Is there an alternative to Premarin vaginal cream? It has helped eliminate frequent bladder irritation/infection after sex, but I would prefer to use something else. -- Karen Pope
Premarin vaginal cream is a prescription product designed for women whose estrogen levels are low, as they are after menopause. I'm assuming that your bladder irritation and infections stem from post-menopausal vaginal dryness, a common cause of these problems. You could try cutting back on the dosage if you're concerned about reliance on the drug, but there are alternatives you can explore.
My colleague Ann L. Mattson, MD, medical director of the Boulder Valley Women's Health Center in Colorado and an associate fellow at the Program in Integrative Medicine here at the University of Arizona, suggests prescription alternatives Estrace or Estrace vaginal cream that are "bioidentical" to the body's own estrogen but are made from plant sources (soy and wild yam) . By contrast, the estrogen in Premarin comes from the urine of pregnant horses and is different chemically from the body's own hormones.
Dr. Mattson also suggest the following non-prescription options which she says have been shown to be helpful in reducing the vaginal dryness that occurs with menopause and should indirectly improve bladder symptoms associated with intercourse:
Dr. Andrew Weil