Health Centres - Premarin vaginal cream
How does it work?
Premarin vaginal cream contains conjugated oestrogens as the active ingredient. These are naturally occuring forms of the main female sex hormone, oestrogen.
Womens’ ovaries gradually produce less and less oestrogen in the period up to the menopause, and oestrogen blood levels decline as a result. The declining levels of oestrogen can cause distressing symptoms, and often affect the delicate lining of the vagina. Oestrogen deficiency can cause vaginal dryness, inflammation or itching, or shrinking and wasting of the vulval tissues. This in turn can lead to sex being uncomfortable or painful, and to an increased susceptibility to vaginal or urinary infections.
Oestrogen can be given as a supplement to replace the falling levels in the body and help reduce the distressing symptoms of the menopause. This is known as hormone replacement therapy (HRT). Oestrogen (in this case in the form of conjugated oestrogens) can also be applied to the vagina or inserted directly into the vagina in the form of vaginal cream, in order to directly supplement the vaginal tissues with oestrogen. This is known as topical HRT and is useful for relieving just the vaginal symptoms of the menopause.
Premarin vaginal cream supplies oestrogen directly into the vaginal tissues and is used short-term to provide relief from the vaginal symptoms of the menopause, such as dryness, itching and irritation. The cream is designed to be used on a cyclical basis. This means it should be used every day for three weeks, followed by a week off.
The oestrogen from Premarin vaginal cream is absorbed from the vagina into the bloodstream. This means it may potentially be associated with the same risks as other forms of HRT and so carries the same warnings. These warnings are most relevent to repeated or long-term use of the cream. You can read more about the risks and benefits of HRT in the factsheet about the menopause linked below. To minimise the absorption of this medicine, the lowest dose to control symptoms should be used. Treatment should be reviewed at least once a year with your doctor.
What is it used for?
- Vaginal symptoms of the menopause (atrophic vaginitis)
- Drying and shrivelling of the external vaginal tissues (a condition called kraurosis vulvae, which is often a result of a skin disease called lichen sclerosis et atrophicus).
Warning!
- Follow the instructions provided with your vaginal cream carefully. The cream can be applied to the external vaginal area, or inserted into the vagina using the applicator provided.
- Using oestrogen-only HRT tablets or patches for a long time can increase the risk of cancer of the lining of the womb (the endometrium). It is possible there may be a similar risk when oestrogen creams, pessaries or rings are used in the vagina for repeated treatments, or over a long period of time.
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