HomeMy WebLinkAboutItem 5.3 Amdmt to Massage Ordnc (2)CITY OF DUBLIN
AGENDA STATEMENT
CITY COUNCIL MEETING DATE: July 22, 1991
SUBJECT: PA 91 -049 A Touch of Health - Veronica Krell
Initiation of Amendment to Massage Ordinance
REPORT PREPARED BY: Carol R. Cirelli, Associate Planner
EXHIBITS ATTACHED: Exhibit A: Letter with attachments from
Veronica Krell dated July 2, 1991
RECOMMENDATION: Provide Staff direction concerning the
Applicant's request
FINANCIAL STATEMENT: Applicant pays for the Ordinance amendment
DESCRIPTION:
The Applicant, Ms. Veronica Krell, is requesting the City Council
to initiate an amendment to the Dublin Municipal Code, Chapter 4.20
Massage Establishments and Massage Services, Section 4.20.020
Exemptions. The Applicant, a massage therapist certified by the
National Holistic Institute and a licensed cosmetician, owns and
operates A Touch of Health located at 6995 Dublin Boulevard.
A cosmetician is licensed in the State of California to massage
the face, neck, arms, bust, or the upper part of the human body, and a
cosmetologist is licensed to massage in addition to these body parts,
the hands, feet and scalp. The State does not issue any other license
that regulates massages other than what is allowed under the State
cosmetician or cosmetologist license. The Applicant indicates that
as a massage therapist, she is certified to massage the entire body,
including legs and lower back. Staff does not know who certifies such
massage and would need to research that certification.
The Applicant's massage and cosmetology business is located in a
C -2, General Commercial District zone. A massage parlor /establishment
is not an allowed use within this zone. A massage parlor/
establishment is permitted in a C -1, Retail Business District zone
subject to the approval of a Conditional Use Permit. Under the
Massage Ordinance, the massage therapist use is considered a massage
establishment.
According to the Applicant, the Dublin Planning Department and
Police Department gave the Applicant verbal approval of the massace
establishment use and massage permit in the Fall of 1988. The City
has no written documentation that this approval was granted. The
massage establishment needs to comply with all current and applicable
zoning requirements.
ITEM NO. COPIES TO: General /Agenda File
Applicant /Owner
Project Planner
PA Address File
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
�ry �
ITEM NO. _�� 'f COPIES TO:
The Applicant is requesting that certified massage therapists be
exempt from the provisions of the Massage Ordinance if they:
1. hold a valid, unrevoked certificate of massage therapy
from an accredited institution,
2. have completed a minimum of 500 hours of massage therapy
instruction,
3. are members of the American Massage Therapy Association, and
4. hold a valid, unrevoked cosmetician's license of
registration by the State of California Board of
Cosmetology.
If massage therapists with these qualifications are exempt from
the provisions of the Massage Ordinance, the massage therapy business
would not be considered a massage parlor /establishment as specified
in the Zoning Ordinance.
Staff informed the Applicant of options to resolve the massage
establishment's inconsistency with the Zoning Ordinance. The
Applicant's request was one of the options presented by Staff. The
following are other options available:
1. With an approved Conditional Use Permit, the Applicant can
relocate her massage establishment in a C -1, Retail Business
District.
2. The Applicant can request an amendment to the Zoning
Ordinance to allow massage establishments in a C -2, General
Commercial District with Conditional Use Permit approval.
3. The Applicant can discontinue her operation as a massage
therapist in the C -2, General Commercial District, but may
continue to perform massages as a cosmetician holding a
valid, unrevoked license of registration from the State
Board of Cosmetology.
If the City Council initiates the ordinance amendment study,
Staff will consider other options such as amending the Zoning
Ordinance definition section to include a definition of massage parlor
and massage therapist. Staff may also consider variations on the
Applicant's request. Staff will research membership qualifications
for the American Massage Therapy Association and the requirements for
approving a massage therapy school pursuant to Section 29007.5 of the
Education Code of the State of California. Staff will also verify
whether the National Holistic Institute is accredited by the State,
whether the school certifies massage therapists and what schools,
agencies or organizations issue certificates of massage therapy. The
draft amendments will be reviewed by the City Police Department and
the City Attorney and all applicable comments will be incorporated
into the amendments.
Staff recommends that the City Council provide Staff direction
concerning the Applicant's request.
