Re: DVT risk
From: Steve & Eryl Raymond (eryl@intekom.co.za)
Fri Mar 26 13:23:36 2004
It seems to me that you wouldn't want to use oestrogen in this scenario as it
would probably worsen her dysfunctional bleeding. My choice would be cyclical
progestagens. Endometrial ablation is another option, but won't help her
non-physical symptoms.
Steve
Richard Chudacoff, MD wrote:
> This is a case of you only lose if she develops another DVT and you have put
> her on hormones. CYA all the way.
>
> I'd try her on Effexor and endometrial ablation.
>
> Richard Chudacoff, MD
>
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> -----Original Message-----
> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Karen Lee
> Sent: Friday, March 26, 2004 9:55 AM
> To: Multiple recipients of list OB-GYN-L
> Subject: DVT risk
>
> 42yo patient with irregular menses and
> peri-menopausal DUB for 2 months, no
> dysmenorrhea, also severe mood swings, night
> sweats disrupting her life, crying at 'nothing',
> etc (you all know the story). Hx of DVT years
> ago, hospitalized on streptokinase. She haas
> 'factor V'. Obviously, no ET can be used. PDR
> lists thrombolic events as a contraindication for
> both Provera and Prometrium. Is this a case of
> 'hormones are bad' by the FDA or is this a real
> risk?
>
> =====
> Karen Lee, ARNP
> OB/GYN Nurse Practitioner
> Certified Menopause Practitioner
> Mount Vernon, WA
> "Courage is the opposite of the instinct to keep everything under control.
> It is against inertia and death, toward intensity and life. The little
> courages of life add up to big courage over time. Resist the offers of small
> safe quarters in your mind."
>
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