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Re: Estrogen supplementation of premenopausal womanFrom: Robert Radnich, M.D. (rradnich@dca.net)Thu Jul 31 18:35:18 1997
At Thu, 31 Jul 1997, Betsy Hyde wrote: > >A 40-ish year old woman was referred to me (by her nephrologist) for >initiation of HRT for prevention of osteoporosis. Menstruating fairly >regularly. > >She and multiple family members have polycystic kidneys. Her renal function >is pretty normal. Her mother has very strong history of osteoporosis, with >numerous fractures starting in late 40's-early 50's. She is a blonde >non-smoker, takes Ca plus vit D, does weight-bearing exercises and is of >normal weight. > >I sent her for a DEXA scan which showed osteopenia at all sites, but no >osteoporosis. Her FSH was 3, and her serum estradiol 125. The nephrologist >was pretty insistent that she be started on estrogen. Given non-menopausal >female with normal serum estradiol, neither I nor any of the gyns in my >practice could see much reason for estrogen replacement. Both the >nephrologist and the patient are now mad! > >Any thoughts? Would Fosamax be useful in this case? > >-- >Betsy Hyde CNM >Branford, CT >Midwife in private OB/CNM practice >Assistant Clinical Professor, Yale University > Betsy, I would agree with your thinking re: HRT. Fosamax would be on option - especially the new 5mg. tablet for prevention of osteoporosis. She will probably find someone who will give her estrogen, however. Bob
-- R.H. Radnich,MD,FACOG OB/GYN Associates of Dover 540 S. Governors Ave. Dover, Delaware 19904
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