WOMENS-HEALTH Messages for August, 1997: Re: IS there a right answer?? (Maybe Dr. Shanahan?)

Re: IS there a right answer?? (Maybe Dr. Shanahan?)

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Fri, 29 Aug 1997 14:39:41 -0500 (CDT)

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At Fri, 29 Aug 1997, Kelly wrote: >
>Help! I am getting conflicting (and confusing) info:
>
>Took last Depo shot in Jan. Have not started cycle.
>Am experiencing extreme breast soreness. Was told may be because of
>"being out of" progesterone? Is this what is also preventing cycle?

I haven't heard of this before, especially with Depo-Provera. Depo-provera actually *increases* the amount of progesterone in your body, and that's what commonly causes the periods to stop while taking this medication. While under normal circumstances you need both estrogen and progesterone to have a regular period, it is perfectly safe to go without one while on Depo-Provera, since the elevated progesterone levels keep the lining of the uterine cavity thin.

It is *very* common to go without a period for many months after the last Depo shot, and I always warn patients about this, since it can be disconcerting. However, it's not unsafe. To induce a period I have had success with prescribing 1.25 mg of conjugated estrogen tablets (i.e. Premarin or equivalent) each day for 10 days. That usually builds up the endometrial lining and induces a period. However, expect your cycles to be "out of whack" for a few months as the excess progesterone leaves the body.

Good luck.

--
Ashley Hill
D. Ashley Hill, M.D.
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
Orlando, FL
I apologize, but I am unable to answer personal e-mail
due to time constraints.

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