Re: Gyn: Amenorrhea
From: Jane Helwig, MD (jane@helwig.net)
Thu Sep 28 20:51:00 2006
Wow! Thanks, TJ.
At Thu, 28 Sep 2006, Terrence.Jones@kp.org wrote:
>
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> Jane, there is a great Review by Jeff Jensen (Oregon) in last
>September's Survey (60:604-12). He cites the original work on comparative
>plasma levels with oral LNG (Nilson: F&S (1986), 45:805-7, and
>Contraception (1978), 17:9-17). The CDC review (Kahn, Diabetes Care (2003)
>demonstrates the increase in abnml GTT and Insulin resistance in DMPA (and
>Norplant). This was not evidenced with Mirena, in a study from Moscow
>(coauthor Dr. Grimes), even early after insertion, when serum levels are
>higher (Rogovskaya O/G (2005), 105:811-5). Nor was there any weight
>increase compared to copper IUD users in the Brazilian study (Yela Rev
>Assoc Med Bras(2006), 52:32-6). Yet the local effects on the endometrium
>(in patients with hyperplasia), were superior to oral progestin (Vereide
>Gynecol Oncol (2003), 91:526-33). There was a slight increase over
>baseline on FBS ("FPG" = fasting plasma glucose) in a study from Turkey
>(Kayikcioglu Contraception(2006), 73:528-31), but not to abnml levels. /tj
>
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>jane@helwig.net (Jane Helwig, MD )
>Sent by: ob-gyn-l@obgyn.net
>09/28/2006 12:40
>Please respond to ob-gyn-l
>
> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
> cc:
> Subject: Re: Gyn: Amenorrhea
>
>TJ, where is the data about lower systemic progestin levels with Mirena?
>(I have a patient with Type I DM and CF and primary dysmenorrhea who
>recently had a DVT.) Thanks.
>
>--
>Jane Helwig, MD, FACOG
>Private practice, 2 MDs
>Lancaster, SC
>
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><br><font size=2 face="sans-serif"> Jane, there is a great Review by Jeff Jensen (Oregon) in last September's Survey (60:604-12). He cites the original work on comparative plasma levels with oral LNG (Nilson: F&S (1986), 45:805-7, and Contraception (1978), 17:9-17). The CDC review (Kahn, Diabetes Care (2003) demonstrates the increase in abnml GTT and Insulin resistance in DMPA (and Norplant). This was not evidenced with Mirena, in a study from Moscow (coauthor Dr. Grimes), even early after insertion, when serum levels are higher (Rogovskaya O/G (2005), 105:811-5). Nor was there any weight increase compared to copper IUD users in the Brazilian study (Yela Rev Assoc Med Bras(2006), 52:32-6). Yet the local effects on the endometrium (in patients with hyperplasia), were superior to oral progestin (Vereide Gynecol Oncol (2003), 91:526-33). There was a slight increase over baseline on FBS ("FPG" = fasting plasma glucose) in a st!
> udy from Turkey (Kayikcioglu Contraception(2006), 73:528-31), but not to abnml levels. /tj <br>
><br>
></font><font size=1 color=blue face="Arial"><b>NOTICE TO RECIPIENT:</b></font><font size=1 face="Arial"> If you are not the intended recipient of this e-mail, you are prohibited from sharing, copying, or otherwise using or disclosing its contents. If you have received this e-mail in error, please notify the sender immediately by reply e-mail and permanently delete this e-mail and any attachments without reading, forwarding or saving them. Thank you.<br>
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><td><font size=1 face="sans-serif"><b>jane@helwig.net (Jane Helwig, MD )</b></font>
><br><font size=1 face="sans-serif">Sent by: ob-gyn-l@obgyn.net</font>
><p><font size=1 face="sans-serif">09/28/2006 12:40</font>
><br><font size=1 face="sans-serif">Please respond to ob-gyn-l</font>
><br>
><td><font size=1 face="Arial"> </font>
><br><font size=1 face="sans-serif"> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net></font>
><br><font size=1 face="sans-serif"> cc: </font>
><br><font size=1 face="sans-serif"> Subject: Re: Gyn: Amenorrhea</font></table>
><br>
><br><font size=2 face="Courier New">TJ, where is the data about lower systemic progestin levels with Mirena?<br>
>(I have a patient with Type I DM and CF and primary dysmenorrhea who<br>
>recently had a DVT.) Thanks.<br>
><br>
>--<br>
>Jane Helwig, MD, FACOG<br>
>Private practice, 2 MDs<br>
>Lancaster, SC<br>
></font>
><br>
>
--
Jane Helwig, MD, FACOG
Private practice, 2 MDs
Lancaster, SC