-2-
july 1991
.fear City COWICIL Plombzrs:
„' L 6995 Dilhlin
My name :is L•''aroni,_a B, Krell. I de business as fl 7cuCh Of H',11 :1 �t and State
E1.v,4 in the Hairihlai1 Emporium, i am a Certified i'lassaga Ther•spi
I have been doing business at ,h o
is Dublin location fr
Licensed Cosmetician,
the last three: years. I was told by former Cit;: of D�.L'oiin officials il,1983
Chief n -,' Police Shores and Associate Planner- Laura HO"fneister
in April, 1983
that T was apRroved tc perform facials, massage and body wa::inq at this
location.
'tll all O.1' tlla Ci 1iy Ii rd J. nallce5 that
I have gone tc great lengths to ccinpiy w_ oiorra�;:ed snd fing'arprinC�ad
was made a:.aare of st that time, irlC1Lldill❑ being Pal n
n.,
by the F'c1.iC2 Department in 1:a8 and attain in ove:Jber.
I Lev_ r�, L. been �.,, J-ed ;,y the i1.
�, rlclrlrtl I += w c 'cl a zoning
w:sh tc cont 11UQ `r
locate n ot,:r:c.1 it C
__ is iOcAtcd in �i_CI ..C�
cation, iy bu =_fines ., `
ercial district _c•n'ed for --_,vice.
raas acm ^,o' pe-ri;IJ ttcd Cs2 within tht. C -2
Aril a ('. i; i �nan�e, _ _ '
a It
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Under n: ,' t ^` -- Cc r ticisn li �:. I t znnlrq w;u'.d
fc Le C1,� u hi,r, b a c am L..Ii r. 1:•e orl, ad•d,.t Lin .� i r� p'r
I ur,:_fl.d 1 Fie to prc';eese an a1n1n'andment to hlassag2 G•di 1,111C'2 i•io. °7 cd:der Sr -coon
the F_XC , c O111= tO lliCliide the fOiio' :J
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RECEIVEb
EMIT A
PA 91 -0 y�
DUBLIN PLANTING / J�
A Touch of
Health
of furs a full
service beau W and
Thu Hair/Hail Emporium and
the health and beauty W:
health complex to their clients enaKinq
them
to manaas
their ha nols and skin and to
their
jcvais of
stress. i have inve&-
,
amount of time, mon?V
old lyfor
t ove-
As last thpoe y2sr5 Q:
"d a consWarabla
hwayt-
and build up a SLUM, -,
e"Oya of--� to contribute tu this WOO
sod
Drozils
600 oy massacs
QwurEnn
and urad:ztjd
frcm tha HatLonal
•
And AKFA an'rWit2d
srhoul. 1 aW:;
Holistic institute which is a ScAn apiraw"A
frQm the Calwornia
3ho-,
yd mv Etate Licaps2 as a
,,aduajej
- A d va rious
seminars
to vurinor
my education and
Cosmetician. I naW attened
in the massal , ,d
.....
jLdids, 1 was arvnip'.'
WOW current knowledne
and "n buy n
tilausand dollars in student inans
to
fina0c! my
ejucah"un
several
,bj, to moko my monthij payments the
lant W13
"arl :!?
In " sua""; of 0'
small husins3s. 1 have five more 1?3rs Of Owymj"
to
OQ'
P II.NliNING
L A BA
May 15, 1991
City of Dublin
Planning Commission
Civic Center
Dublin Boulevard
Dublin, CA 94568
Subject: Use Permit
A Touch of Health - Located at 6995 Dublin Boulevard
Veronica Krell, Licensed Esthetician /Massage Therapist
Dear Planning Commission:
to the problem Veronica
Krell has encountered concerning
I am writing in response
above - referenced location.
I am a client and I
am very
her use permit for the
concerned that the City is not treating this
business
in it marine lSebusiness
special circumstances involved. This is a
now provided
ablf
very p rofits and
would cut into the p
clientelle
and not allowing the service
to establish over the
years.
Mrs. Krell has worked
I understand that you do not permit this particular service in this location.
this business has built its clientelle based on the fact that she did receive a
do business at this location and since the time the business was approved by
of Police the law has changed. Since she has changed nothing but the
changed I would respectfully request that you allow a conditional use permit
for the current service to remain at the same location. This would not be
precedent because this is not a new application.
application but I believe it is very unreasonable to
conduct the service she has been doing (with
However,
permit to
the Chief
law has
in order
setting a
I could understand denial of a new
tell her that she can no longer
permission) in previous years.
Thank you for consideration of this matter.
Sincerely,
Darleen Good
11369 Dillon Way
Dublin, CA 94568
iP. / ?$ F
P' 9/- 0
DUBLIN PLAN:MMG �/ /�
Seth Yarx D.C.
