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Re: Fibroids/endometriosis/adenomyosis From: Elrod Darryl G MAJ 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL) Thu Apr 7 02:23:34 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: Lawsuit-Minded Doctors, Hospitals Restrict Delivery-Room Videos" Previous message: Efrain Ramirez: "Re: FFN blind testing" Next in thread: Garry E. Siegel, M.D.: "Re: Fibroids/endometriosis/adenomyosis" Reply: Garry E. Siegel, M.D.: "Re: Fibroids/endometriosis/adenomyosis" Reply: Andrew Folley: "Re: 34 week prom" I'd have to agree. I've used Aygestin with most women I put on Lupron with good resolution of the hotflushes. Why does she or would she want to keep her uterus? Glen -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Larry Glazerman Sent: Thursday, April 07, 2005 3:18 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Fibroids/endometriosis/adenomyosis Whenever I use Lupron, I add Aygestin, 5 mg daily, as per the extensive data published by Eric Surrey. I don't think there's any significant DVT risk. I also think, however, I'd offer hysterectomy, since the Lupron isn't often a long term cure. Larry R. Glazerman, MD Ob-Gyn at Trexlertown, PC 610-402-0161 l.glazerman@rcn.com > -----Original Message----- > From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. > Siegel, M.D. > Sent: Wednesday, April 06, 2005 9:38 PM > To: Multiple recipients of list OB-GYN-L > Subject: Gyn: Fibroids/endometriosis/adenomyosis > > 49 YO P2102 with: > > known fibroids--4 cm intramural/subserosal one seen at lapscope a few > years ago, still seen on scan and felt on exam > > Stage 2 endometriosis from same lapscope, excised totally > > S/P endometrial ablation for menorrhagia, done concurrently with > lapscope. No fibroids in the cavity > > Also germane is that she has had a LEEP subsequent to the above for CIN2 > (clear margins) with adenomyosis. > > Lastly, in college, she had a traumatic DVT and never has been on the > pill. > > She was seen in December with worsening menometrorrhagia and pelvic > pain, and placed on Lupron. She has become amenorrheic, has no pain, > and says her abdomen is smaller (clinically she is around 8 weeks size > today, no real change). > > She is very troubled by hot flashes. > > Options I've kicked around: > > 1. Increasing her Zoloft dose (already on 100 mg/day). > 2. Adding a progestin (which one? dose?). > 3. Add low dose combination estrogen/progestin therapy (remember the > DVT); if this is considered, might thrombophilia testing be in order? > 4. Of course, LAVH-BSO, but for the sake of discussion, let's stick to > non-surgical options for now. > > Garry > > -- > Garry E. Siegel, M.D. > Private Practice > Roswell, GA Next message: Efrain Ramirez: "Re: Lawsuit-Minded Doctors, Hospitals Restrict Delivery-Room Videos" Previous message: Efrain Ramirez: "Re: FFN blind testing" Next in thread: Garry E. Siegel, M.D.: "Re: Fibroids/endometriosis/adenomyosis" Reply: Garry E. Siegel, M.D.: "Re: Fibroids/endometriosis/adenomyosis" Reply: Andrew Folley: "Re: 34 week prom"

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