A mixture of a variety of estrogens obtained entirely from natural sources, usually from the urine of a pregnant mare. These estrogens are blended to represent the average composition of the hormonal materials.

They usually contain estrone, equilin, and 17 a-dihydroequilin, and smaller amounts of 17 a-estradiol, equilenin, and 17 a-dihydroequilenin

The most well-known and most common of pharmaceuticals containing conjugated estrogens is Premarin.

There are synthetic, FDA-approved alternatives. such as Ogen, Estrace, Estradiol Transdermal System, Estradiol tablets, Estropipate, Estrone, Meneste, and Cenestin.


Dosage varies widely with the reason for taking the drug. 1.25 mg is most common for post-menopausal women, with dosage adjusted based on the patient's reaction to the medication. For less common medical problems, dosage may run up to 7.5mg daily.

A physical examination is recommended before a patient starts taking conjugated estrogens, and also regular examinations while the drugs are being taken.

Side Effects:

Changes in vaginal bleeding pattern and abnormal withdrawal bleeding or flow, Breakthrough bleeding, spotting, increase in size of uterine fibromyomata. vaginal candidiasis, changes in amount of cervical secretion, breast tenderness or enlargement, nausea, vomiting, abdominal cramps, bloating, skin chloasma or melasma, loss of scalp hair, intolerance of contact lenses, headache, migraine, dizziness, depression, increases or decreases in weight, reduced tolerance to carbohydrates, changes in libido

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