51+6 Weldon Ave
Oakland, Ca 94610
(415) 834 -1557
To Whom it nay concern;
I are a Chiropractor practicing holistic health and natural
healinx in Oakland, Ca. Veronica Krell is.on ry referral list
for patients in need of therapeutic FSssaxe and I consider her
work to be outstanding and her services invaluable. Therefore,
it is imperative that she be able to continue to offer her services.
If yott have any further questions please contact me.
sincerely;
Seth Na x D.C.
U /25/91
RECriV=D
9/-0
�U�LIN rLANNIN
Kaiser I mente Medical Center
Public Affairs Department
115o veterans Boule.ard
Redwood City , Califomia 94063 -2087
(415) 7W2452
IVAISGR PCRMANCNTC
City of Dublin
City Planning Department
Civic Center
Dublin Boulevard
Dublin, CA 94568
To Whom It May Concern
May 21, 1991
RE: A Touch of Health
6995 Dublin Boulevard
Dublin, CA 94568
A Touch of Health is owned and operated by Mrs. Veronica Krell a Licensed Esthetician and
Massage Therapist. Mrs. Krell has been notified that her use permit will not be renewed at her present
location.
I am urging the City Planning Department to please reconsider the judgement made to not
reissue the use permit for A Touch of Health at the present location on Dublin Boulevard.
The original use permit was issued two years ago by the Chief of Police and since that time the law has
changed. It would seem in a case such as this, where the law changed but the business did not, that an
existing business would be grandfathered and would be allowed to remain in the present location. A
new business coming into the location would then be subject to the new law.
A Touch of Health is a professional and responsible service and an asset to the City of Dublin.
Because of Mrs. Krell's expertise in massage therapy I am not at the mercy of a stress related illness.
My job as a public affairs professional is stressful and intense; it was at a friend's urging that I contacted
Mrs. Krell at A Touch of Health, and received my first session with her. It was as though someone
provided a light at the end of the tunnel for me. She is in a very accessible location and it would be a
shame to move her services to another area.
Thank you for your time and your consideration regarding this particular use permit.
Sincerely,
_/ tricia �n
RE E C E l V E _ 5343 Blackbird Drive
_.
1991 Pleasanton, CA 94566
PA 9 / -Ovq
DUBLIN PLAT G
ALAN _ ..r MAN CHARLES, M. D.
A MEOICAL CORPORATION
1414 MARIA LANE
WALNUT CREEK. CALIFORNIA 94396
TELEPHONE (415) 937.3331
April 23, 1991
To Whom It May Concern,
I am a physician in Walnut Creek,
practicing preventive medicine for
the treatemnt of pain disorders.
This letter is to affirm that
Veronica Krell is practicing massage
for the past three years. Her
qualifications are exceptional and
she is on our list for referrals
for massage therapists.
If you have any questions re-
garding Veronica Krell please
contact me.
Sincerely,,, p
Alan S. Charles, M.D.
ASC /cl
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DUBLIN PLANNING
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LICENSE NO. Z 9397
RECEIPT NO. 06900970
THIS PERMIT DUES
NOT AVTHORIZE THE
HOLOEN TO ENGAGE
l All
OVSiN ESs
cOflraRr To LAws
PEG VLA TING THAT
VSIHESS OII TO
P O S s E 5 S O R
OPERATE. All IL-
LEGAL DEVICE,
CALIFORNIA STATE BOARD OF EQUALIZATION
SELLER'S PERMIT
ACCOUr4T NUMBER
FT/89 SR CHB 21- 831189
6995 Dublin Blvd., Dublin
Veronica B. Krell & Craig E.S. Krell
1569 Greenridge Dr.
Pittsburg, CA 94565
L_
IS HEREBY AUTHORIZED PURSUANT TO SALES AND USE TAX LA's/
TO ENGAGE IN THE BUSINESS OF SELLING TANGIBLE PERSONAL
PROPERTY AT THE ABOVE LOCATION
STATE BOARD OF EQUALIZATION
THIS PERMIT IS VALID UNTIL REVOKED OR
CANCELLED BUT IS NOT TRANSFFP.ABLE
Not valid at any other address
BT -642 -R Rev. 9(1 -83)
DISPLAY CONSPICUOUSLY AT THE PLACE OF BUSINESS FOR WHICH ISSUED ee n257
VERONICA 8 KRELL �I C
6995 DUBLIN BLVD
DUBLINI /CA 94568
BOARD OF COSMETOLOGY
1020 N STREET, ROOM 426
SACRAMENTO, CA 9E314
(9 16) 445 -7061
VALID UNTIL APRIL 30, 1992
In accordance with the provisions of
Section 7373 of the BUSINESS .A_ND
PROFESSIO \S CODE, the individual
named hereon is issued a Cosmetician
renewal license, and is subject to the
rules and regulations of the California
State Board of Cosmetology.
