"...stable supply of urine from pregnant horses" -- love that line...
Thank you for this, and your other posts. I am a WHNP, and for the life of me, I couldn't understand why, even though nobody uses porcine insulin anymore, why anyone would want to use equine estrogen either. But your articles have presented a more nuanced view.
I'd previously learned from a Wyeth rep that the horses were kept indoors due to the weather, but your piece on this was also more comprehensive.
The equine estrogens are different than just estradiol, and they do have different benefits. I often use Premarin if someone isn't doing well with transdermal therapy. It's good to have more tools.
Thank you for doing this deep dive! I had wondered about this. I am a life long horse lover, and one thing I can say FOR SURE is that horses bred for sport are usually taken care of better than some humans. Sport horses have massage therapists, eat specialized feed, take supplements, are carefully watched over 24/7 (there is usually a caretaker living at the barn and cameras), see vets often, have farriers come out every 8 or so weeks, see a dentist yearly, etc etc. So if these are sport horses (it sounds like they are) I would have zero qualms about their care. And from a business standpoint, this care makes sense because a healthy well taken care of mare produces offspring that are as well.
This subject seems to evoke a visceral response from people. However, when the American Veterinary Medical Association feels that the standards are acceptable and there have been independent inspections that feel the horses are well cared for, I think we have to trust these experts.
Sport horses (I’m assuming you mean race horses) are some of the most abused animals out there. Only the winners get therapists etc. Many, many get run over and over again until they break down. They get injected with steroids and other substances to mask pain and get them to run faster. When we talk about Kentucky Walking horses the story gets even worse. Their lies get “treated” with caustic substances and weights to cause pain to get them to lift their legs higher so they look better in performance.
And those that don’t do win get sent to Mexico or Canada to be slaughtered for horse meat. Often the transport is under atrocious conditions.
Hi - I wasn’t referring to race horses (I was involved in hunter/jumpers). I do know about Tennessee walkers and that is just horrific. When I started riding and didn’t know anything about horses yet, I visited a saddle seat farm to see if I wanted to start riding there. They put chains around the horses pasterns...and their hooves in general looked really suspect. It was similar to the walkers. 😭 Obviously I didn’t ride there. Anyway, unfortunately there are bad actors in all disciplines and I’m not naive enough to think all sport horses are treated with the same care. At the same time, in the environment I was in, our horses were treated really well. I hope the conditions for these horses have improved.
Thank you for the deep dive into this. While I deeply appreciate that you collected all the facts from the drug maker and the rules, there is a lot of propaganda involved as well. Most of the horses bred are not sport horses who go on to live happy lives as horses. The horses used on these farms are large draft horse types and are strictly kept for this purpose. Draft horses are not that popular anymore. As for not sending the babies off to the horse meat market, most of the males are sent off. Raising a male horse that may or may not be sold is expensive (feed, vet, feet etc). Premarin became less attractive many farms shut down and guess where those horses went, to feed lots.
Full disclosure: I am vegan and a horse owner and what happened then was cruel. Hopefully, the situation has improved. My neighbor owns 3 horses from a Premarin farm, 2 mares and a stallion, now gelding. They are giant over 2000 lbs Percheron horses.
Just wanted add a little background to this. And again, hopefully the regulations have changed and the horses are treated better.
THANK YOU for this!!!!! Not a vegan, but do care that animals are not mistreated. Evaluating HRT with my Dr. Next week, so this is perfect timing to continue my quest for real solutions for myself. Still SHOCKED regarding the information desert and how little funding is being leveraged for this portion of our population. Love what you are doing. Soul searching for how I might join the fight!
As I’m reading about and considering all the choices for my MHT on this incredibly informative and invaluable publication, it doesn’t escape my thoughts that history was like How do we help women? I know! Horse pee!!
Dr. Jen -- I have a question in the 'folklore' dept. I recently got a blurb in the mail talking about 'food as medicine' -- e.g. 'eat pineapple to cure your back pain...'
