Premarin Vaginal Cream: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Premarin Vaginal Cream contains conjugated estrogens, a type of estrogen replacement hormone. It is applied inside the vagina to relieve dryness, itching, burning, and painful intercourse linked to menopause, as well as to treat atrophic vaginitis and kraurosis vulvae. It works by replacing estrogen the body loses after menopause. It should be used exactly as prescribed, with regular check-ins with a healthcare provider.

What is Premarin Vaginal Cream

Premarin Vaginal Cream is a medicine that contains a mixture of estrogen hormones. It is applied inside the vagina to treat symptoms of menopause.

Premarin Vaginal Cream uses

• Treats dryness, itching, and burning in and around the vagina after menopause
• Treats moderate to severe pain during sex caused by menopause
• Treats atrophic vaginitis and kraurosis vulvae

Benefits of Premarin Vaginal Cream

• Relieves vaginal dryness
• Reduces burning and irritation
• Helps treat painful intercourse related to menopausal vaginal changes
• Improves vaginal tissue associated with estrogen deficiency
• Helps manage genitourinary symptoms of menopause

How Premarin Vaginal Cream works

The cream contains a mix of estrogen hormones. It works by replacing the estrogen your body loses after menopause, which helps relieve vaginal dryness and irritation.

Premarin Vaginal Cream dosage

Use the applicator provided to insert the cream into the vagina. Lie on your back with your knees bent, then gently insert the applicator deep into the vagina and press the plunger down to release the cream. Depending on what you're using it for, you may apply it daily for three weeks followed by one week with no cream, repeated in cycles, or apply it twice a week.

Wash your hands before and after applying the cream, and wash the applicator with mild soap and warm water after each use. Do not boil the applicator or use hot water to clean it. Use the lowest dose that controls your symptoms, and talk with your healthcare provider regularly, such as every 3 to 6 months, about whether you still need treatment.

Available forms and strengths

• Vaginal cream

Side effects of Premarin Vaginal Cream

Common

• Headache
• Breast pain or tenderness
• Irregular vaginal bleeding or spotting
• Stomach or abdominal cramps, bloating
• Nausea and vomiting
• Hair loss
• Vaginal burning, irritation, and itching from inserting the cream
• Pelvic pain
• Vaginal discharge

Serious

• Breast cancer
• Cancer of the uterus (womb)
• Ovarian cancer
• Stroke
• Heart attack
• Blood clots
• Dementia
• Gallbladder disease
• Severe allergic reaction

Warnings and precautions

• Estrogens can increase the risk of cancer of the uterus (womb) in women who still have a uterus, especially with unopposed estrogen use. Report any unusual vaginal bleeding right away.
• This medicine should not be used to try to prevent heart disease, heart attacks, strokes, or dementia—it does not protect against these and may increase some risks.
• Studies found a higher risk of stroke and blood clots in the legs or lungs in women taking this type of estrogen.
• A study in women age 65 and older found a higher risk of developing probable dementia in those using estrogen therapy.
• Using estrogen combined with a progestin was linked to a higher risk of invasive breast cancer in a major study.
• The cream can weaken latex condoms, diaphragms, or cervical caps, so other forms of protection should be considered.
• Do not use this medicine if you have unusual vaginal bleeding that hasn't been checked by a doctor, a history of certain cancers, a recent stroke or heart attack, current or past blood clots, liver problems, or a known allergy to the ingredients.
• This medicine should not be used during pregnancy or if you think you might be pregnant.
• Tell your healthcare provider if you are breastfeeding, because the hormones in this cream can pass into breast milk, and it may reduce the amount and quality of your milk.
• The effects of kidney problems on how this medicine works in the body have not been studied.
• This medicine should not be used by people with liver problems or a history of liver disease, since the body may not process the hormone properly.
• No major direct interaction with alcohol is expected, but excessive alcohol can increase some estrogen-related health risks.
• This medicine generally does not impair driving.

Storage

• Store at room temperature (approximately 25°C)
• Keep out of the reach of children

When to see a doctor

• Call your healthcare provider right away if you notice new breast lumps, unusual vaginal bleeding, changes in vision or speech, sudden severe headaches, severe chest or leg pain, shortness of breath, or swelling of the lips, tongue, or face.
• Seek emergency care right away if you have signs of a stroke, such as sudden trouble talking or walking, numbness on one side of the body or face, severe headache, dizziness, or confusion.
• Seek emergency care right away if you have signs of a heart attack, such as chest pain or tightness, shortness of breath, sweating, nausea, or pain spreading to your shoulder, arm, neck, or jaw.
• Seek emergency care right away if you have signs of a blood clot, such as chest pain, shortness of breath, dizziness, fast heart rate, or swelling, pain, or redness in the arms or legs.
• Tell your healthcare provider right away about any lumps, pain, swelling, or changes in your breasts, swollen lymph nodes, unusual or heavy vaginal bleeding, bloating, extreme tiredness, or stomach-area pain, as these could be signs of cancer.
• Stop using the medicine and contact your healthcare provider if you suddenly cannot see out of one or both eyes, or if you have bulging eyes, double vision, or migraines.

Alternatives

• Estradiol vaginal cream
• Estradiol vaginal ring
• Prasterone vaginal insert