SIGNATURE MCA- ----- .PpSZ I0 'PZITLIC tJIEZ.h -----
(ousz- SE IDIS•PLA`JS'D AC, •PRIL DA•R L) U (D:R K S�AZ Ic?1?
BY NICK ba LLV rr � . . - • --
THE BENEFITS OF MASSAGE
gncient relief
for today's stresses
My body feels
like one big knot," groans
Laurie Brown, 39, her mus-
cles tense and aching after a
stress -filled morning.
Draped by a sheet, she Lies
facedown on a massage table
and stretches out beneath
the soothing hand of Meta
Chessin- Yudin. As the Seat-
tle massage practitioner rubs
out the kinks in her muscles,
Brown grows more relaxed.
An hour later, she is smiling
and buoyant. "After a mas-
sage, I feel like a weight has
been lifted from me," she
says. "All my tension floats
away."
Brown is not the only one
being rubbed the right way.
In the last decade, massage
has enjoyed a boom in popularity. Once thought of as a
luxury for the pampered, it has become a hands -on favorite
of stressed -out office workers, recreational athletes, and
wellness enthusiasts. Massage has transcended its image as a
euphemism for shady adult entertainment. It has come out
of the shadows to present its legitimate side, popping up in
health clinics, shopping malls, and even corporate suites.
An ancient art. Faddish as it sounds, massage is an
ancient healing art, mentioned in Chinese literature as early
as 3000 B.C. Centuries ago, Greek and Roman physicians
used it to treat their rulers. "Massage has its root in earliest
medicine," says Richard van Why, president of the Texas -
based Bodywork Research Institute. "It's been an integral
part of the health systems of most cultures."
But massage is no panacea. "It won't cure your arthritis,"
says Rita Corell, a massage therapist in Omaha. By law,
therapists can't diagnose, prescribe, or claim to treat or cure
specific illnesses.
But massage can be part of an overall strategy for good
health and well- being, says Corell.
For most people, the practice is safe. However, experts
warn anyone with a history of blood clots or diabetes, a
recent fracture or sprain, or a high fever to avoid massage.
Doctors recommend caution to those with circulatory, skin,
or cardiac problems. If you have a chronic health problem,
consult your doctor for advice.
Benefits. Massage stimulates the circulation of blood
Massage: a much - "kneaded" break in a ras. -pace
off r l >>c
1 RFrrER'NOMES AN GARDENS, AV0.11 1991
ANN" G
and lymph fluids, fueling the
muscles with fresh oxygen
and nutrients while flushing
away metabolic waste prod-
ucts. By stretching and loos-
ening muscles, it also
releases physical tension and
soothes the nerves.
The result is a blend of
energy and relaxation. Like
a tune -up designed to pro-
duce smoothness, a massage
is likely to leave you feeling
refreshed, but not revved uD.
Massage often helps people
reduce stress and think more
clearly, says Patricia Benis-
min, Director of Education
for the American Massage
Therapy Association
(AV1TA). "It can have an
effect similar to meditation,"
she says. "It calms the mind through calming the body."
Increasingly, medical doctors find massage useful. Regu-
lar rubdowns may help with relief, breaking the cycle of
spasm and pain. Tension headaches, sore backs, and neck
cricks may benefit. "Massage has helped patients of mire
with cervical strains, where the neck muscles have gone into
a chronic cramp because of an auto accident," says David
Yonker, M.D., a Washington State family practitioner.
The physical benefits of massage have value for athletes,
claims Ralph Stephens, a sports - massage therapist in Iowa
Citv, Iowa. Properly administered massage helps prt%ent
injury, aids recovery time for injured muscles, and improves
'athletic performance, he says.
Healing touch. For many, massage answers an ernoc;cn-
al need for touch. Doctors and psychologists have long
known of the benefits of physical contact. A Universi;c et
Miami study reports that premature infants gained weight
quicker and were able to leave the hospital earlier aver
regular massage. Similarly, people who are lonely er cs-
abled may be touch - starved. "Massage is sometimes mscn-
derstood as being sexual," says Corell. "Done in a save,
nonsexual setting, it can be nourishing and therapeutic."
Bottom line. Promising as the benefits of massage so=d,
not everyone agrees that all have been well documented by
scientific studies. Many people believe massage has t:-e po-
tential to deliver both physical and emotional benefis. but
conrirhued on Pc;, :6
55
RECEIVED
n; I - 1991
MASSAGE PA 91-OVNI
wU3l dGB� ✓�'
continued from page SS �7
much of the evidence is anecdotal. Skeptics also suggest that
the positive effects of massage tend to be short - lived.
