Premarin for older women

I am 74 and have taken Premarin since age 31 (43+ years), which means that I have never had any chemistry change within my system. There are 3 chemistry issues within the body: thyroid, pancreas, and estrogen. The medical community balances the thyroid and pancreas (diabetes), but not estrogen. My doctor retired and I found only ONE doctor who was willing to prescribe an Estradiol patch for the next 12 months because she is retiring at that time. I have not seen any difference with the patch. I now find that there is an enormous problem for all of us who have taken estrogen for the long term, and the result of that problem is the lack of data and/or studies to guide or advise us as to what medical consequences, if any, we may suffer if we stop taking it after more than 30-50 years. An equally important problem is what options are there if we want to continue taking estrogen because we experienced a lifetime of excellent health? Taking Premarin for more than 43 years has prevented heart disease for me since it was a result of hereditary factors. At age 43, my cholesterol was almost 500 and at age 58, with the same cholesterol level, my triglycerides were 672. I have battled those scores for more than 40+ years and they are now in the normal ranges but I still have to monitor them. My bone density (June 2021) came in with a Z-score for the lumbar spine of 0.3, neck -0.1, and hip .04, and those scores are compared to the bone mass of a 30 year old adult, the lower the number, the greater loss of bone. I have been medically diagnosed as "frozen in time" to a young/middle-aged women because of long term use of Premarin and statins. I had a normal mammogram in June 2021. The problems are "(1) what to do if I/we can't continue getting the prescription for estrogen, and (2) if hospitalization won't continue coverage." I believe going public with our "specific group of long term estrogen users" is the only way to bring these problems to the attention of the medical and pharmaceutical communities. They must work on finding a healthy solution, including producing data and studies, for our "long term estrogen group," a group that no one acknowledges or even knows exists.

I am 74 and have taken Premarin since age 31 (43+ years), which means that I have never had any chemistry change within my system. There are 3 chemistry issues within the body: thyroid, pancreas, and estrogen. The medical community balances the thyroid and pancreas (diabetes), but not estrogen. My doctor retired and I found only ONE doctor who was willing to prescribe an Estradiol patch for the next 12 months because she is retiring at that time. I have not seen any difference with the patch. I now find that there is an enormous problem for all of us who have taken estrogen for the long term, and the result of that problem is the lack of data and/or studies to guide or advise us as to what medical consequences, if any, we may suffer if we stop taking it after more than 30-50 years. An equally important problem is what options are there if we want to continue taking estrogen because we experienced a lifetime of excellent health? Taking Premarin for more than 43 years has prevented heart disease for me since it was a result of hereditary factors. At age 43, my cholesterol was almost 500 and at age 58, with the same cholesterol level, my triglycerides were 672. I have battled those scores for more than 40+ years and they are now in the normal ranges but I still have to monitor them. My bone density (June 2021) came in with a Z-score for the lumbar spine of 0.3, neck -0.1, and hip .04, and those scores are compared to the bone mass of a 30 year old adult, the lower the number, the greater loss of bone. I have been medically diagnosed as "frozen in time" to a young/middle-aged women because of long term use of Premarin and statins. I had a normal mammogram in June 2021. The problems are "(1) what to do if I/we can't continue getting the prescription for estrogen, and (2) if hospitalization won't continue coverage." I believe going public with our "specific group of long term estrogen users" is the only way to bring these problems to the attention of the medical and pharmaceutical communities. They must work on finding a healthy solution, including producing data and studies, for our "long term estrogen group," a group that no one acknowledges or even knows exists.

I'm so glad that you posted this. As I posted before, I have been taking Premarin or its equivalent since 1988 and am now 81. After Express Scripts (Blue Cross Blue Shiedl) suddenly stopped covering Premarin. I found a new gynecologist who says he believes that women should be in control of their health care decisions and that while the only concern is blood clots, stopping Premarin, would trigger menopause and could result in very adverse health risks for me. Based on his factual information, he prescribed Premarin at a slightly lower dose 0.3. I am paying $202 every month and waiting for my Canadian online pharmacy to delivery Premarin at a much more reasonable rate of $87 for a three month supply. I am absolutely terrified that I will be cut off and plunged into the unknowns of menopause in my 80's. Express Scripts sent a form asking me to show reasons why they should cover my prescription of Premarin. I think I will forward these excellent posts.

