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Q: Is there a nonprescription alternative to Premarin?

Q: Is there a nonprescription alternative to Premarin?

by Dr. Barb DePree MD

You note that the Premarin you’re using several times each week is expensive, and wonder about a nonprescription alternative. It’s the estrogen contained in that treatment that makes it both a successful treatment and available by prescription. The tissues of the vulva and vagina are very receptive to the healing effects of estrogen, and nothing else is equally effective.

Vaginal moisturizers

Vaginal moisturizers offer benefit to retain moisture especially when the vulva and vagina are healthy; they aren’t able to reverse the atrophy that occurs in menopause. If you’d like to try a vaginal moisturizer, be sure to use it very consistently, two to three times a week. 

You can experiment with a moisturizer to see whether it helps to maintain comfort. 


  • Diana, Premarin is not a significant risk for cancer, and in fact, those women who take Premarin alone (no progesterone, they have had a hysterectomy) had less breast cancer than those who took placebo. If this hormone therapy is working well for you I would recommend you continue it.

    Dr Barb on

  • im a 56 year old women. I taking Premarin for hormones replacement, but I hear this produce cancer cells. I love this pill because I don’t have anymore hot flashes, but I noticed that im loosing my temper leyle also im loosing sleep. I want to take somenting simular, but im looking for helt body too.

    Diana on

  • Jodi, for the treatment of vulvodynia I prescribe a compounded product of estradiol and testosterone, a cream applied directly to the involved area. A careful exam is needed to make sure this is the proper diagnosis.

    *sorry for the delayed response, we had power outages for several days due to storms.

    Dr Barb on

  • Hello Dr. Dupree,

    I was on a zoom call with Revel today and I just learned from you about vulvadynia. I go once a year to my Kaiser doctor and she always said it is dryness that’s causes pain, but no one has answered my question about the awful burning inside and I don’t call that pain. I am having a phone apt with my gynecologist tomorrow and I want to suggest what you said with a cotton swab test and treating the specific area. What other products do you sell or suggest to apply regularly. I have tried hormone cream which burns more and coconut oil which is a temporary relief. Appreciate any more info and thanks for the zoom talk today. I will purchase your book as well.

    Jodi on

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