On the other hand, these effects probably are cumulative.
From one session to the next, a person is able to relax more
and release tension easier. Over the course of time, massage
sessions teach people where they store tension and how to
watch out for it in their day -to -day lives. "The beauty of
massage is that you learn from it," says Corell. "You be-
come more sensitive to
your own patterns of
ae..:
stress."
MASSAGE BUYER'S GUIDE"
Derived from the French
word for kneading, mas-
sage is a general term for
manipulating muscles and
soft tissue. Over the centu-
ries, a wide variety of ap-
proaches has evolved, each
with its own goals and techniques. The most commonly
encountered methods of massage are:
Swedish, or Western - style, massage. The most prev-
alent form of massage found in the U.S., Swedish is an all -
purpose method to get the blood moving and promote
general well- being. Featuring long, gliding strokes followed
by kneading and rubbing motions, it usually is relaxing and
enjoyable. Clients lie under a drape, either totally or partial-
ly undressed so that oil can be applied for smooth stroke'-..
If you are too embarrassed or uncomfortable to take your
clothes off for a massage, don't give up, says Benjamin.
Take off only as much clothing as you want to, she advises.
Keep on your underwear or wear a swimsuit. "You can't
DO- IT-YOURSELF MASSAGE
with a little special care and at-
temlon, you can give your spouse
or a friend a relaxing, enjoyable
massage. Follow these tips from
Meta Chessln- Yudin, a massage
practitioner and Loban movement
analyst with New Seattle Massage
In Seattle.
Begin in a warm, quiet space,
softly lighted, with gentle music, If
you like. Find a good, firm surface.
(A couch or had Is likely to be too
soh and too few.) Pour a little oil
on your hands and rub them to-
gether so that the oil feels warm.
Coconut oil Is good, but even vege-
table oil will do. Have your partner
take deep, comfortable breaths.
use a smooth, gentle approach
and a light teach. Make a long,
continuous stroke the entire length
relax if you don't feel comfortable," she says.
shiatsu. Used widely in Japan for more than 1,000 years,
this form of acupressure is derived from traditional Chinese
medicine, which postulates that chi, or life energy, flows
along invisible body pathways called meridians. Illness oc-
curs when energy becomes blocked at specific pressure
points. During shiatsu sessions, therapists press on these
points with their fingers or feet, even with their knees, to
release energy trapped within the body and restore health.
While Swedish massage is oriented to physiology —blood
flow and contracted muscles --- oriental massage has a spiri-
tual goal to get mind and body in harmony. It is done
without oil, sometimes
When considering a through loose clothing on a
mat rather than a table.
massage practitioner, Shiatsu, like Swedish -
style massage, can involve
look for a licensed some discomfort. However,
a massage shouldn't be
therapist. Ask about painful, says Jocelyn
training, credentials, Granger, a massage thera-
pist in Ann Arbor, Michi-
and experience. gan. "If it hurts, tell your
therapist to stop."
Reflexology. Practitioners of this method of massage
believe that various reflex areas in the feet and hands corre-
spond to parts of the body. Reflexologists apply pressure to
these spots on the feet and hands to promote the health of
the corresponding body part, organ, or gland. Independent
of any medical value, foot massage also can be a very sooth-
ing and relaxing process.
Sports massage. Borrowing basic techniques from other
traditions, therapists recently created a specialty massage
for active people. Sports massage practitioners usually tar-
get specific muscles rather than attempting to induce whole -
body relaxation.
continued on page 56
of a limb, following the contours of
the muscle and bone. Lightly re-
trace the area in the apposite direc-
tion. Repeat the same gliding
stroke many times, Increasing pres-
sure as you do It, but always re-
trace lightly when you return to
your starting place. Generally,
massage toward the heart.
As you bath get comfortable,
vary the stroke. Aker gliding
strokes, try kneading the skin.
Imaglns you are kneading dough,
and create different shapes.
Experiment with little side- to-side
strokes. Try moving the muscle in
little circles. Check often with your
partner to see if the pressure Is
comfortable.'io `.Inbh one -
area, hold your hands lightly on it
for about 10 seconds. Gently and
slowly take your hands away.
You can use the same kind of
strokes for both sides of the arms,
legs, and torso. When working on
the head, cradle it for a little while,
letting your partner enjoy the feel.
Ing of support. Use gentle, smooth -
Ing strokes on the face, as If you
are trying to Iron out all the wor-
ries and wrinkles. Outline the fore-
head, eyebrows, and nose. You can
apply a little more pressure to the
cheekbones and taw. Try rubbing
the ears. Give the scalp a vigorous
rub, from the base of the skull to
the very top, supporting the head
with one hand while rubbing the
other side.
