Koala,

1 Microgram = 0.001 Milligrams.

It SOUNDS like your doc has your right around 1 gram per day to start with. But with time and as you said, you will be taking that down to 2x a week. I have to laugh because when I first started using the Premarin Cream, I was told to use 1 gram per day which equates to .625 per day. Oh, boy, did I ever get "hits" from that. I was having PMS like symptoms those whole two weeks. I hadn't had PMS for ages so I didn't recognize it for what it was. But that's when the doc explained that the vaginal mucosa acts like a sieve. Since my tissues were very thin I was abosrbing it fast and often of course. But then when I started the "maintenance" dose as he put it, 2x a week, I was much, much better. Over time and of course after stopping the Vivelle dot patch .025, I now use the .625 3x a week but at HALF a gram. I no longer have the "hits" at all and again, at the last checkup my tissues are in great shape...so he said.

Anyway, I have no doubt that acne could occur but I just didn't have that happen at all as I never even used 1 gram of the Vivelle dot. It was always .05, then down again and finally to .025.

A friend of mine called yesterday and she was talking about the Premarin Cream. A bit OT I know. But she had issues with the Vivelle dot and can
t use any form of transdermal patch or oral estrogen. So, she is also using the Premarin Cream and sees the same Urogyn and the same RE I do. Anyway, it was also a balancing act for her so I suggested to try it the way I was doing. She was using 1 gram (.625) twice a week but then went ahead and took it down to half a gram. She told me she is doing much, much better using that amount 3x a week. It seems to the both of us that it is just enough and more consistent. Forgot to add too...both of us have had total hysterectomies so it has been a real balancing act through the years.

And know too, our requirements have changed. That was something else that was mentioned by our doc. In the beginning we were taking or using higher doses. But since 8 years have passed since our surgeries we were able to go much, much lower.

Anyway, what it all comes down to is what is the lowest and most effective dose to treat our symptoms. Everyone is sooo different.

As for the Evening Primrose Oil, I tried that a LONG time ago. I can't really comment on it since I didn't take it for very long. Maybe Mrs. D. can explain more about it.