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Re: GYN: Continuous Combined Hormonal Therapy From: Joanne Bulley (islesannie@yahoo.com) Sun Oct 29 20:16:59 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: CarynRybs@aol.com: "a few cases" Previous message: Garry Siegel: "Re: Delay until conception after hysteroresection" In reply to: Garry Siegel: "GYN: Continuous Combined Hormonal Therapy" Good start of a new thread ! If the patient says "No Horse Stuff" - I tell her there are lots of choices and make (depending on the patient) an aside comment that all the products start with natural sources - mammal or plant. Unless there is some compelling reason I don't start with patches. A compelling reason may be someone who says I was always nauseous with OCP's - or I can't take pills - or some such. The Activella, OrthPrefest and FemHrt are new enough to nbot be on many formularies - HMO or more traditional insurance. So those go to women who want one pill but want no horses. I know the Ortho's reasons for designing the 3 day progesterone cycle but am not convinced we know enough yet about the on/off stuff and E/P reseptors and whether it makes a difference. Many folks want the generic option which affects where I start. As I tell the reps - I like having many options - since HRT does not yet have a test which will say Jane will do best on product/regimen A and Suzy will do best on product/regimen B. PERSONALLY - I have tried most all of the straight estrogen options (oral and patch) I have had in the office. (I am 45.5 and S/P supra cervical abd hyst and RSO for endometriosis, menopause at 43 - three years after surg - should have had the L ovary out too...) I think the matrix Cenestin patented for its conjugated - not equine - estrogens does make a difference. So that is what I have been on for 6 months or so. My $0.02 worth! JB At Sun, 29 Oct 2000, Garry Siegel wrote: > >How do you decide on which product/regimen to use for those menopausal >patients in whom you prescribe long term, continuous comibined therapy? >Until recently, the only available product in one pill/patch was >Prempro. Here are the ones that I know about. > >Prempro 2.5 (congugated estrogens 0.625 and MPA 2.5 mg) > >Prepro 5 (congutated estrogens 0.625 and MPA 5 mg) > >CombiPatch 50/140 (Estradiol 0.05 and Northinedrone Acetate [NETA]0.14) > >CombiPatch 50/250 (Estradiol 0.05 and NETA 0.25) > >FemHRT (Ethinyl Estradiol 0.05 and NETA 1 mg) > >Activella (17 beta Estradiol 1 mg and NETA 0.5 mg) > >Ortho Prefest (17ß-estradiol 1 mg/norgestimate 0.09 mg dosed on an >intermittent basis—3 days off and 3 days on—in a continuously repeated >pattern throughout therapy) > >Other--for example, I have used estrogen equivalent to 0.625 Premarin >and Prometrium 100 mg/day. > >Anyway, I don't have an compelling reason to use one versus the other, >and just wondered how others decided. > >Garry > >-- >Garry E. Siegel, M.D., F.A.C.O.G. >Roswell, GA >Private Practice > -- Joanne Bulley, MD, FACOG Keene, NH, USA Take time to smell the roses. Next message: CarynRybs@aol.com: "a few cases" Previous message: Garry Siegel: "Re: Delay until conception after hysteroresection" In reply to: Garry Siegel: "GYN: Continuous Combined Hormonal Therapy"

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