There Is no "one way" to do
massage. Start with what you
think would feel good and listen for
feedback. Feel free to explore
what works.
BEM2 HOMES AND GAiDENS. A »IL 1101
56
MASSAGE
continued from page 56
Rapid or rhythmic pummeling
strokes often are used to warm up
muscles before an event. Long, gliding
movements after a strenuous workout
aim to prevent muscle soreness and
shorten recovery time.
Choosing a therapist. While there
are dozens of methods of massage and
body work, most U.S. therapists are
trained in one form of massage—I
ally Swedish -style --and incorporate
other methods to suit their interests.
58
Many practitioners offer a broad,
eclectic range of techniques, but some
have a narrow, specialized focus. It's
important to match your need —
whether it's basic relaxation or sports
massage or deep - muscle work, for in-
stance —with the right therapist.
To find a good therapist:
• Get referr.::s from friends, health
professionals, or a reputable health
club in your area.
• Stick to licensed massage therapists
if your state licenses practitioners. Or
check with the 1 1,000 - member Amer-
ican Massage Therapy Association for
its Active Member list. The group,
which sets industry standards and
provides continuing education, has a
referral service for its members. Call
312 /761 -AMTA.
• When you shop around for a thera-
pist, ask about experience and train-
ing. If the therapist advertises as a
specialist —a sports massage therapist
or shiatsu practitioner, for example —
ask about his or her credentials and
training.
• Expect to pay about S30 to 540 for
an hour -long session, perhaps more in
major metropolitan areas. If pre-
scribed by a physician, massage some-
times is covered by insurance. ED
BETTER HOMES AND GARDENS, APRIL 1991
Please see an important message
about osteoporosis prevention on the previous page. and
BRIEF SU'AetARY(FOR FULL PRESCRIBING INFORMATION AND PATIENT INFORMATION. SEE PAG.rAGf Stu estrogen adverse
reroacemem on site Choice of p!cysltin and may may It IncmtaranumnemuEg these
chicl JEi) adverse. effects.
REA)ARIN• Brand 0I conlupate0 esuU,k n
REMARIHe Brand al coaIinto Ed aAlragents Vaginal Cream, In a nonllguOVing base
I ESTRCGENS HAVE SEEN REPORTED TO INCREASE THE 81SK OF ENDCMEf HIAL CAHUtaumd,
Close eLLCaI Surve,lance of all'nOmen taking estrogens is imperianl. Adequate dlarl if masuRi
ia0l o s.9 endomeNldl Samotn'Qwhen indicalM- Should be undertaken to Nle Out maligaanry, m all e3se501
undiagnosed qe 'sisienl or tan-9 abnormal vaginal ble-aing. There is currently no evidence that
- natural estrogens are mare a less hazardous than - synthetic estrogens At burstogenic doses.
2. ESTROGENS SHOULD NOT BE USED DURING PREGNANCY.
Estrcgfn therapy during pregSwq is associaled with an increased risk of congenital detects in the
leonoGUdlve organs of Ind mile and lemale fetus, an increased risk of vaginal apenosis. SOuamouacell
assails, at Ire uterine cervb- and vaginal cancer in the female later in life. the 1985 DES Task Force
ccnnuCea;bar women who usa OES during their pregnancies may subsurenUy "Offence an mCYac.J
risk of lead cancer. HOw!vQ a causal relaliou ship is still unproven, and the obsHVed level 01 risk :S
similar t0 that for a number a Other breast cancer risk fall
Them is no indication tar estrogen therapy Strung pregnancy. Estrogens are ineffective for the rievenllon
or Informed Of in ... test Or lout aborlion.
DESCRIPTION: PREMARIN (cuj.'galed estrogens. OSP) contains A mixture 01 Csuugaln. UUI<ma :....•.•.,
from natural sources, blended u mfesenl the average composition of material derives Item pregqnant males
mine. II contains estate. eCU84 and 17.4hydmeouilin, together with smaller amounts at Ira Official,
,currents. ALL 11a- mnyameouilmn as salts 01 [Pell Sulfate eimis Tablets are available in 0.3 at 0.625 10.9
mg, 125 r. g and 25 mg stFe4ts of conjugated estrogens. Cream i0 available as 0.625 mg conjugated
emSens Pe gram.