Among the many 'breakthroughs' purported were two ways to treat menopause: ground flax seed & eating pomegranates (the latter advertised as 'from the Garden of Eden'). Now, I'm sure these two 'remedies' work just as well for menopause as pineapple for back pain, but can you enlighten us as to where these things came from? Thanks.
No real idea, just guesses. Pomegranates are common in "ancient therapies," they show up in a lot of Ancient Greek writings. But medicine and religion were essentially the same, so it's probably more likely related to being the fruit of the dead than anything else. Flax seed I am not sure at all, but suspect it's more modern. Both of these foods are good for you, but won't cure anything.
https://pubmed.ncbi.nlm.nih.gov/22240636/ -- bottom line, it doesn't work, but I'll bet someone is touting the results a 'showing a decrease in hot flashes.' But that's for the *oil*, not even for 'eating pomegranates' as the mailing claimed.
As for flax seeds, I found similar, w/ a report that ground flax seeds contained phyto-estrogens; again no proof of anything.
Not that I needed to be convinced that the thing in the mail didn't have a leg to stand on, but I have to admit, I can understand how the unsuspecting can be caught up in the hoax.
Thank you so much for this timely article. It's perfect and answered so many questions I have about Premarin. I'm thinking about switching from Estrogel to Premarin. I'm beginning to experience
an uptake in hot flashes thru the night. I've been using estrogel for 5 years and my flashing is getting worse. After talking to my mom about my symptoms she suggested I try Premarin based on the success she had with it.
Thank you! I'm on a three-month trial of Duavive and you have helped to eliminate one of the concerns I had about the product. I really appreciate you doing all this research. (I have actually seen women who use Premarin being shamed by animal rights activists on social media.)
Fascinating article that I am so glad you wrote! Is there data head to head comparing estradiol vs Premarin and breast cancer risk? I have heard Premarin may have some advantage for a BRCA carrier but am not sure on the details.
"...stable supply of urine from pregnant horses" -- love that line...
Thank you for this, and your other posts. I am a WHNP, and for the life of me, I couldn't understand why, even though nobody uses porcine insulin anymore, why anyone would want to use equine estrogen either. But your articles have presented a more nuanced view.
I'd previously learned from a Wyeth rep that the horses were kept indoors due to the weather, but your piece on this was also more comprehensive.
The equine estrogens are different than just estradiol, and they do have different benefits. I often use Premarin if someone isn't doing well with transdermal therapy. It's good to have more tools.
Thank you for doing this deep dive! I had wondered about this. I am a life long horse lover, and one thing I can say FOR SURE is that horses bred for sport are usually taken care of better than some humans. Sport horses have massage therapists, eat specialized feed, take supplements, are carefully watched over 24/7 (there is usually a caretaker living at the barn and cameras), see vets often, have farriers come out every 8 or so weeks, see a dentist yearly, etc etc. So if these are sport horses (it sounds like they are) I would have zero qualms about their care. And from a business standpoint, this care makes sense because a healthy well taken care of mare produces offspring that are as well.
This subject seems to evoke a visceral response from people. However, when the American Veterinary Medical Association feels that the standards are acceptable and there have been independent inspections that feel the horses are well cared for, I think we have to trust these experts.
Sport horses (I’m assuming you mean race horses) are some of the most abused animals out there. Only the winners get therapists etc. Many, many get run over and over again until they break down. They get injected with steroids and other substances to mask pain and get them to run faster. When we talk about Kentucky Walking horses the story gets even worse. Their lies get “treated” with caustic substances and weights to cause pain to get them to lift their legs higher so they look better in performance.
And those that don’t do win get sent to Mexico or Canada to be slaughtered for horse meat. Often the transport is under atrocious conditions.
Hi - I wasn’t referring to race horses (I was involved in hunter/jumpers). I do know about Tennessee walkers and that is just horrific. When I started riding and didn’t know anything about horses yet, I visited a saddle seat farm to see if I wanted to start riding there. They put chains around the horses pasterns...and their hooves in general looked really suspect. It was similar to the walkers. 😭 Obviously I didn’t ride there. Anyway, unfortunately there are bad actors in all disciplines and I’m not naive enough to think all sport horses are treated with the same care. At the same time, in the environment I was in, our horses were treated really well. I hope the conditions for these horses have improved.
