Prempro (conjugated estrogens/medroxyprogesterone acetate tablets), Wyeth, contains two kinds of hormones: estrogens and a progestin. Adding progestin reduces the risk of endometrial cancer in a woman with a uterus. Wyeth estimates that approximately 5 million U.S. women are taking Premarin and 1.5 million are taking Prempro. Approximately 10 million postmenopausal women are taking some form of estrogen, either alone or in combination with a progestin.

Prempro is given to postmenopausal women with a uterus to:

reduce hot flashes
treat vaginal dryness, itching, and burning
help reduce chances of getting osteoporosis (thin weak bones)

Some major points have arisen from a Women's Health Initiative (WHI) stud, these are:

Postmenopausal women should not take estrogen and progestin to protect the heart.
Estrogens and progestins may increase the risk of heart attack, stroke, blood clots and breast cancer.
Although other doses of Prempro and other estrogens and progestins were not studied, postmenopausal women who take estrogens and progestins should also be warned about potential risks, which must be presumed to be the same.
When these drugs are being prescribed only to prevent osteoporosis, other treatments should be considered before prescribing estrogen or estrogen with progestin.
Estrogens and estrogens with progestins should be used at the lowest dose for the shortest duration.

The study results show that of every 10,000 women per year taking Prempro, there would be:

8 more cases of breast cancer
7 more cases of heart attacks
8 more cases of stroke
18 more cases of blood clots in the lungs and leg

Some side effects of estrogens and progestins:

Less common but serious side effects include:

Breast cancer
Uterine cancer
Stroke
Heart attack
Blood clots
Gallbladder disease
Ovarian cancer

Common side effects include:

Headache
Breast pain
Irregular vaginal bleeding or spotting
Stomach cramps
Nausea and vomiting
Hair loss

Specific study findings for the estrogen plus progestin group compared to placebo include:

A 41 percent increase in strokes
A 29 percent increase in heart attacks
A doubling of rates of venous thromboembolism (blood clots)
A 22 percent increase in total cardiovascular disease
A 26 percent increase in breast cancer
A 37 percent reduction in cases of colorectal cancer
A one-third reduction in hip fracture rates
A 24 percent reduction in total fractures
No difference in total mortality (of all causes)

These are not all the possible side effects of Premarin or Prempro. For more information, a health care provider or pharmacist should be consulted.

Long-term risks of Prempro in postmenopausal women include increased risks of breast cancer and thromboembolic disease associated with estrogen and combination estrogen/progestin therapy, as well as increased risk of cardiovascular disease, including myocardial infarction and stroke, in healthy women. (more)

Prempro Links

Prempro Product Information

Wyeth — Prempro manufacturer

NHLBI Stops Trial of Estrogen Plus Progestin Due to Increased Breast Cancer Risk, Lack of Overall Benefit

Systematic Evidence Reviews from the U.S. Preventive Services Task Force

JAMA article on National Use of Postmenopausal Hormone Therapy

Facts About Postmenopausal Hormone Therapy

Questions and Answers for Estrogen and Estrogen with Progestin Therapies for Postmenopausal Women

Facts About Postmenopausal Hormone Therapy

NIH Postmenopausal Hormone Therapy

Hormone Therapy -- Latest News

FDA Office of Women's Health, Menopause & Hormones

Estrogens and Progestins Information Page

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