As I receive more and more requests from patients and physicians alike about alternatives to Premarin, I am compelled to share with you the following information. 

As you are probably aware, Premarin is manufactured from pregnant mares' urine, complete with its impurities as well as ingredients not yet identified.  Wyeth-Ayerst conceals this urine in Premarin by coating each tablet 20 times, but the odor of urine is unmasked by simply crushing the tablet. Adding a drop or 2 of water makes a pungent urine scented broth

More and more women are seeking alternatives to Premarin as they learn that it contains urine and its production entails a 6 month confinement of pregnant mares in narrow stalls, with harm being caused by lack of synovial fluid moving through fixed legs, chronic thirst from restricted water, psychological distress from extreme boredom, and a slaughter process faced by over 50,000 "by-products" (baby horses) of this "pee-line" process.  Additional information about the production of Premarin is found at a toll free number maintained by Dr. Kachman "1-800-KNOW-PMU".

The very good news is, there are several plant-derived and synthetic alternatives that contain estrogen without  the impurities found in urine or contribute to the distress of  animals.  The most common alternative I observe being prescribed is Estrace, followed by Estratab.  As a pharmacist, I have yet to hear complaints from a patient who is using an alternative to Premarin.

Just as the utilization of pigs in the production of insulin is antiquated, so is the production of estrogen from horses.  There are now plant and synthetic Estrogen sources available(see attached).  When it is my turn for hormone replacement, I will not be taking Premarin.

Please share the enclosed information with fellow physicians and pharmacists. Our patients certainly have a right to hear what is in the drugs they are prescribed and how they are obtained!   Alice Walker, author of The Color Purple has said, "We are not spiritually unconnected from the drugs we take, or from the pain and suffering that goes into their making."  These are good watchwords, especially touching as you realize the suffering occurring and that this is needless pain.

Will you please share your thoughts on this subject by taking a few moments to complete the enclosed survey regarding ERT Therapy?

Towards the good of all animals, (including human)

I am respectfully,


Christine Emmons, R.Ph.

P.S. PMU ribbons, much like the AIDS and breast cancer awareness ribbons, are available by writing or calling me.  The ribbons are made of horse hair and contain a crystal "tear" to recall the 50,000 baby horses facing the slaughter process every year from the production of Premarin..