Awareness .. Is your HRT made from Pregnant Mares Urine?

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Is Your HRT made from Pregnant Mare’s Urine?by Angie Macdonald on March 24, 2014 in HEALTH, MENOPAUSE

If you’re pre or post-menopausal you may have been prescribed or even begged your GP for Hormone Replacement Therapy (HRT) to try and relieve some of the awful symptoms.

Perhaps you’ve read up on the wonders of bioidentical hormones and decided you’d like to try them.

But, if your experience is anything like mine, you would have been fobbed off by your doctor and told that bioidentical HRT is too difficult to take, or there’s not enough known about it, and been handed a prescription for Prempak-C or Premarin.

What is Premarin?

If you’ve been prescribed Prempak-C, Prempro, Premique, Premarin or the combined menopausal-osteoporosis drug Duavee (formerly known as Aprela), you have been prescribed a synthetic form of HRT that contains conjugated horse oestrogens.

The Premarin family of drugs contains estrogenic compounds that are made from the urine of pregnant mares.

That’s where the name is derived from: PREgnant MAres’ urINe = Premarin. Any HRT with Prem in the brand name is likely to contain conjugated equine (o)estrogen (CEE).

Although it sounds disgusting, you may still be wondering what the fuss is all about. After all, we may eat gelatin or inject Botox, and most of the time we have no idea what ingredients are in our medicines or beauty products.

So what’s wrong with a little pregnant mare’s urine if it’s going to get rid of your hot flushes and make you feel better?

The problem is two-fold. Firstly, drugs containing CEEs are not well tolerated by the human body and the Premarin family of HRT increases the risk of suffering from thrombosis or a heart attack or breast cancer. And secondly, treatment of the pregnant mares is very cruel.

The Women’s Health Initiative Study and Risks of Prempro Use

Back in July 2002 the Women’s Health Initiative (WHI) study into hormone therapy was stopped abruptly because it was clear that long-term risks of Prempro use clearly outweighed the benefits.

Prempro was a combination pill made up of Premarin and Provera, a synthetic form of progesterone. Women in the study on Prempro were found to suffer more breast cancers, heart attacks, strokes and blood clots than the women taking the placebo.

The results of the WHI study sent shockwaves around the world and women stopped taking HRT in droves. Doctors stopped prescribing it and for over a decade there was a lot of confusion around the safety of HRT.

Unfortunately, when the results of the study were publicised, no distinction was made between synthetic conjugated horse oestrogens like Premarin and bioidentical oestrogen and progesterone.

Bioidentical Hormones

Bioidentical hormones are synthesised in laboratories from hormone precursors found in soybeans or yams and their molecular structure is designed to be an exact replica of the hormones produced by your body. This means that they are easily recognised and produce few of the side effects and diseases associated with synthetic hormones.

The Risks Associated with Premarin

[Premarin tablets] According to Dr Uzzi Reiss in his book The Natural SUPERWOMAN, some of the risks and side-effects associated specifically with Premarin include:


Increased body fat

Cardiovascular events

Arterial sclerotic disease

Venous thrombosis (blood clots in veins) and

Migraine headaches.

And recent research published in JAMA Internal Medicine Journal in January 2014 found that “CEEs use was associated with a higher risk of incident venous thrombosis and possibly myocardial infarction than estradiol use.”

Premarin in the Most Commonly Prescribed HRT in the USA

Premarin is manufactured by global pharmaceutical giant Pfizer. On their website they say “PREMARIN is the #1 prescribed branded estrogen therapy for the relief of moderate to severe menopausal symptoms.”

It begs the question, if so much is known about the risks of Premarin, why are so many doctors continuing to prescribe it for their menopausal patients?

PMU Farming and Cruelty to Horses

Apart from the obvious health risks to women, there is also the issue of cruelty to horses.People for the Ethical Treatment of Animals (PETA) describe how the pregnant mares are:

“Tied in small stalls, unable to move either backwards, forwards, or sideways or lie down comfortably, they stand with sacks strapped to their groins for months on end. In order to make the urine more concentrated, their water intake is restricted, so the horses are constantly thirsty. The foals are considered “byproducts,” and most are fattened up, slaughtered, and sold for horsemeat or turned into dog food.”

[Premarin horses in stall] Up until 2002 Pregnant Mares Urine (PMU) farming was big business in North America and Canada. Hundreds of PMU farms churned out gallons of oestrogen-rich pregnant mares’ urine on a daily basis and were handsomely rewarded by large pharmaceutical companies like Wyeth and Pfizer.

