[Becky]

As a Premarin cream user (down to 0.5g every other Wednesday), I want to comment that we don't know the vaginal atrophic state of the women in the study. If they started out fully atrophic, then their vaginal vault had no mature cells in the lining to prevent any absorption of estrogens into the bloodstream. Also, they were using the cream everyday at 1g (1g - 1.5g is the usual dose to be given daily via package directions. After relief, one should scale back to the smallest effective dose). So, they are measuring the estrogen uptake during the absolute worst time ever_ during true therapy to replenish local estrogen levels in order to get maturation of immature vaginal epithelial cells. Not a good study at all. Good only in that we know that even Estring causes a temporary rise in systemic estrogen for the same reason and then it scales back.

I have had my prior to use level taken and then my onc didn't want to remeasure until after 6 wks on Estring (started with this product) and my level was the same. At 9 months, I switched to the small dose of Premarin once a week to "maintain" and I eventually moved to the once every other week and I am fine. I don't worry about this issue at all due to a healthy vagina protecting me as well as such a reduced use.