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Re: AmenorreiaFrom: mohammad nouroddin (m_nouroddin@hotmail.com)Wed Apr 24 10:53:30 2002
>From: "Braun, R. Daniel" <rbraun@iupui.edu> >Reply-To: ob-gyn-l@obgyn.net >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.medispecialty.com> >Subject: RE: Amenorreia >Date: Wed, 24 Apr 2002 10:20:36 -0500 > >OR reassure her this is normal and continue the Depo. Most of my patients >on >depo want this outcome. > >R. Daniel Braun, MD > >There are strange things done in the midnight sun > By the men who moil for gold; >The Arctic trails have their secret tales > That would make your blood run cold; >The Northern Lights have seen queer sights, > But the queerest they ever did see >Was that night on the marge of Lake Lebarge > I cremated Sam McGee. > Robert W Service > > -----Original Message----- >From: gynendohaiti jean louis [mailto:gynendohaiti@hotmail.com] >Sent: Wednesday, April 24, 2002 7:57 AM >To: Multiple recipients of list OB-GYN-L >Subject: Re: Amenorreia > >people who use injectable contaceptive such as depo provera for a long time >very often experience amenorhea. the test you have done would be normal and >they will fail to bleed with progesterone withdrawal because the >endometrium > >is already thin . what you should do is to try oestrogen instead at >increased doses for two weeks and control the endometrium growth with >ultrasound .than introduce progesterone in low dose for a week. she will >probably bleed than. >once you have that response try to induce regular cycle using clomiphene >citrate for two cycles (the patient must be aware of the risk of pregnancy) >.Normal status should resume than and you will shoose another contraception >method. > > >From: lac.@uol.com.br (Luiz Antonio C. M. Mario) > >Reply-To: ob-gyn-l@obgyn.net > >To: Multiple recipients of list OB-GYN-L ><ob-gyn-l@mail.medispecialty.com> > >Subject: Amenorreia > >Date: Wed, 24 Apr 2002 07:45:28 -0500 > > > >Paciente de 30 anos, nuligesta, fez uso de Contraceptivo injetável > >mensal por 18 meses.Após a última ampola entrou em amenorréia, que > >persiste por 8 meses. > >Beta hcg NEGATIVO,Ultrassonografia pelvica normal, função tireoidiana > >normal,prolactina normal, teste de progesterona oral negativo, teste de > >estrogenio + progesterona orais negativo. > >Gostaria de sugestões de como continuar a investigação diagnóstica > > just do not do any thing for that patient and give her another combined hormonal contraceptive pills , she'll bleed spontaneously and i want to tell that i don't priscribe that injectable depot provera because it causes prolonged amenorrhoea and psychic symptoms and breast lumps and liver tumors and the fertility index will be late by about 2 years if the patient stopes the injections for getting pregnant in future Dr.nouroddin / egypt >
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