women. Bone loss accelerates during the earliest phase of menopause because of estrogen loss.
Estrogen therapy after menopause slows down bone loss, although it should be considered mainly by women who have the greatest risk of osteoporosis. Consult your physician.
Are estrogens completely safe?
Estrogen replacement therapy may increase the risk of uterine (endometrial) cancer, blood clots, and breast cancer. The FDA admits that nobody knows what all the "active" ingredients in Premarin are, although 8 estrogen compounds are currently considered essential. Wyeth-Ayerst researchers claim that there are more than 100 steroids in Premarin. The potential effects of the other 92-plus waste equine steroids
that are no considered "active" are unknown. As with any medication, exercise caution.
When should estrogens be avoided?
Women should
avoid taking estrogen replacements if they are pregnant, have unusual vaginal bleeding, have had cancer, have any circulation problems, after childbirth or when breast-feeding.
Is Premarin the only choice?
Most doctors agree that Premarin is
not the only estrogen replacement effective for preventing osteoporosis and treating the symptoms of menopause. Other estrogen drugs, derived from plants, do not harm mares and foals. A number of herbal and dietary alternatives to estrogen may produce the same beneficial results.
To help prevent osteoporosis, some doctors recommend taking an adequate amount of calcium your life long, either in calcium-rich foods, or by calcium supplements. Others suggest a low-fat high-fiber plant-based diet to help prevent onset of osteoporosis, heart disease, cancer, and some menopausal symptoms. Weight-bearing and strength training exercises also help keep bones strong.
Are there holistic remedies for relieving menopausal symptoms?
Many symptoms can be relieved by diet and lifestyle changes. Plant-based estrogen-like substances called phytoestrogens can mimic some of Premarin's actions. These are found in tofu, berries, soybeans (and isolated soy isoflavones), citrus fruits, and yams. Vitamin E and Omega-3 fatty acids (found in flaxseed oil) have numerous beneficial effects. Many herbs contain phytoestrogens or ahve other actions that may alleviate menopausal symptoms. These include dong quai, black cohosh, red clover, chaste berry, and Siberian ginseng.
Sleeping in a cool room, regular exercise, relaxation and breathing exercises, and yoga may relieve hot flashes and other symptoms. A water-soluble lubricant cream (with or without estrogen) can relieve vaginal dryness.
What other estrogen replacement products are available?
Premarin, PremPro, Premphase, and Estratab are all made, at least in part, from equine (horse) estrogen. Premarin and Estratab are estrogen products; Prempro and Premphase contain both estrogen and progesterone. Many plant-based alternatives are available for all of these.
- Cenestin contains virtually the same active estrogens as Premarin, but contains
no equine product.
- Menest is similar to Estratab but is entirely derived from plants.
- Estrace contains estradiol; it is similar in effect to Premarin. It is a natural plant estrogen but requires a higher dose than some other products.
- Ortho-est and Ogen are tablets containing estrone estropipate, a modified plant estrogen.
- Estraderm, Climera, Vivelle, and Alora are topical patches that release small amounts of the hormone estradiol through the skin into the bloodstream. They do not contain equine products.
- Estratest is an estrogen-progesterone combination derived from plants.
- FemHRT is an estradiol plus progestrone combination that is also used for birth control.
- Fosomax - the first non-hormonal treatment option for post-menopausal women who cannot or will not take estrogen - is available for the treatment of osteoporosis.
- Miacalcin is a nasal spray for the treatment (not prevention) of post-menopausal osteoporosis.
Price Comparison Chart
Average Wholesale Prices from June 15, 2000.
All strengths 0.625 mg, 100 count, unless noted.
| Premarin |
$60.54 |
| Estratab |
$61.72 |
| Menest |
$30.63 |
| Estropipate (Duramed) |
$40.90 |
| Ortho-est, 1.5 mg |
$54.90 |
| Ogen |
$75.60 |
| Fosomax, 10 mg |
$202.96 |
| Estratest, 1.25 methy. and 0.625 est. |
$97.53 |
| Estraderm, 0.1 mg/24 hr patch, 8 count |
$25.59 |
| Estrace, 0.5 mg |
$39.20 |
| Cenestin |
$52.02 |
| Miacalcin, 4 ml bottle |
$61.35 |
Is estrogen replacement therapy right for you?
Before deciding for or against estrogen replacement therapy, discuss it with your doctor. Some alternatives to Premarin may not be right for you - you might be allergic to some medications, or they may not deliver the precise estrogen therapy you need. Not every estrogen drug is approved for every use discussed in this pamphlet.
Please, say "No" to Premarin. By using alternatives to Premarin, you can help stop the endless and unnecessary suffering of mares and the senseless slaughter of their foals.
Restorative and Alternative Therapies
A recent and welcome trend across the country is the opening of menopause centers that help women with hormonal and midlife complaints.
To enhance health, natural therapies such as Chinese medicine, acupuncture, herbs, homeopathy, supplements, vitamins, and natural progesterone are used. Consultations may be offered as well as treatment plans.
An important focus is on education. Many centers feature classes (day and evening) on menopause and osteoporosis, and teach women how to use alternative medical therapies to deal with the discomfort they might be experiencing.
Menopause support groups are popular, offering women the opportunity to share their stories, difficulties, and successes; books and other resources they've discovered; sympathetic practitioners who have helped them; mineral-rich recipes and other supplements that have helped relieve their discomfort.
More Ways You Can Help
Share this information with your family and friends, and take it with you when you see your physician.
Let Wyeth-Ayerst know that it needs to seek estrogen alternatives that don't require an unnecessary production line of horses. Let it know you are changing from Premarin and PremPro and tell it why. Send your letters to:
Robert Essner, President
and
Marc W. Deitch, M.D., Vice President, Medical Affairs and Medical Director
555 Lancaster Avenue
Radnor, PA 19087
A Wyeth-Ayerst toll-free number is (800) 999-9384, or call Dr. Deitch at (610) 971-5500.
Boycott the wares of American Home Products, Wyeth-Ayerst's parent company, which also manufactures Advil, Anacin, Black Flag, Chef Boyardee, Dristan, Easy Off, Jiffy Pop, Neet, Pam, Preparation H, Quick and Easy, Sani-Flush, and Woolite. Be sure to tell John Stafford, American Home Products CEO, at: 5 Giralda Farms, Madison, NJ 07940; or call (973) 660-5000.
For additional information, visit
Premarin: What is It? 
