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Re: GYN: Continuous combined HRTFrom: Zach Newton (zbnewton@mindspring.com)Tue Oct 24 20:59:42 2000
Garry Siegel wrote: > > What do y'all do when a patient on continuous combined there apy--like > CombiPatch, or Prempro, etc.--has symptoms such that you think that she > needs more estrogen. > > Obviously, when someone is on cyclic HRT, you just up the estrogen, and > give 10 or 12 days of progestin. > > I'm unaware, for instance, of adding Premarin 0.625 to Prempro 2.5 or 5 > and knowing if the endometrium is sufficiently protected. > > Any thoughts? --------------------------------------------------------------- Fuzzy assessment. --------------------------------------------------------------- --------------------------------------------------------------- Assessing estrogen status by symptoms is crude; predictive value is so poor that assay of E2 achieves easily the status of cost and benefit value for clinical decision the appropriate measure for action.
Caveat: note time of last dose prior to blood draw. If >24 hrs (probably
>18 hours), assay worthless.
-- Zach Newton Z. B. Newton, III, M.D. Atlanta/Gyn
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