WOMENS-HEALTH Messages for August, 1999: Re: Hormone Testing and HRT

Re: Hormone Testing and HRT

From: William D. McIntosh, MD (anonymous@obgyn.net)
Mon, 30 Aug 1999 14:53:45 -0500 (CDT)

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In reply to: Susan: "Hormone Testing and HRT"

At Sun, 29 Aug 1999, Susan wrote: >
>Is there any reason to get hormone tests before starting HRT for
>menopause?
>Is there any reason to monitor hormones while on HRT? If so, when should
>these tests be ordered?
>Should the HRT doses be adjusted according to these tests?
>
>Thanks for answering all of the above!

The short answer is no, it is not worth getting hormone testing before starting HRT, though there are exceptions.

There are two groups of problems that are being treated with HRT. The first group is those problems that are a threat to your long term health, but have little in the way of symptoms, at least at first. These would include osteoporosis, accelerations of cardiovascular disease, Alzheimer's, etc, etc. The dosage to prevent these problems is very low.

On the other hand, the second group of problems are highly symptomatic, but have little impact on long term health, and might include hot flushes, night sweats, emotional lability, vaginal dryness and so on. The dosage required to manage these problems is substantially higher that for the first group. Since it is these sorts of problems that bring the majority of patients to their physician, we can safely presume that a woman who is having say, hot flushes, is also losing bone mass, and needs treatment.

It is the women that do not have any of this second group of problems, or who do not care that they do have them, that may require hormonal testing to prove that there is a lack, and that that lack is causing problems. In my opinion, that is also the primary use of bone densitometry (bone scans), to prove to a patient that there really is a problem with not having appropriate amounts of estrogen.

-- William D. McIntosh, MD, FACOG Clarksville, TN

This is for educational purposes only. It is not intended to replace consultation and examination by your physician or other health care provider.

Next message: Jennifer: "Colon problems v. possible endo."
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In reply to: Susan: "Hormone Testing and HRT"

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