Re: DepotProvera

From: Andrew Folley (agfolley@hotmail.com)
Sat Jun 9 11:44:00 2007


She has a diagnosis of hypothalamiic hypogonadotropin secondary amenorrhea. Mostl likely secondary due suppression from depo but it seems rather long at 24 months usually just for one year. Probably should have a lateral view of the skull or CAT of head to rule out empty sella syndrome. Otherwise her biggest risk would be infertility and osteoporosis. Estrogen supplement with pill or HRT would be adequate and consider baseline DEXA at this point.

>From: Rafael Haciski <haciski@earthlink.net>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: DepotProvera
>Date: Sat, 9 Jun 2007 00:39:34 -0500
>
>Not being a fan of this drug, and not having much experience with the pts
>who used it, I am interested in how others would handle a 23 yo who took
>DepotProvera for 3 years then stopped in 2 years ago and still has no
>menses.
>Current bloods: E2 18, PRL 12, FSH 6, TSH 1.508
>
>She is not interested in fertility at this time, but concerned over
>amenorrhea this far out. My concern is the continued low E2 and the
>effects on bone. My initial inclination is to put her on OCP.
>
>On another topic, I have inherited several pts in late reproductive years
>who are on progestin only OCP with very low E2 (10-20 pg). Should I be
>concerned about bone health sufficiently to recommend change to estrogen
>containing OCP or discontinuation of progestin only OCP?
>
>Rafael Haciski MD FACOG
>Naples, FL.
>





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