New Estrogen With Lower Risk

Is taking estrogen safe or not safe? It depends. A new medication pairs an “old estrogen” with a “new partner” to tip the balance towards safety. The results look promising.

Are you confused about estrogen? You are not alone. Before the Women’s Health Initiative (WHI) was published in 2002, Premarin® was one of the most widely used medications in the world. But after the WHI suggested that Premarin’s side effects caused an increase in breast cancer, blood clots, stroke and heart attacks, women panicked and threw away their estrogen. Understandable in light of the report, but new data sheds new light on the subject.

More recently, two important things have changed: 1) many of the negative claims about Premarin have since been either reduced or modified and 2) the latest and greatest new estrogen teams up the medication Premarin with a new SERM or selective estrogen receptor modulator called bazedoxifene. The brand name for this is called Duavee®.

The exciting part about this medication is that bazedoxifene, which acts like a progestin meaning it blocks the potential negative side effects of the Premarin, but does not block the hormone’s beneficial effects. This fact has increased the bazedoxifene approval levels greatly.

The March 2014 issue of the journal Menopause has two articles on Duavee and its beneficial affect on improving sleep in women coping with menopause. The study was part of the SMART (Selective estrogens, Menopause, And Response to Therapy) trials.

Bazedoxifene blocks the potential negative side effects of Premarin

In the first study, 318 women with moderate to severe hot flashes and 459 patients with severe hot flashes and sleep disturbances were analyzed. The study was about hot flashes causes and how they can be treated. The women receiving Duavee had significantly improved hot flashes and sleep quality, mostly because their hot flashes got much better and stopped waking them up. However, among the women with the most severe hot flashes, their sleep improved directly due to the medication’s effect on sleep.

The second study looked at the affects of Duavee on a woman’s sleep and health-related quality of life (HRQoL) after one year of treatment. In this study of 459 women with bothersome to severe hot flashes, the women received either Duavee, PremPro (which is Premarin + medroxyprogesterone – the medication in the WHI study) or a placebo. PremPro reviews vary according to the woman using the medicine.

At the end of one year, the Duavee was as good as the PremPro for improving hot flashes and sleep and much, much better than placebo. But here is the interesting part: The Duavee has been shown to also protect bones from osteoporosis and prevent vaginal dryness while having no negative affect on breast or the uterine lining so it does not carry an increased risk of uterine cancer. The difference is due to pairing up the Premarin with bazedoxifene rather than with medroxyprogesterone. This new medication holds great potential for helping women treat hot flashes and sleep issues with a lower risk of potential serious side effects.

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