INDICATIONS AND USAGE: kbWale- lobnela vaeom01011ymploms associated will, the menopause. (There
r5 no eCeCt! INI estrogens n NICCIiVe 101 net Oars SymOloms 01 deCIeSS :Cn vision miglll L<Gr dUnOg
men0pauu Aral :hey'M uld'01 husea 10 real these Conditions I Ptevenbon after management at 0,fachroiis
(aia0nr.a' bone mass). A is vaglNbS. Atrophic 'JI21111i1is. HyOcesticgenlsm due IC hypogcotosm.
...falter or J .mart Ovarian laden
PRE :tAB:N (conjugated ecors) Vaginal Cream Is Indicates in the vealmenl of atrophic vm:rFF,S and
fau053 ".vie.
,ii AS NOT BEEN SREWN TO BE EF °KTIVE FOR ANY PURPOSE CLAIMS PREGNANCY AND ITS
USE MAY CAUSE SEVERE eAF1A TO THE FETUS ;SEE BOXED' WARNING).
CONTRAINDICATIONS: ESltogm should not oe used'IA women (01 men) with any of Ihelallcwing cc. ^Clitoral'
I Racwn ar msceaed oregnara.Y lsee Sexes Warning). 2. Bnewn or suSoecleri cancel 01 the bte..I !I :n
aooloena!!ly selected part, 5 �+9 treated lot metastatic muse. 3. Nnown or SusdeC:M ¢Sfcgea- CLCafter'
negOldS :d 4.'IdiagrosM Rossini genital Sleeting. 5. A.Ive hOm00phloaris Of Ihlom ce"i cilmCe6.
6. Esnc;n Retirement Irera]y has not been reported to IAVUSe the risk of Ihmmbook" iti5 land,
inamocec.000 disease. Hcwes1 !here is insufficient mlorm0110n regarding women who nave had mev,eu5
;monea-.:c:x disease. ests
PREki ia0mis and V, use Cream sl,auld nor Se trsee In patients hyp¢6Cn51livC 10 melt IagmaiShi
WARNINGS. Ems StuE r.2 "g bat a possiblt increased :ncdl Cf boost Cancer !n omen taking 111gn¢r
cases LI IS Cron Is' oncron Fire ln; aFiOCS.Ire majority of studies have dal snOwn an aSSCdlan tlr I'll
estrogen ¢% aliment acs^ -s. EraSCemal cancer risk among estrogen users was about 4 -Idd m great: Ivan In
a0mu411 ac Appears cescear An treatment Cuta110n and cY.lOg¢n dose. In palleno On comb lea IsIlOgyen.
o¢gul" C?Ody. this t6k RD,ox A be D,c,c,,e6 (So, PRECAUTIONS below )
Estmren?drops during peONAM is 35SCCamd win an inuee5¢d risk of teal "'I" dal "Ved'i "act
enter's
A 2 5 IYD increase in me list Of sul9ica11y confirmed gall starlet dis¢aie in women ¢cervtnq
pOSlfnen_i us.l eslmg!ns has Idea sudden
Large Costs 01 estrogen SuchaeSGSe used retreat postale and breast Cancer have been Sn0'xn IO IOcmase me
16k at son ralal myocamial hfan on, pulmonary embolism, and IhOmbrok ih3 m mom This Cannel
nN- OSYlily : ??tanp0jaled to wmi However. to void IteatetrQl car RI risk ..USet by hgn estrogen
cases, Ire ones for estligen n lament Ihelaay snCUjt n01 one N I<Camm¢OC¢d tCSe.
Blood Gessure Should be mood with estrogen use, esdectally 111 doses are used
Estrogens ,ray lead Io Se2re lyjacalcemla in pd119n1$ with breast cancel and bone m¢IaslJies.
PRECAUTIONS: Rs ac d.lion ala:Ngeatm!at 7 or are aayi 01 a cycle at eilfogen ACmturranIhn RCO' :a :ry
InxC6!R rocence LI enCalnenaloycaeeolaSla. Studies it enDOmelfran Suggest that 10 10 13 Flats of p tocir.I
are Fee� a:;Owde maalmal rucca:r01 mall and elimnali0n Of hYdeplasbc CM1anges. AdIrolal risks,
R E C E- ! t' r �. ,A d1,,
^UTKIN °LANNL!G
rule medical ROD family history Should be :area ;nor to me Iniliafitn of any
eKe to blood pllsSrue, brea512, aadOmen, era :'lure attain. Ala SAOi
A general rule. estrogen Should not be aff or loner Iran One year
card's at
with nyaelcalcemla.
the hallowing druglIttleactratory test interactions have been lepgnes, some Orly with eslmgeropmgestin
combinations (oral contraceptives):
1. Increased prolhronst n and 111:015 VII, VIII, M. and X; decreased anfithromEin 3. Inceased no¢p :ne0hrl0e-
inCUCed platelet aggreqabilily
2. Increased Ihymid binding globulin (TBG) leading to increased cio:ualms 10-31 thyroid hoopoe, is
mneured by T, levels delummed by column or by radioimmunonssay, Free T? esa uptake is Decreased.
tellecline the clevaled TBG: free T, ccncentralion is unaltered.
e. Reduced response to melyraOCne test.
