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GYN: Initiation of ERT after OCPsFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Wed Feb 24 17:30:33 1999
Dear listers: I'm interested in how everyone starts folks on ERT in certain circumstances. I'm especially interested in how the private practice folks do it, even those who don't post much these days (Harvey, Ashley, Kelly, Ricky--hope I didn't forget anyone). Anyway, the circumstances: 1. Perimenopausal, irregular cycles with symptoms amenable to ERT, ie hot flashes, approximately age 50. Generally, I am reluctant to go straight to a continous combined method because the breakthrough bleeding takes forever to resolve, and these patients are impatient. I usually start cyclic therapy, and after one or two years, offer continous combined. I especially am reluctant to use continous combined therapy in the younger (45) folks. 2. Menopausal for several years, late 50s, not on ERT. Generally, I'll go straight to the continous combined method. 3. Someone on a low dose OCP nearing 50, who has a screening FSH after the skipped week of pills that clearly is menopausal. Would you go continous combined, or cyclic? Again, I tend to go cyclic for a year or two. Garry
-- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga.
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