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Re: Gyn: Rendering someone amenorrheic From: Charlie Chambers (ricechaz@earthlink.net) Tue Jul 11 22:14:08 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Diana Saari MD: "Endometrial Implant" Previous message: Garry E. Siegel, M.D.: "Gyn: Rendering someone amenorrheic" In reply to: Garry E. Siegel, M.D.: "Gyn: Rendering someone amenorrheic" Next in thread: ginny lee, CNM: "Re: Gyn: Rendering someone amenorrheic" Reply: ginny lee, CNM: "Re: Gyn: Rendering someone amenorrheic" How about a Mirena? On Jul 11, 2006, at 8:05 PM, Garry E. Siegel, M.D. wrote: > I only know a few bits of the story, but any thoughts welcome. My > partner heard of a consult for one of us to see tomorrow. > > 32 YO S/P delivery 11 months ago, obese, underwent a D and C by > another > gyn for AUB in late May--let's assume all was OK. She was placed on > LoOvral for DUB, and was taking it until a few days ago, as she was > in a > terrible MVA and is now hospitalized and quadraplegic. > > The neurosurgeon wants her not to bleed, or the patient wants > that--again, details are lacking. Apparently, she's off her pills and > now bleeding. > > My initial thought was Depo-Provera, even if I had to give a bigger > and/or more frequent dose. Years ago, in residency, I remember having > mentally challenged patients from some county home come in to our > county > clinic for periodic (?Monthly) Depo-Provera, 300 to 400 mg., to keep > them amenorrheic so that menstrual hygiene was a non-issue. > > My partner thought about Lupron, and was concerned about DVT and > Depo-Provera. I said that I didn't think that it was > thromobegenic, and > that ACOG actually had a statement somewhere saying it was OK in > situations such as this. > > He mentioned ablation, even hysterectomy, but my inclination was to > manage her medically. > > I think that the pill, even continuous, is not a good idea due to > immobilization and DVT risk. > > Any thoughts welcome. > > Garry > > -- > Garry E. Siegel, M.D. > Private Practice > Roswell, GA ************************************************************************ * Charlie Chambers -- Hood River, OR cchamber@alumni.rice.edu "No matter where you go... there you are." Dr. Buckaroo Banzai ************************************************************************ Next message: Diana Saari MD: "Endometrial Implant" Previous message: Garry E. Siegel, M.D.: "Gyn: Rendering someone amenorrheic" In reply to: Garry E. Siegel, M.D.: "Gyn: Rendering someone amenorrheic" Next in thread: ginny lee, CNM: "Re: Gyn: Rendering someone amenorrheic" Reply: ginny lee, CNM: "Re: Gyn: Rendering someone amenorrheic"

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