WOMENS-HEALTH Messages for May, 1997: Re: Oestrogen only

Re: Oestrogen only

From: Kelly (anonymous@obgyn.net)
Thu, 15 May 1997 22:18:38 -0500 (CDT)

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At Thu, 15 May 1997, Sharon wrote: >
>I am living in Japan and have currently been taking Suprecur,(Buserelin
>Acetate) for 10 weeks. I want to start a form of "add-back" therapy in
>another two weeks. I have a very kind gynaecologist who answers my many
>questions and takes my requests seriously. She has never used "add-back"
>before but read some articles I gave her on it and agreed to do it. She
>suggested I use oestrogen only. Her reason for this was when I took
>"premarin" last year to make my period come early it made me quite sick
>and I vomited the tablets back up after 5 days of taking them. She put it
>down to the progesterone in it. I am worried about the consequences of using
>oestrogen only, even if only for three months. Can this cause endometrial
>hyperplasia? Would this just have the same effect as having a period
>where I didn't ovulate for three consecutive months.
>
>Thank you very much
>
>--
>Sharon
>(P.S. I am 29 and have adenomyosis)

Sharon

Premarin is conjugated equine (horse) estrogen. There is no progesterone in it. Premphase and Prempro are 2 new hormone preparations that contain both estrogen and a progestin (medroxyprogesterone acetate). Maybe you were one one of those? *Usually* it's the estrogen component that causes nausea.

Estrogen add-back in the context of using a GnRH agonist like buserelin should not increase your risk of endometrial hyperplasia. It will help with hot flashes and decrease the risk of loss of bone mass.

In my practice, I usually start with a low dose of estrogen -- either 0.5mg of Estrace (estradiol) or 0.05mg via transdermal estrogen (patch -- Climera, Estraderm). If the woman is still having hot flashes, I'll increase the dose. I'm sure other doctors have other ways of giving add-back and I hope you'll get some more feedback.

It sound like you have a good relationship with your doctor and she is willing to consider new things -- that's great. maybe she could talk with some of her local colleagues to see if any of them have any experience with estrogen add-back -- or point her to the medical professional list (OB-GYN-L) on obgyn.net! >

--
Kelly Shanahan, MD, FACOG
S. Lake Tahoe, CA

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