Speaking as someone who has used Premarin, I do get a bit annoyed by the blanket scare tactics that are used about the medication. We get enough scare/guilt tactics put on us from outside sources without it also coming from within MM. It just seems that even women who are supposed to be supportive of each other, will still try to undermine or scare/guillt other women into not using something that might actually be working better than any other type of HRT. For the right women, Premarin actually presents very little risk.
When it comes to HRT, it ALWAYS comes down to "use what works for you". I posted this recently on another thread, but I had a discussion with my pharmacist recently and she confirmed that she dispenses Premarin far more than estradiol. Here in Australia Premarin is actually more expensive than estradiol, because Premarin isn't covered by PBS, so it's not because it's "cheap". Women want to use what works for them, and I'm sure if the estradiol did the same job they would be using it - and saving money.
For me, over my years of HRT use, I've also had difficulties with another medication to take into account, so I have always tinkered with and chopped and changed the type of HRT I used. Sooner or later whatever I was using would cause me to think there was a problem with the absorption of it, including estradiol patches.
The only one that ever seemed to be really reliable long-term was Premarin. I have recently been back on it for about a month (after a very failed experiment with conti patches), but I'm in the process now of switching back to estradiol tablets, where I hope to stay if I can, but if I can't I will continue to take Premarin.
It does bother me a little that there always seems to be so much emphasis on MM being put on using Utrogestan and estradiol (and patches being the preference). There seems to be this subtle inference being made that if you use anything else you're using something inferior, or dangerous, but for some, using those products may not be applicable or desirable.
We always say we are here to support each other, but there is often that subtle undermining going on that indicates to me that some like to "tell" women what they should use (by pointing out supposed risks etc), rather than "telling" them to use whatever works for them.