But the WHI scare saw a drop in Premarin and Prempro sales and after 2002 many PMU farms were scaled down. Now, according to equine advocacy organization The Horse Fund, most PMU farming has been relocated to countries with less regulation, like Kazakhstan and China, which has a reputation for animal rights abuses.

Just Say ‘No’

With so many safer alternatives on the market it seems unnecessary to still be manufacturing synthetic oestrogen from pregnant mare’s urine. Not only is it a cruel practice, but it is harmful to the health of the women who are prescribed it.

So, if your doctor prescribes you Prempak-C or Premarin, refuse to accept the prescription. You are under no obligation to accept it. Object on the grounds of animal cruelty and the fact that it is associated with higher risks.

Ask for bioidentical hormones (usually in the form of oestrogen patches or gel and Utrogestan progesterone capsules). If your doctor is reluctant to prescribe them, ask for a referral to a Menopause Clinic or a Gynae-Endocrine Consultant at a hospital.

If more and more women refuse to take this product, there will no longer be a commercial reason to manufacture it. And that will not only benefit the health menopausal women around the globe, but those poor suffering pregnant mares as well.

“We are not spiritually unconnected from the drugs we take, or the pain and suffering that goes into their making.” — ALICE WALK


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8 Replies

  • Posted

    Hi Jayneejay

    Wow!! That was awesome, thanks for great posting. Im a bit stunned actually.

    Is there a bioidentical brand we can research and possibly switch to? Must say, never heard of bioidentical but would like to know more


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    • Posted

      Hi Jean

      its hard to say who should take what.. Its personal choice ... 

      But this info is interesting to know too ..

      Beware of Synthetic Hormone Replacement

      Synthetic progestins (like Provera) are responsible for many, if not most, of the detrimental side effects of HRT. For example, one meta-analysis published in the British Medical Journal in January 20057 found that synthetic HRT is linked to an increased risk of stroke, typically ischemic (caused by blockages of blood flow to your brain). In fact, synthetic HRT boosts your risk of stroke by almost one-third, and your risk of fatal or disabling stroke by more than half.

      One of the trials reviewed in that meta analysis also linked synthetic HRT with higher risks of both breast cancer and heart attack. The trial (which included almost 17,000 women over 50), also found taking HRT for five years doubled your risk of life-threatening blood clots. Other potential side effects of HRT include:


      High blood pressure

      Vaginal bleeding

      Skin rashes and acne

      Weight gain

      Ideally, Use Bioidentical Hormones

      Premarin (the most popular estrogen replacement) comes from **horse estrogens ( pregnant mares urine !!) and is not bioidentical.

      While it may sound “natural,” I recommend avoiding animal estrogens for hormone replacement, as there are excellent human bioidentical estrogen hormones easily available through any compounding pharmacist. Your body recognizes these as “normal” and virtually identical to the hormones produced in your body, which makes them far safer than synthetic prescription versions.

      There are three types of estrogens commonly used in bioidentical hormone replacement therapy: estrone, estradiol, and estriol. A common mixed formulation known as Tri-est includes 80 percent estriol with 10 percent each of estrone and estradiol.

      Estradiol is the primary human female hormone found in all premenopausal women, whereas estriol is produced in significant amounts during pregnancy.

      Estriol is considered the safest of the three and is the most commonly prescribed. It has been used safely for decades, and I believe it's particularly useful when you've had a hysterectomy.

      such as Gynest cream, Ovestin Estriol vaginal cream..

      Unfortunately, there is still much unnecessary concern about bioidentical estrogen supplementation. What the FDA, most doctors, and patients do not realize is that bioidentical hormone supplements can actually optimize your health. That said, your hormone levels should ideally be monitored by either blood, urine, or saliva, to ensure they reach a target level that corresponds to the reference ranges for healthy young women.

      I also believe that menopausal hot flashes that do not resolve with phytoestrogens such as black cohosh, are another valid indication for short-term estrogen use. However, if estrogen is used, it is nearly always wise to use it in conjunction with natural progesterone.

      The Best Way to Administer Bioidentical Hormones

      Keep in mind that when it comes to administering bioidentical hormones, some delivery methods are clearly superior to others. Oral supplementation is perhaps your worst option, as your liver processes everything in your digestive tract first, before it enters your bloodstream, which will metabolize most of the swallowed hormones to inactive and potentially harmful derivatives. Any method that bypasses your liver will therefore be more effective.

      Hormone creams are one common alternative that achieves this. However, since hormones are fat-soluble, they can build up in your fatty tissues and lead to having too much in your body. This in turn can disrupt other hormones. It's also near impossible to accurately determine the dose when using a cream. Sublingual drops can be a good option, as it enters your blood stream directly and will not build up in your tissues like the cream can. It's also much easier to determine the dose you're taking, as each drop is about one milligram.

