Many women who are 45-50 years old experience a sudden feeling of heat and sweating. For some, this happens several times a day, and for some, it even wakes them up at night. We call this condition 'Menopause'. Although this is a natural thing, the discomfort that comes with it can be a bit annoying. So today we are talking about a special medicine that doctors prescribe to relieve these discomforts.
What are these conjugated estrogens?
Simply put, this is a female hormone. These pills contain a hormone called estrogen, which is naturally produced in our bodies. During menopause, when menstruation stops permanently, a woman's estrogen levels drop significantly. That's why symptoms like hot flashes, sweating, and vaginal dryness occur.
So what this medicine does is to restore the decreased estrogen hormone to the body. We call that Hormone Replacement Therapy (HRT) .
This medicine is mainly used for:
- Control symptoms associated with menopause, such as hot flashes .
- Prevent osteoporosis, a bone thinning disease caused by low estrogen levels.
- As a treatment for women who have had their ovaries surgically removed or who have low hormone levels for other reasons.
In Sri Lanka, this medication is often sold under the brand name Premarin.
Things you need to tell your doctor before taking this medicine
Since this is a hormonal medication, it may interact with some medical conditions you may have. Therefore, it is extremely important to tell your doctor your complete medical history before starting this medication. Especially if you have any of the following conditions, be sure to tell them.
| Disease or condition | Why is it important to be aware of it? |
|---|---|
| If you have or have had breast, uterine, ovarian, or cervical cancer | These types of cancer are at risk of further growth due to the hormone estrogen. |
| Vaginal bleeding of unknown cause | Because this can be a symptom of a serious condition, hormone treatment is not appropriate before the cause is identified. |
| If you have recently had a blood clot, stroke, or heart attack | Estrogen can further increase the risk of blood clots. |
| High blood pressure, diabetes, high cholesterol | This medication can make these conditions difficult to control, so frequent monitoring is necessary. |
| Liver disease or kidney disease | These organs are important in the process of removing drugs from the body. If there are any diseases in them, the dosage of the medicine may have to be changed. |
| If you are a smoker | The risk of blood clots and stroke is very high , especially for women over the age of 35 who smoke . |
| If you are pregnant or trying to get pregnant | This medicine is not suitable during pregnancy. |
How should I use the medicine and what precautions should I take?
The correct way to take medicine
This is very simple.
- Take the prescribed dose with a glass of water , as prescribed by your doctor.
- The most important thing is to take the pill at the same time every day . This helps maintain the body's hormone levels in a consistent manner.
- Always read the patient insert that comes with your medicine. It contains a lot of important information.
- If you miss a dose: Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next dose at the scheduled time. Never take two doses at once.
- If you drink too much: If you think you have taken too much medicine, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital .
Important: This medicine has been prescribed for you only. Do not give this medicine to a friend, even if they have the same symptoms as you.
Things to be careful about when taking medicine
- Regular medical checkups: While taking this medication, it is important to see your doctor at regular intervals. Talk to your doctor about a schedule for breast exams, Pap smears, and, if necessary, mammograms.
- Before surgery: If you are scheduled to have any surgery, inform your doctor and ask for advice on whether you should stop taking this medication before the surgery.
- Risk to the uterus: If a woman who has not had a hysterectomy takes estrogen-only pills for a long time, there is a very small risk that the lining of the uterus (endometrial hyperplasia) will thicken and turn into cancer. To prevent this, doctors usually prescribe another hormone called progestin along with estrogen. Talk to your doctor about this and choose the treatment that is best for you.
Side effects that may occur due to medication
Like any medicine, this one can cause some side effects. Some of them are serious, some of them are common.
| Serious side effects that should be reported to your doctor immediately | |
|---|---|
| • Chest pain | • Difficulty breathing |
| • Pain, swelling, and redness in the leg, especially the calf | • Sudden, severe headache |
| • Vision changes, difficulty speaking | • Sudden numbness or weakness in the face, arm, or leg |
| • Yellowing of the eyes or skin, dark urine, pale stools | • Abnormal vaginal bleeding |
| • Breast lumps, changes, or discharge | • Allergy symptoms such as skin rashes and itching |
| Common side effects that should be reported to the doctor if they persist or are bothersome: | |
| • Hair loss | • Vaginal infections (itching, discharge) |
| • Nausea, vomiting | • Minor changes in body weight |
Take-Home Message
- Conjugated estrogen is a hormone therapy used to manage menopausal symptoms. It should only be taken under medical advice.
- Before starting this medication, tell your doctor about all medical conditions you have (especially cancer, history of blood clots) and all medications you are taking.
- Women who smoke, especially women over the age of 35, are at a much higher risk of stroke and blood clots when taking this medication.
- If you experience symptoms such as chest pain, difficulty breathing, leg swelling, or severe headache, seek medical advice immediately.
- Do not skip scheduled medical checkups (breast exams, Pap tests) while taking the medication.
- Do not recommend this medicine to your friend or family member, even if their symptoms are similar.
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