I read with interest a letter by Carol Tannenbaum. I would first like to thank Ms. Tannenbaum for reading my article and finding my topic worthwhile enough to warrant a response. However, I would like to clarify my position regarding Premarin and bioidentical hormones. In her letter, Ms. Tannenbaum expressed concern that I would recommend Premarin, and cited that Premarin is derived from pregnant mares’ urine. In my article, I did not recommend Premarin. I also cited that Premarin is derived from pregnant mares’ urine and that as a stronger non-human version of estrogen was shown to dislodge clots in a small percentage of women. However, I also noted that this risk is negated with the use of bioidentical estradiol. Thus, I recommend bioidentical estradiol, which provides the benefits of hormone replacement including improved mood, better energy, reduced risk of heart disease, reduced risk of osteoporosis, reduced risk of dementia and better sexual health without the cardiac risks that have been associated with the pharmacologic version of these hormones, including Premarin.Warren Slaten, M.D.