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Premarin is a combination of more than ten various estrogens - including estrone (which we make in our own bodies), and equilin and equilenin (horse estrogen - which, of course, we don't make in our own bodies). In fact, the name Premarin comes from "pregnant mare's urine". . . which is its source. Since it comes from horse urine, the pharmaceutical company that manufactures Premarin (Wyeth-Ayerst Laboratories) deems it a natural estrogen. They are theoretically correct; after all, horse urine is positively natural! However, by most standard descriptions of natural as it applies to HRT, Premarin isn't considered one of the "naturals" because it isn't the same as the estrogen we create in our own bodies.

Some individuals have a prejudice against Premarin due to its source, however, in all equality, because conjugated estrogen is comparable to our own estrogen, Premarin has been publicized to eliminate the warning signs of menopause, to avoid bone loss and appears to defend against cardiovascular disease. Additionally, studies performed by the pharmaceutical company signify that the horse estrogen may be more successful than human estrogen in improving blood cholesterol levels and may in fact help avert the increased risk of breast cancer.   These results, however, have not been confirmed by an outside study, therefore it is tough to be sure about these claims. Actually, other studies hold that Premarin, based on the fact that it isn't natural to your body, may cause cancer, while natural estrogens won't. It's yet another facet of the ongoing HRT debate.

These are the downfalls -. It seems that you get a increased amount of estrogen in your blood with Premarin than you do with other estrogens. The perpetrator here is the equilin. The quantity of equilin you get from Premarin is much higher than your usual level of the human estrogens, estradiol and estrone. Since it is so strong, it appears to tax your liver more than other non-equine estrogens do, which can mean trouble particularly if you have a history of liver disease in your family or have had liver disorder yourself, smoke, are obese, or have high blood pressure.

Generally, the subject, as to whether or not Premarin is the right choice for you comes down to your longing for a natural (that is, bioidentical) estrogen or one that only approximates the estrogen you physically make. Studies have shown that Premarin will work to battle osteoporosis and heart disease and reduce symptoms as well as other forms of estrogen. Furthermore, because it has been studied so widely, doctors often feel most comfortable prescribing this.

Pluses: Broadly studied; most commonly prescribed estrogen; seems successful in alleviating symptoms and preserving bone density

Minuses: Not the same as the estrogen your body makes; some women feel awkward taking an estrogen made from horses' urine; stronger than many other estrogens, so may cause changes in your liver