Re: Depo-Provera and FSH level

From: dahmd@gate.net
Wed Aug 7 16:53:52 1996


In article Malcolm Griffiths <Malcolm@mgriff22.demon.co.uk> writes:

>What is ARNP ? Why is the ARNP wanting to start HRT ?

An ARNP is a" Registered Nurse Practicioner", a registered nurse who has completed extra formal education to provide health care on a more autonomous basis. My understanding was that the ARNP thought that the patient was probably approaching menopause (due to her age, around 50) and wanted to provide estrogen.

>Depo-provera is contraceptive largely by blocking the pituitary ovarian
>axis. Hence FSH levels will be expected to be low, but what does it
>matter ?

I don't think it really matters that much. Some say that checking the FSH level on day 6 or 7 of the "sugar pill" week of the birth control pill to diagnose menopause is helpful, although I recently read that it is not. Similarly, she wondered about checking an FSH level, since she would change the Depo-Provera to estrogen/progesterone therapy. Since standard HRT does not necessarily provide contraception, she wanted to be sure she was doing the right thing.

>There are some studies which have suggested osteoporosis in very long-
>term use of depo-provera, but the results are very equivocal.
>Progestagens alone may be effective in symptomatic control of
>climacteric symptoms, there is some evidence to suggest they are also
>protective of bone density.

I agree. However, the long-term benefits of estrogen use are well known, and I think the bottom line is that the ARNP wanted to begin HRT as soon as possible.

Thanks, Ashley D. Ashley Hill, M.D. dahmd@gate.net Orlando, FL

>Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt
>Obstetrician & Gynaecologist Luton & Dunstable Hosp.,UK.
>Tel: 01582-497459 (office)
> 01525-222849 (home)
>Fax: 01582-497424
>email: Malcolm@mgriff22.demon.co.uk

>"It is dangerous to be right on a subject on which the established authorities
>are wrong." (Voltaire)





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