Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Estrogens are one of the two major classes
of female hormones. (Progestins comprise the second major class). Estrogens are
used primarily to treat the symptoms of menopause and states in which there is a
deficiency of estrogen, for example, in women who have had their ovaries
removed.
Conjugated estrogens are a mixture of several different estrogens (estrogen
salts) that are derived from natural sources and blended to the approximate
composition of estrogens in the urine of pregnant mares. The main components are
sodium estrone sulphate and sodium equilin sulfate. Estrogens have widespread
effects on many tissues in the body. Estrogens cause growth and development of
the female sexual organs and maintain female sexual characteristics such as the
growth of underarm and pubic hair, body contours and skeleton. Estrogens also
increase secretions from the cervix and growth of the inner lining of the uterus
(endometrium).
PRESCRIPTION: Yes.
GENERIC AVAILABLE: No.
PREPARATIONS: Tablets: 0.3, 0.45, 0.625, 0.9, and 1.25 mg. Vaginal
cream: 0.625 mg per gm of cream. Injection: 25 mg
STORAGE: Conjugated estrogen tablets and cream should be stored at
room temperature, between 15-30°C (59-86°F). The injection should be stored
between 2° and 8°C (36° and 46°F).
PRESCRIBED FOR: Conjugated estrogens are used for treating the
symptoms of menopause including hot flashes, vaginal dryness, and vaginal
atrophy. They also are used as therapy when the body does not produce enough
estrogen due to castration (removal of the ovaries), ovarian failure or
underdevelopment of hormone-secreting organs (hypogonadism). Conjugated
estrogens also may be beneficial in treating advanced prostate and breast
cancer. Although estrogens are approved for preventing osteoporosis, other drugs
are more commonly prescribed for this purpose. Intravenous conjugated estrogens
are used for treating abnormal uterine bleeding due to hormonal imbalance.
DOSING: To minimize side effects, the lowest effective oral dose of
conjugated estrogens is used. The usual starting dose for treating symptoms
associated with menopause and for preventing postmenopausal osteoporosis is 0.3
mg/day. The dose should be increased based on response. Conjugated estrogens may
be administered in a continuous or cyclical interval (i.e., 25 days on treatment
then 5 days off treatment).
Hypogonadism is treated with doses of 0.3 mg or 0.625 mg daily with a
cyclical interval of 25 days on treatment followed by 5 days off treatment. The
dose for women who have been castrated or have ovarian failure is 1.25 mg daily
in a cyclical interval of three weeks on treatment and one week off treatment.
In reality, most women take estrogens continuously since during the week off
treatment, symptoms return because of the lack of estrogen. For treatment of
breast cancer, the recommended dose is 10 mg daily for three months.
Abnormal uterine bleeding due to hormonal imbalance is treated with one 25 mg
intravenous or intramuscular injection. Another injection may be given in 6-12
hours if needed.
The vaginal cream is used for treating vulvar and vaginal atrophy, and the
recommended dose is ½ to 2 g daily.
DRUG INTERACTIONS: Estrogens increase the liver's ability to
manufacture factors that promote the clotting of blood. Because of this,
patients receiving warfarin (Coumadin), a drug that thins the blood and prevents
clotting by reducing clotting factors, need to be monitored for loss of the
blood thinning effect if treatment with an estrogen is begun.
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, conversely, high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Learn about osteoporosis, a condition characterized by the loss of bone density, which leads to an increased risk of bone fracture. Unless one experiences a fracture, a person may have osteoporosis for decades without knowing it. Treatment for osteoporosis may involve medications that stop bone loss and increase bone strength and bone formation, as well as quitting smoking, regular exercise, cutting back on alcohol intake, and eating a calcium- and vitamin D-rich balanced diet.
Premature menopause is when a woman goes through menopause before the age of 40 because of genetics, illness, or a medical procedure. Symptoms of premature menopause include irregular or missed periods, mood swings, hot flashes, periods that are heavier or lighter than usual, vaginal dryness, bladder irritability, incontinence, dry skin, eyes or mouth, sleeplessness, and decreased sex drive. Though premature menopause cannot be reversed, the symptoms can be managed with methods similar to those used for natural menopause.
Vaginal dryness and vaginal atrophy occurs in women during perimenopause, menopause, and postmenopause. With vaginal atrophy, the lining of the vaginal wall becomes thinner, drier, less elastic, and light pink to bluish in color. Symptoms of vaginal atrophy include vaginal dryness, itching, irritation, and/or pain during intercourse. Treatment options for vaginal dryness and vaginal atrophy include hormone treatment and over-the-counter vaginal lubricating and moisturizing products.
Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.
Pseudotumor Cerebri (intracranial hypertension) is a condition where there is an increase in pressure of fluid surrounding the brain and spinal cord (cerebrospinal fluid or CSF) mimicing a brain tumor. The cause is unknown. The most common symptom is headache but also include eye-pain, vision loss and double vision. Pseudotumor cerebri is diagnosed with MRI or CAT scans and treated by discontinuing offending medications (if applicable), weight loss and diuretic medications. The condition can also be helped by repeated drainage of spinal fluid using the lumbar puncture.
Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones. Osteopenia is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis.
Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-...