5. Reduced serum fatale cancithition,
AIUTAGENESIS AND CARCINOGENESIS: Long term, conlinuaus administrLair of natural and synthetic
estrogens uncertain animal sDi incressesthe frequency alcarrhadmasal the areas!, cervix, vagina. and liver
PREGNANCY CATEGORY X: Estrogens Should cot be used during pregnancy See CONTRAINDICATIONS
aca Boxed Warning,
NURSING MOTHERS: AS a general pllnciale. be adminislralion of any drug to nuts no mothers should be done
only when clearly necessary Node mans (Irugi are excreted in human milk.
ADVERSE REACTIONS: The following take been redolt it with eSI1O§s is mefaa',II c-aages in vagma bleeding
pattern aca abnormal withdrawal CCeing or flow, breakthrough bled^- -tag, Sit! !volatile In are Of uterine
IF bnamyoka It vaginal carl change in amount at cervical S .loom XnC s ... largemen :I C¢asls'
nau$u, vomiting, abdominal : :amps..feeling. cron,vat c aund-i hloasmd of _e'.s.a that Ray CessLA`len
Lug i5 0isconhnuea, erylhema mW6lolme, effiti FOLOSU 1, resell ,'::Imm joss Of Scalp It 'r.
tus'lism: steepening at corneal c: "Anne.intolerance !a ct lei hedaEC-?. - .Igraine, Ciro -SS, RRCIat
Wmession. cirri Increase or decrease In weiBn! reduced cdm0.hyG010 lbuac:e, ay9ravation Of TCranytd.
Stoma: changes In flood
ACUTE OVERDOSAGE: May cause nausea and vomiting,
DOSAGE AND ADMINISTRAT104:
PREMARINt Brand of conjugated estrogens tablets, USP
I.Given cyclically IOr socu-elm use only For ifoo d0j 01 moderale- :0- Severe vas- IOlOf symptoms Map"
va9inilis, Or almph0 urelhrills a$$ce:alea with the menopause (11.3 and to 125 my cr,: ce carry). tie b'west case
that will control sym0loms should Le chosen and armcailon SNOUL be ariccnl :neC as prOmolly as Lassiole.
AMimSlralion Should be cyclic (N. B:ree weeis an and one 'odes oil). A!! ? ^::s to aiSC:nr',ree Or facer
arefortion should be FORCE al le to S 'r:om. intervals.
2. Given cycncally Hypoeslmge "s OsleepOms :S _
Hypoesimgeli s0- due lo. Female hyporloi .5 mg to 75 mg oft tv Is c irci costs !or 20 Cars
IcillMea b' ID day rest pence, It bli Joss all Frow by the end 01 ills set cc. :r? sell, O"Sage S,ri l 0
e;ea!e0
r. estate casuabon or pn• 2ryy ovauan talite—I 25 mg calls. rytllCalli ^'ust uOwarC OF c :hai
according to response Of :he pallet! FOf .manleri adjust Casale m 'Most ' ere'.:, 31 will plavtce?Ileellve
control.
Osleopawsis -0.625 mg Carry Administration $'auto be cyclic (hl, cor' wed 31 and one week off
PREN INS Brand of conjugated estrogens Vaginal Cream
Given cyNlcally IOI sh0t1-rNm use ors For trutr Rtl 01 Armoric vaginihs or kr>.oafs vulvae,
The lowest dose that will control Symplom5 Should Ce [Noses and medlCRi;.n 5 -Auld be disc :elated as
prcmoily as possible.
Attempts to 06crali0u< or facer medicalion should be made at 'he.. 10 six'mdnit Interval'.
Usual dosage range: 2 g 10 4 g Carry mlravar rely, oepeadlQ an the severi!y 01 ;Ce conGjicn.
Patients whin an i01aC1 uterus No are treated win either PR IAANIN Tablets 3 Y3^kinal Cream Should be
mCndOrea lot signs 01 FanelliI cancer ono aopromiale nsafires:akea to rule ta'afignarc'y In the event of
ption :eOI or returning aorro mal var'mal 01eeCi19 Revised August 21, 19ag
rD SEC. Wyem-AyersLLabOANOies
.fisemeney