      Educate Yourself on the Risks and Benefits of HRT

      As you can see, HRT is a very complex subject where it's virtually impossible to make blanket statements covering a majority of women. The risk versus benefit ratio is likely to shift depending on which camp you're in here. Factors to take into consideration are:

      Have you had a hysterectomy?

      Are you pre- or post-menopausal?

      And are you considering HRT for prevention of chronic disease, opposed to treating symptoms of menopause?

      Keep in mind that treating hormone imbalances requires a holistic approach; the best approaches are often preventive and involve diet, exercise and other lifestyle-based strategies. For instance, both estrogen and progesterone are necessary in the female cycle, and their balance is key for optimal health. Many women have an imbalance of these hormones, regardless of their age. And if you have insufficient levels of progesterone to counter excessive estrogen, this imbalance can be further exacerbated by chronic stress.

      So your answer—provided you're not in surgical menopause due to hysterectomy—might not necessarily lie in using hormones, but rather in addressing your stress levels so that your body can normalize your hormone levels naturally... Refined carbohydrates, processed and heated fats, empty foods -- and too much of them -- all serve to raise your estrogen to abnormal levels, as much as twice the normal, which are maintained for the better part of the adult lives of most American women. This is a MAJOR contributing cause of menopausal symptoms in the first place.

      For some women, consuming phytoestrogens (plant-estrogens), such as licorice and alfalfa, before menopause can also help moderate your day-to-day estrogen levels so that when menopause comes, the drop won't be so dramatic. (Beware, however, that soy is not a good option here.)

      You'll also want to make sure your vitamin D levels are optimized, as this is a must for gene regulation and optimal health.

      Certain polyphenols have also been shown to have some HRT-like benefits without the drawbacks, and are associated with a lowered risk of heart disease.

      Royal Matcha seems to be an amazing adaptogenic herbal solution for menopause that has helped many women. Be sure to avoid the inexpensive varieties, as they typically don't work. If you choose this option, make sure to obtain the authentic version from Japan.

      You'll also want to get plenty high-quality animal-based omega-3 fats, such as krill oil, and Black Cohosh may help regulate body temperature and hot flashes.

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  • Posted

     Once again, great post, lots of info we should all be aware of. I am guessing you have a medical background or done tons  of homework. I will be looking into the natural alternatives very soon. Thank you very much for the facts. I found  stress levels most interesting in the control of symptoms, it all makes sense really.

    One point I have, HRT has allowed many, many women to reclaim their lives back again. Some have reported suicidal thoughts, not wanting to endure the day  etc. Please dont be frightened / panicked by these shocking facts, absorb them and decide your next move calmly.  Anyone who has alternatives to share please let us know. 

    Many, many th


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    • Posted

      Hi Jean

      HRT can be a life saver for some women yes ..

      all personal choice ... 

      its also nice to know exactly what your being given too..

      something thats not explained at the GPs surgery..

      i am not against it ... I had a 9-10 years natural peri.. 

      But now using the kinder oestrogen  Estriol vaginal cream just on occassion to assist with vaginal dryness..

      i am noting how it makes me feel, whether it improves anything for me, side effects if any etc etc ..

      estriol is the weaker of the three oestrogens ... And this one was recommended for me personally by my Gyno.. I am post menopause just, age 50 and had a full gyno well woman check before this was even mentioned as a occasional treatment for me ..


      jay xx 


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  • Posted

    It was great to share with you.

    Many many thanks. I am far more informed now. Wonderful post.

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  • Posted

    Hi Jay!

    How've you been? I haven't chatted with you in a while. I was wondering, how many milligrams of B12 do you take? And also do you know if it is safe or unsafe to start birth control at age 40. My GYN mentioned something about the risk of cvancer when taking birth control at age 40 and on. I have never heard of such a thing. I know quite a few women who are on birth control in their 40's and some of the women on this forum mentioned being on it and they were in their 50's. I have been contemplating going back on them to help regulate my horomones and my cycle. What are your thoughts?

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    • Posted


      i  am very good now thanks .. 

      B12 you want the highest .... like jarrows B12 -  5000mcg .. 

      the higher the mcg the better..

      as for combination pill.. i cant comment on that... up to you and your doctor..

      doctors do say smokers are at higher risk over age of 40.. 

      i came off it in lates 30's ... but its all personal choice.

      i chose to get my peri over with and let nature takes it course..

      again all personal choice

      Jay xx


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