: Derived from conjugated estrogens found in the urine of pregnant mares [14, 15].

Now, she clicked through page after page of results. The websites were a dizzying mix of clinical information and bright, flashing "Buy Now" buttons. She learned things she hadn't known—that the name was a portmanteau for gnant Mar es' Un ine [14, 15], a fact that made her pause, thinking of the horses on the farms she passed during summer drives. She read about the history of the drug, how it had been helping women since the 1940s [15, 22].

: A valid doctor’s prescription is required to legally buy Premarin [5, 12]. If you're comfortable sharing,

: There is currently no therapeutically equivalent generic version of Premarin [10, 14].

: Potential increase in the risk of blood clots, stroke, heart disease, and breast cancer [1, 2, 3].

He had nodded sympathetically. "There’s no generic for Premarin, Martha. It’s a complex biological drug."

Her doctor had written the prescription weeks ago, but a trip to the local pharmacy had left her in shock. "One hundred and forty dollars?" she had whispered to the pharmacist. "For a thirty-day supply?"

: Treatment of menopause symptoms (hot flashes, vaginal dryness) and prevention of osteoporosis [3, 20, 21]. Forms : Available as oral tablets and vaginal cream [4, 17].