It doesn't sound like such a good idea when you put it like that... And that's because it isn't. Aside from the risks associated with premarin, it also doesn't make sense when it comes to the actual hormones in a human body.

Human Hormones .v. Horse Pee

There are three major estrogens made by humans: estrone, estradiol and estriol.

Estrone is an estrogen made in the body by metabolizing estradiol or another cutely named molecule called androstenedione, and it is rarely used in supplementation. The estrogen Estradiol is the most widely recommended estrogen for menopausal symptoms. Estriol has great benefit to the cells of the vagina but has little effect on breasts or bone. The good news about that is that it doesn’t seem to promote breast cancer and may even be protective against it for most women. So, if a woman has vaginal dryness and/or vaginal cell atrophy, estriol is the best type of estrogen to use.

What is Premarin?

Premarin used to be the first choice, but both doctors and patients have begun to realize that Premarin isn’t estrogen per se, it’s an estrogen like substance found in an extract of pregnant horse urine. Ew. That urine includes both the estrogen estrone, found in humans and horses, and equilin, an estrogen found only in horses. Double Ew.

In contrast, when you use estriol or estradiol, you know exactly what you’re getting: a bioidentical hormone, meaning one that exactly matches what your body makes.

Now that you know why you would want to take estriol, the next logical question is... HOW?

The most common options are pills and creams. Taking a pill means that it is first broken down in your liver. As much as 80% of the hormone in a pill is broken down in the liver, leaving 20% to be used as active hormone. That puts extra strain on the liver.

Creams have become a popular alternative; because they are absorbed quickly and easily into the body, you need to use a lot less, and it’s easy to vary the amount you use. For example by using half a pump or a pump and a half if needed on occasion.

Creams like Silky Peach are a topical, low dose, and effective way to get a dose of estrogen where you need it most. You can buy it here! If you still have questions about the science behind low dose topical estriol, you can check out our amazing Science of Menopause page that has all the details.

If postmenopausal women take more estrogen than they need, they could experience vaginal bleeding*. If that happens, reduce the estrogen amount per day and per week. There is no reason for postmenopausal women to recreate their periods. None. At all. For any reason. Ever. It’s one of the perks of menopause. Enjoy it!

*If scattered vaginal spotting occurs, it is wise to consult with your doctor to rule out the risk of cancer of the uterus. Several recent studies show that progesterone is an important protector against cancer of the uterus, as well as against breast cancer. Progesterone is a major hormone and, after around age 40 we make less and less. So while you are learning this cool stuff about estriol, check our Progesterone blog here.