Hello @donna393 and welcome to Mayo Clinic Connect. I can see this is of great concern to you for many reasons. I am so glad that @jumbley39 can relate to your experience and has quickly responded to you.

I'm curious what your current doctor, who is retiring soon, shared with you regarding her thoughts and recommendations for how to manage this concern going forward after the 12-month Rx is up?

Hi, thanks for your response. My doctor's form letter that we received, listed 5 doctors that we could contact. That gives me about 12 months to find someone who will give a 74 year old woman an estrogen prescription. I believe that is going to be a needle in a haystack but have started looking around. For me personally, my excellent long term health depends on getting a prescription but I find it funny that most doctors who would be likely to give me a prescription, are around my age and they all are retiring. Further, I think my medical situation is something that younger doctors are not familiar with and I don't think they want to jeopardize their medical license prescribing estrogen to a 74 year old women. I don't think the medical community is fully aware of how many senior citizen women are taking estrogen. However, given this enormous task, I am ready for the challenge.

I'm currently waiting for my delivery of Premarin from my Canadian pharmacy, and meanwhile have had to pay another $202. for a month's supply of Premarin which my doctor prescribes, but is not covered by Express Scripts. My question today is what is the difference between Premarin and Estradiol? Premarin does not have a generic substitute so if I just switched to Estradiol, as Espress Scripts suggested, wouldn't I be taking a different formulation? To switch from Premarin to Estradiol could cause problems which I currently don't have. Express Scripts is asking me to fill out forms saying that I have tried Estradiol and had a bad reaction, before they will consider covering it If I do have a bad reaction, isn't the bad reaction caused by having to switch medications unnecessarily? At my age, 81, should I risk it?

Estradiol is a naturally occurring estrogen hormone while Premarin is a drug that consists of a mixture of estrogen.
As mentioned before, I switched from Premarin to Estradiol in March 2021 (at age 74 after taking Premarin for 43 years) and I have not experienced any changes of any kind. I have read a few articles indicating that, based upon when Estradiol was started, it has some indication of preserving brain function (memory, etc). I seem to have a little more energy over these past several months but can't say if it was a result of changing estrogen as I have always had a very high level of energy. I would be interested in knowing what your decision is and any result you may experience.
Donna 393

I'm currently waiting for my delivery of Premarin from my Canadian pharmacy, and meanwhile have had to pay another $202. for a month's supply of Premarin which my doctor prescribes, but is not covered by Express Scripts. My question today is what is the difference between Premarin and Estradiol? Premarin does not have a generic substitute so if I just switched to Estradiol, as Espress Scripts suggested, wouldn't I be taking a different formulation? To switch from Premarin to Estradiol could cause problems which I currently don't have. Express Scripts is asking me to fill out forms saying that I have tried Estradiol and had a bad reaction, before they will consider covering it If I do have a bad reaction, isn't the bad reaction caused by having to switch medications unnecessarily? At my age, 81, should I risk it?

Donna, are you using the Estradiol cream? I’ve had wicked hot flashes since my Premarin pills were taken away, even though I had a hysterectomy 25 years ago. Nothing seems to help - not even extra-strength Estroven. I’m so tired of being told that’s the way it is by every doctor I’ve talked with.
Estradiol three times a week is a placebo for me. 🙁
Deborah

Hi Deborah, thanks for responding. I was put on .625 mg of Premarin at age 31, and went off in March, 3 months ago. I was immediately put on 0.05 mg of Estradiol (patch) so I am getting 7 days of estrogen and have not any changes from Premarin to estradiol. I am not a believer of any estrogen cream products—from what people have said—it just doesn’t get the job done! When did you go off Premarin & what was the dosage?