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Re: Amenorreia From: Steve & Eryl Raymond (eryl@intekom.co.za) Wed Apr 24 14:01:07 2002 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Steve & Eryl Raymond: "Re: Gyn: Fibroids" Previous message: Steve & Eryl Raymond: "Re: CTG anomaly - with the correct URL" Maybe in reply to: Luiz Antonio C. M. Mario: "Amenorreia" Next in thread: Efrain Ramirez: "Re: Amenorreia" Reply: Efrain Ramirez: "Re: Amenorreia" Dr. Nouroddin, Where is the evidence for breast lumps, liver tumours and "psychic symptoms" in users of Depo Provera? And what are the "psychic symptoms"? I have been using it for the last 30 years and have never had such problems. Amenorrhoea is common, indeed expected, and of benefit for those for whom the method is best indicated i.e. the woman whose family is complete but who has yet to decide on a permanent method. As has been said, if the amenorrhoea worries the patient after reassurance that it is normal, a withdrawal bleed can be induced with Ethinyl oestradiol 50 mcg for a week. Ultrasound tracking of the endometrium is unnecessary, and so is the addition of progestagens. This does not require them to come off the injection. Contrary to what you said about the fertility index being delayed by 2 years, the delay in the return of fertility after finishing Depo is 3 months on average, but for those in whom it is longer, and this is a problem, the same 50 mcg oestrogen course usually kick-starts ovulatory cycles. Clomiphene is only indicated if ovulatory cycles are not established after that. mohammad nouroddin wrote: > >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. > > > 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 stops the injections for getting pregnant > in future > Dr.nouroddin / egypt -- Dr.S.H. Raymond Head of Department of O & G Empangeni Hospital South Africa 3880 Phone: (+27) 35-9028560 Fax: (+27) 35-7922596 Next message: Steve & Eryl Raymond: "Re: Gyn: Fibroids" Previous message: Steve & Eryl Raymond: "Re: CTG anomaly - with the correct URL" Maybe in reply to: Luiz Antonio C. M. Mario: "Amenorreia" Next in thread: Efrain Ramirez: "Re: Amenorreia" Reply: Efrain Ramirez: "Re: Amenorreia"

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