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Traditional HRT has been used for years to treat menopausal symptoms. It is
beneficial in promoting bone health, protection against Alzheimer’s and
genitourinary health. Until recently it was also indicated to prevent heart
disease.
 HRT
uses synthetic conjugated estrogens with or without progestins to replace the
failing ovaries. Premarin is the most popular and best tested synthetic
estrogen. The estrogens in Premarin are derived from the urine of pregnant
horses. It contains conjugated estrogens found in the human body as well as
Equilin which is solely found in horses. The structure of estrone (an estrogen
found in humans which makes up 75-80% of Premarin), and equilin (6-15% of
Premarin) is shown below. Premarin also contains 5-19% E2 estradiol
The image was obtained from: (www.nyu.edu/projects/
geacintov/WEB_EstrR.htm)
HRT came under sharp scrutiny in 2002 when one arm of the WHI study was
cancelled because a predetermined threshold for adverse events was reached. The
women on HRT exceeded the boundary for breast cancer risk that was established
at the beginning of the study. There was also an increased risk for heart
disease for participants on HRT compared to the placebo group.
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