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Re: WHI and Progestins From: Braun, R. Daniel (rbraun@iupui.edu) Wed Jul 17 06:51:28 2002 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Jay Kulkin: "Re: WHI and Progestins" Previous message: Jay Kulkin: "Re: WHI and Progestins" Maybe in reply to: J. Hellriegel: "WHI and Progestins" Next in thread: Jay Kulkin: "Re: WHI and Progestins" Where do you find one with "nil" absorption?? Dan -----Original Message----- From: Jay Kulkin [mailto:jkulkin@whrassociates.com] Sent: Wednesday, July 17, 2002 6:27 AM To: Multiple recipients of list OB-GYN-L Subject: Re: WHI and Progestins Can use vaginal cream with essentially nil absorbtion as long as you'd like. Even OK for breast ca patients with atrophic vaginitis. JK >----- Original Message ----- From: "Joanne Bulley, MD" <islesannie@yahoo.com> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.medispecialty.com> Sent: Tuesday, July 16, 2002 10:46 PM Subject: Re: WHI and Progestins > At Tue, 16 Jul 2002, Garry E. Siegel, M.D. wrote: > > > >One patient today told my nurse (phone call)that her internist told her > >to stop--what did we think? > > > >Duh--why not stay on it for a bit and come in for a discussion? However, > >feel free to stop until then. > > > >Garry > > > Today I had the same message: > "I have been on it 10 years and just saw my internist who said that my > bones are fine and since we are working on the blood pressure and the > rapid heart beat we must get you off of those hormones" This patient > told the internist that she wanted to talk to me first - and luckily the > internist said fine. > > She has been on estradiol and provera. If it were me on that for 10 > years - I'd probably just switch to activella. She may have a good bone > density now - but her vaginal epithelium is still atrophic in appearance > despite the above hormones AND vaginal estradiol. > > So how long can we use tha vaginal estradiol if we have no progesterone > on board. Any ideas anyone??? > > I sure think we are thorwing the baby out with the bath water... If the > woman's body has had 17Beta Estradiol for 40 plus years - can it really > be a bad thing to continue it? How can we determine the "best" progestin > to protect the uterus??? > > My next job is to to a chart by chart review to see who all is on CHRT > or ERT and get my letters out to them... > > -- > Joanne Bulley, MD > Keene, NH, USA Next message: Jay Kulkin: "Re: WHI and Progestins" Previous message: Jay Kulkin: "Re: WHI and Progestins" Maybe in reply to: J. Hellriegel: "WHI and Progestins" Next in thread: Jay Kulkin: "Re: WHI and Progestins"

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