Estrogens, conjugated equine

Amenorrhea (primary Conjugated equine estrogen 0.625-1.25 mg by mouth daily Thromboembolism, breast... 

Many systemically administered estrogen products are available in the United States, but conjugated equine estrogens (CEEs), prepared from the urine of pregnant mares, is the most widely prescribed. Transdermal estrogen preparations are also available and usually are prescribed for patients who experience adverse effects, elevated triglycerides, or liver function abnormalities while taking an oral product. Transdermal preparations also have a lower incidence of venous thromboembolism than oral preparations.9... 

Topical Estrogens Vaginal creams Conjugated equine estrogens 0.5-2g/day... 

Anderson GL, Limacher M, Assaf AR, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy The Women s Health Initiative randomized, controlled trial. JAMA 2004 291 1701-1712. 

Espeland MA, Rapp SR, Shumaker SA, et al. Conjugated equine estrogens and global cognitive function in postmenopausal women Women s Health Initiative memory study. JAMA 2004 291 2959-2968. 

Utian WH, Shoupe D, Backmann G, et al. Relief of vasomotor symptoms and vaginal atrophy with lower doses of conjugated equine estrogens and medroxyprogesterone acetate. Fertil Steril 2001 75 1065-1079. 

BA, bioavailability BP, blood pressure CEE, conjugated equine estrogens CrCI, creatinine clearance CYP450, cytochrome P-450 DR, delayed-release Ml, myocardial infarction PV, per vagina Sign., significantly TD, transdermal TE, thromboembolism. 

Conjugated equine estrogens are composed of estrone sulfate (50% to 60%) and other estrogens such as equilin and 17 a-dihydroequilin. 

Conjugated equine estrogens 03, 0.45, 0.625,0.9, 1.25 mg Orally administered estrogens stimu-... 

CEE, conjugated equine estrogens MPA, medroxyprogesterone acetate NETA, norethindrone acetate. 

Low-dose hormone therapy (conjugated equine estrogen 0.45 mg and medroxyprogesterone acetate 1.5 mg/day) has demonstrated equivalent symptom relief and bone density preservation without an increase in endometrial hyperplasia. Whether such lower doses will be safer (cause less venous thromboembolism and breast cancer) remains to be seen. 

An estrogen dose equivalent to at least 1.25 mg conjugated equine estrogen (or 100 meg transdermal estradiol) is needed to achieve adequate replacement in young women, and a progestogen should be given for 12 to 14 days per calendar month to prevent endometrial hyperplasia. 

Jayachandran M, Mukherjee R, Steinkamp T, Labreche P, Bracamonte MP, Okano H, Owen WG, Miller VM (2005) Differential effects of 17 beta -estradiol, conjugated equine estrogen and raloxifene on mRNA expression, aggregation and secretion in platelets. Am J Physiol Heart Circ Physiol 288 H2355-362... 

Mijatovic V, Netelenbos C, van der Mooren MJ, de Valk-de Roo GW, Jakobs C, Kene-mans P (1998) Randomized, double-blind, placebo-controlled study of the effects of raloxifene and conjugated equine estrogen on plasma homocysteine levels in healthy postmenopausal women. Fertil Steril 70 1085-1089... 

Reid IR, Eastell R, Fogelman I, Adachi JD, Rosen A, Netelenbos C, Watts NB, Seeman E, Ciaccia AV, Draper MW (2004) A comparison of the effects of raloxifene and conjugated equine estrogen on bone and lipids in healthy postmenopausal women. Arch Intern... 

Anderson GL,LimacherM,Assaf ARetal. (2004) Effects of conjugated equine estrogens in postmenopausal women with hysterectomy. J Am Med Assoc 291 1701-1712... 

Estrogen replacement therapy can prevent bone loss and actually increase bone density in postmenopausal women. Estrogen treatment is the most effective therapy for osteoporosis and significantly reduces the incidence of bone fractures in postmenopausal women. The usual dose of estrogen prescribed is 0.625 mg/day of conjugated equine estrogens (Premarin). Alternatively, a transdermal estrogen patch can be used. 

Conjugated equine estrogens (Premarin) are the most commonly used estrogens in the treatment of menopause-associated vasomotor symptoms and osteoporosis. Premarin is a mixture of estrogen sulfates, including estrone, equilin, and 17-(3-dihydroequilin. The sulfate derivatives are orally active and are cleaved within the body to yield the active, unconjugated estrogen. 

Some women are rejecting conjugated equine estrogens in favor of preparations containing lower-potency estriol, a weak human estrogen produced in pregnancy and thought to be more protective of the... 

In a randomized, double-blind, placebo-controlled arm of the Women s Health Initiative, 10 739 postmenopausal women, aged 50-79 years, with prior hysterectomies, were randomly assigned to receive either conjugated equine estrogen 0.625 mg/day or placebo. There was an increased risk of stroke (RR = 1.39 95% Cl = 1.10,1.77). 

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