Premarin – estrogen drug, which regulates the development and maintenance of the female reproductive system, formation of female secondary sex characteristics. Once in the bloodstream, forms a complex with the specific receptor (in the fallopian tubes, cervix, excretory ducts of the mammary glands, vagina, urethra, breast, liver, hypothalamus, pituitary) and stimulates the synthesis of DNA and proteins.
While there is proliferation of the epithelium, increased sensitivity of the muscles of the uterus and tubes to their exciting motor HP.
Decreases bone resorption of Ca2+ in menopause, prevents involution of the genitals. Has hypolipidemic effect, reduces the concentration of LDL in the blood increases – LPVP, the sensitivity to the action of insulin, improves utilization of glucose; stimulates liver globulin, linking sex hormones, renin and blood clotting; impact on the exchange of Ca2+ and phosphorus (contributes to maintenance of normal bone structure, indirectly contributes to the formation of the skeleton and its final growth). In large doses it retains water and Na+ in the body, inhibits the erythropoiesis. Through participation in the implementation of positive and negative feedback in the hypothalamic-pituitary-ovarian system, the drug is moderately expressed Central effects. Simplifies (eliminates) the symptoms of menopausal syndrome: hot flashes, increased sweating, dizziness, irritability, depression; prevents the development of post-menopausal osteoporosis. Helps to normalize menstrual cycle in women. In men decreases testosterone concentration.
During treatment it is necessary to remember about the risk of developing cancer of the endometrium in postmenopausal women. Before taking, you should conduct a thorough General medical and gynaecological examination, including examination of the mammary glands and performing vaginal smear Papanicolaou testing for the detection of malignant cells. Similar studies should be carried out every 6 months of treatment. Patients with intact uterus to reduce the risk of hyperplasia or endometrial cancer is administered in combination with a progestogen 10-14 days of the menstrual cycle. If therapy with progestins is not shown gynecological examination with mandatory biopsy of the endometrium. Information about the risk of developing breast cancer in postmenopausal women during treatment with estrogen are controversial. There is an opinion that the use of high doses or prolonged therapy for more than 10 years increases the risk of developing breast cancer.
However, currently most researchers regard this fact unproven. Women receiving estrogen replacement therapy should have regular breast examination, and must be trained in the skills of self-examination. While therapy may increase the existing leiomyoma. There are reports of increased risk of gallbladder disease in women taking estrogens in postmenopausal women. Estrogens accelerate epiphyseal ossification, and therefore should not be used in children and adolescents in the period of intensive growth. The use of estrogens during pregnancy increases the risk of birth defects of the reproductive system in the fetus. Treatment should be discontinued for 1 mo before the planned surgery, a period of prolonged immobilization. If you experience thromboembolic complications, or in case of their appearance estrogen therapy should be terminated immediately. Patients with an increased risk of thromboembolic complications should be monitored carefully.