Some mild side effects have been reported. These may include:

•  Breast pain, leaking of milk from the nipple
•  Inflammation of the vagina, vaginal itching or discharge
•  Breakthrough bleeding, spotting, changes in menstrual flow, painful periods
•  Joint pain, leg pain
•  Hair loss
•  Changes in weight (increase or decrease)
•  Nausea, vomiting, bloating, abdominal pain
•  Dizziness
•  Headache (including migraine)
•  Changes in libido
•  Mood disturbances, irritability
•  Rash, itching, hives, tender red nodules on the shins and legs, acne.

Tell your doctor, nurse, or pharmacist if these affect you.

More serious side effects have also been reported. In such a case, stop taking the medication and talk immediately with a healthcare professional. The side effects may include:

• nausea and vomiting that don’t stop
• mood changes, depression, or memory loss
• breast lumps
• unusual vaginal bleeding such as spotting, breakthrough bleeding, prolonged or recurrent bleeding
• increased or new vaginal irritation, itching, odor, or discharge
• severe stomach or abdominal pain
• yellowing around the eyes or on the skin 
• dark urine
• swelling of the hands, ankles, or feet
• increased thirst
• increased and more frequent urination.

There have been some cases of severe allergic reactions to this product. If symptoms like a rash, itching or swelling (especially of the face, tongue, or throat), severe dizziness, or trouble breathing appear, get medical help immediately.

Premarin Vaginal Cream is prescribed as a hormone replacement therapy for women in menopause to treat vulvar and vaginal atrophy and kraurosis vulvae (itching, burning, dryness in or around the vagina, difficulty or burning on urination) associated with menopause. It is also prescribed to treat dyspareunia (pain during intercourse) associated with menopause. 

It can also be prescribed to reduce the development of postmenopausal osteoporosis.

During the menopause, the levels of estrogen in the body decrease. This may lead to a sensation of increased heat over the face, neck, and chest (hot flashes). 

As a result of lower estrogen levels, there may be changes inside the vagina and on the labia. The condition can cause sensations of dryness, itching or burning. It can also cause discomfort during sexual intercourse.

As well, women in menopause run higher risks of developing osteoporosis (bone density loss) that can result in the increased risk of fractures.

The usual recommended treatment for these conditions is known as hormone replacement therapy (HRT) or sometimes postmenopausal hormone therapy. HRT works by replenishing the diminishing levels of estrogen hormone in menopausal women. HRT also works to regulate secretions of luteinizing hormones (LH) and follicle-stimulating hormones (FSH) that are involved in the menstrual cycle and are necessary for regular sexual function. This helps to alleviate the symptoms of menopause.