Thank you for the deep dive into this. While I deeply appreciate that you collected all the facts from the drug maker and the rules, there is a lot of propaganda involved as well. Most of the horses bred are not sport horses who go on to live happy lives as horses. The horses used on these farms are large draft horse types and are strictly kept for this purpose. Draft horses are not that popular anymore. As for not sending the babies off to the horse meat market, most of the males are sent off. Raising a male horse that may or may not be sold is expensive (feed, vet, feet etc). Premarin became less attractive many farms shut down and guess where those horses went, to feed lots.
Full disclosure: I am vegan and a horse owner and what happened then was cruel. Hopefully, the situation has improved. My neighbor owns 3 horses from a Premarin farm, 2 mares and a stallion, now gelding. They are giant over 2000 lbs Percheron horses.
Just wanted add a little background to this. And again, hopefully the regulations have changed and the horses are treated better.
Thank you for adding this context, Andrea. That’s really sad. I hope things have improved, too.
THANK YOU for this!!!!! Not a vegan, but do care that animals are not mistreated. Evaluating HRT with my Dr. Next week, so this is perfect timing to continue my quest for real solutions for myself. Still SHOCKED regarding the information desert and how little funding is being leveraged for this portion of our population. Love what you are doing. Soul searching for how I might join the fight!
As I’m reading about and considering all the choices for my MHT on this incredibly informative and invaluable publication, it doesn’t escape my thoughts that history was like How do we help women? I know! Horse pee!!
Dr. Jen -- I have a question in the 'folklore' dept. I recently got a blurb in the mail talking about 'food as medicine' -- e.g. 'eat pineapple to cure your back pain...'
Among the many 'breakthroughs' purported were two ways to treat menopause: ground flax seed & eating pomegranates (the latter advertised as 'from the Garden of Eden'). Now, I'm sure these two 'remedies' work just as well for menopause as pineapple for back pain, but can you enlighten us as to where these things came from? Thanks.
No real idea, just guesses. Pomegranates are common in "ancient therapies," they show up in a lot of Ancient Greek writings. But medicine and religion were essentially the same, so it's probably more likely related to being the fruit of the dead than anything else. Flax seed I am not sure at all, but suspect it's more modern. Both of these foods are good for you, but won't cure anything.
Thanks. But I was still curious. So I found this:
https://pubmed.ncbi.nlm.nih.gov/22240636/ -- bottom line, it doesn't work, but I'll bet someone is touting the results a 'showing a decrease in hot flashes.' But that's for the *oil*, not even for 'eating pomegranates' as the mailing claimed.
As for flax seeds, I found similar, w/ a report that ground flax seeds contained phyto-estrogens; again no proof of anything.
Not that I needed to be convinced that the thing in the mail didn't have a leg to stand on, but I have to admit, I can understand how the unsuspecting can be caught up in the hoax.
Thank you so much for this timely article. It's perfect and answered so many questions I have about Premarin. I'm thinking about switching from Estrogel to Premarin. I'm beginning to experience
an uptake in hot flashes thru the night. I've been using estrogel for 5 years and my flashing is getting worse. After talking to my mom about my symptoms she suggested I try Premarin based on the success she had with it.
Thanks so much for continuing to educate us!
Thank you! I'm on a three-month trial of Duavive and you have helped to eliminate one of the concerns I had about the product. I really appreciate you doing all this research. (I have actually seen women who use Premarin being shamed by animal rights activists on social media.)
Yeah, I just had to close comments on my Instagram because of that. It's really not ok.
Fascinating article that I am so glad you wrote! Is there data head to head comparing estradiol vs Premarin and breast cancer risk? I have heard Premarin may have some advantage for a BRCA carrier but am not sure on the details.