Re: HRT and vaginal bleeding
From: R. Daniel Braun (rd.braun@gmail.com)
Tue Oct 30 08:12:48 2007
And what form of health care provider are you???????
You should see your local Gynecologist this week.
On 10/30/07, Phillippa Meyer <fmeyer@brenthurst.co.za> wrote:
>
> Hallo there - I have just discovered your site. I have been on
> Angelique for the last 20 months. I have felt so good on it, really it
> made a huge difference in my life. About a year ago, I did begin
> spotting, much to the surprise of my GP because its something that just
> should'nt happen with Angelique andon an examination by my gynae,
> everything appeared to be in order. I was absolutely fine until
> recently, starting about 6 weeks ago, I begain to feel really
> uncomfortable again. Very pre-menstrual, tender breasts, bloated,
> subtle weight gain and yesterday, I began a period - not heavy, but
> certainly enough to be in no doubt! I am quite concerned and thought I
> would wait a few days to see what happens and then make an appointment
> to see my doctor.
>
> t Tue, 21 Nov 2006, Rafael Haciski wrote:
> >
> >The dearth of responses surprised me somewhat.
> >
> >There is no secret formula - I use continuous estrogen and
> >progesterone therapy, preferring transdermal approach, if agreeable
> >with the pt. Less frequently I use one of the combination oral
> >preparations (FemHRT, Activella) - some pts just do not do well with
> >transdermal approach. Being a fan of drosperinone, I am looking
> >forward to the new Angelique.
> >
> >I have not used cyclic HRT in years, just because of bleeding, even
> >though it is regular/cyclic.
> >
> >--
> >Rafael Haciski MD FACOG
> >Palmetto, FL
> >
> >On Nov 21, 2006, at 3:59 PM, Atkinson, Samuel M wrote:
> >
> >> I have sat on a reply for a week. I must say that the collective
> >
> >> 20 %. In the first paper on combination estrogen and progesterone
> >>
> >> By sezar axsel (sic) at South Ala, she reported that 50% were
> >> amenorrheic at 6 months. Every one quickly forgot that the other
> >> 50 % were having irregular bleeding. Wyeth certainly didn't
> >> advertise that 50% were still bleeding on Prem Pro . If your
> >> patients are 100% without bleeding you need to publish your magic
> >> formula. Personally, I give estrogen continuously. After three
> >> to four months I then add Provera for 14 days. If they bleed I
> >
> >> not accepted as normal and I do an endo sampling at the most, once
> >
> >> ca and let them continue the 3-4 periods a year. I certainly do
> >> not make them stop. I do not use prempro for the multitude of
> >> things published about it in the WHI even though it was bad
> >> statistics.
> >>
> >> Sam Atkinson
> >>
> >> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
> >> Rafael Haciski
> >> Sent: Sunday, November 12, 2006 9:37 PM
> >> To: Multiple recipients of list OB-GYN-L
> >> Subject: HRT and vaginal bleeding
> >>
> >> Something does not compute!
> >>
> >> I was just reading the blurb about the new HRT med, Angelique
> >> (estradiol and drospirenone), and there is Dr. Archer quoting that
> >> there is a 20% incidence of vaginal bleeding while taking HRT. I
> >> find that surprising, because NONE of my postmenopausal women on
> >> HRT have vaginal bleeding. Am I missing something? What is the
> >> collective experience in administering HRT as far as bleeding is
> >> concerned?
> >>
> >> I have always considered postmenopausal bleeding an alarming
> >> situation that needs investigation thus I accept no bleeding at
> >> all, and adjust meds to achieve that.
> >>
> >> And while on the subject of drospirenone, they tout the progestin
> >
> >> put natural progesterone in the pill?
> >>
> >> Rafael Haciski MD FACOG
> >>
> >> Palmetto, FL
> >>
>
--
R. Daniel Braun, MD FACOG(L) CMT
Professor Emeritus
Dept. of Obstetrics and Gynecology
Indiana U. School of Medicine
R. Daniel Braun
"Science without Religion is LAME; Religion without Science is BLIND"
Einstein 1941
