Conjugated Oestrogens

Conjugated Oestrogens tablets are an oestrogen only continuous HRT for women with or without a uterus. Previously under the brand name Premarin, Conjugated Oestrogens are the generic form of this Hormone Replacement Therapy for symptoms in postmenopausal women caused by an oestrogen deficiency. This kind of treatment is beneficial for patients without a womb/uterus (following hysterectomy) who have had no bleed for at least 12 months. Treatment to control menopausal symptoms should be initiated with the lowest strength; 0.3mg (300mcg). If symptoms are not adequately controlled, higher doses may be prescribed. Once treatment is established the lowest effective dose necessary for the relief of symptoms should be used.

Conjugated Oestrogens are used for relief of symptoms occurring after menopause. During the menopause, the amount of oestrogen produced by a woman’s body drops. This can cause symptoms such as hot face, neck and chest (“hot flushes”). This medication alleviates these symptoms after menopause.

Please Note: This medication is not a contraceptive. If it is less than 12 months since your last menstrual period or you are under 50 years old, you may still need to use additional contraception to prevent pregnancy. Do not use a hormonal contraceptive while using HRT.

For menopausal symptoms the usual dose is one tablet every day. Starting at 0.3mg as the lowest dose, your prescriber will work with you to find the lowest dose to control your symptoms. If your symptoms are not adequately controlled at the lowest dose, then a higher dose can be used. Do not try to take off the coating, divide or crush the tablets as this could affect the way the medication works. Take your tablet at the same time each day as this will help to remind you to take your medicine.

If you are not already taking a HRT product or if you are taking a HRT product that does not give you a monthly bleed you may start your first pack of Conjugated Oestrogens at any convenient time. If you are changing from a HRT product that gives you a monthly bleed, start this new medication the day after you finish the course of the previous product, unless instructed otherwise by your doctor. While you are taking Conjugated Oestrogens you will have no “pill-free” days. You should start your next pack the day after you finish the previous one.

If you forget to take a tablet, don’t worry. Take it as soon as you remember and then carry on taking the remaining tablets at the usual time. Do not take a double dose to make up for a forgotten tablet. Missed tablets may cause a short period of light bleeding in women who have not had a hysterectomy.

Like all medicines, Conjugated Oestrogens can cause side effects, although not everybody gets them. The following side effects are reported more often in women using HRT compared to women not using HRT:

The following serious side effects may occur during treatment:

• swelling of the skin around the face and neck which may cause difficulty breathing
• heart attack
• heavy, irregular or painful bleeds

If any of these side effects occur, you should stop treatment immediately and contact your doctor.

The following side effects may occur during treatment:

Common (in less than 1 in 10, but more than 1 in 100 patients treated):

• headache
• feeling sick
• leg cramps
• abdominal pain
• pelvic pain
• unscheduled bleeding or spotting
• wind
• feeling weak (asthenia)
• weight changes
• rash or itching

The list above isn’t exhaustive. If you experience serious side effects or side effects lasting longer than 3 months then you should consult your doctor immediately.

Make sure you read the patient information leaflet for a full list of side effects, cautions and contraindications. You should only take HRT once you have understood all the warnings and precautions as HRT may increase your chances of getting certain cancers or cardiovascular disease. If you are concerned discuss this with your doctor or The Family Chemist clinician.

Do not take this medication:

• If you are allergic (hypersensitive) to conjugated oestrogens or any of the other ingredients of this medicine
• If you have or have ever had breast cancer, or if you are suspected of having it.
• If you have cancer which is sensitive to oestrogens such as cancer of the lining of the womb (endometrium) or if you are suspected of having it.
• If you have any unexplained vaginal bleeding.
• If you have excessive thickening of the womb lining (endometrial hyperplasia) that is not being treated.
• If you have ever had a blood clot in a vein (thrombosis), such as in the legs (deep venous thrombosis) or the lungs (pulmonary embolism).
• If you have a blood clotting disorder (such as protein C, protein S, or antithrombin deficiency).
• If you have or recently have had a disease caused by blood clots in the arteries, such as a heart attack, stroke or angina.
• If you have or have previously had liver disease.
• If you have a rare blood problem called “porphyria” which is passed down in families (inherited).
• If you are pregnant, or you are breast-feeding.

If any of the above conditions appear for the first time while taking Conjugated Oestrogens, stop taking at once and consult your doctor immediately.

Warnings and precautions

Before you start treatment, speak to your doctor, pharmacist, or nurse if you have ever had any of the following problems, as these may return or become worse:

• fibroids inside your womb
• growth of womb lining outside your womb (endometriosis) or a history of excessive growth of the womb lining (endometrial hyperplasia)
• increased risk of developing blood clots
• increased risk of getting oestrogen-sensitive cancer (such as having a mother, sister or grandmother who has had breast cancer)
• high blood pressure
• heart disease
• a liver disorder (e.g. a benign liver tumour)
• kidney disease
• fluid retention due to cardiac or kidney problems
• diabetes
• gallbladder disease or gallstones
• migraine or severe headaches
• a disease of the immune system that affects many organs of the body (systemic lupus erythematosus, SLE)
• epilepsy
• asthma
• a disease affecting the eardrum and hearing (otosclerosis)
• low blood calcium levels (hypocalcaemia)
• a very high level of fat in your blood (triglycerides).

Stop taking and see a doctor immediately if you notice any of the following when taking HRT:

• any of the conditions mentioned in the “Do not take” section above
• yellowing of the skin or the whites of your eyes (jaundice) as this may be signs of a liver disease
• a large rise in your blood pressure (symptoms may be headache, tiredness, dizziness)
• migraine-like headaches which happen for the first time
• if you become pregnant
• have an allergic reaction, signs of which include a rash, itching, shortness of breath, difficulty in breathing and a swollen face
• if you notice signs of a blood clot, such as:
  • painful swelling and redness of the legs
  • sudden chest pain
  • difficulty in breathing

For more information visit:

https://www.medicines.org.uk/emc/files/pil.100544.pdf

https://www.womens-health-concern.org/

https://patient.info/medicine/oestrogen-and-progestogen-for-hrt

https://www.nhs.uk/conditions/menopause/

https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/