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Re: ERT/HRT- personal prescribing trend From: Efrain Ramirez (eramirezt@coqui.net) Fri Oct 25 22:09:33 2002 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Steve & Eryl Raymond: "Re: Labia Minora Fusion" Previous message: Efrain Ramirez: "Re: Labia Minora Fusion" In reply to: Zach Newton: "ERT/HRT- personal prescribing trend" Next in thread: Steve & Eryl Raymond: "Re: Gyn: PCO" Each case must be individualized - takes a lot more time but it'd worth it -- At Wed, 16 Oct 2002, Zach Newton wrote: > >The noise level in the role of use of ERT/HRT exceeds the specs on >commercial grade ear protectors. >The signal level has become garbage on the screen. > >Take any EBM you like, then place your bet. > >One thing rings true: it makes sense to assess and recommend on basis of >individual risk/benefit >analysis. Actually, that truism is meaningless, as there is no standard for >such assessment. > >I digress to common sense and some science. > >Bad things happen to those who hold bad cards more often then to those who >hold good cards. >The baggage carried by bad card holders should not burden potential benefit >to the good >card holders. Life is not fair. > >The patient population in the pre,peri,post menopausal age group that I see >are on average >in generally good health. Heavy duty morbidity is certainly represented, but >lightly on a numbers >basis. > >Big morbidity translates into premature death risk. Other than vasomoter >instability, where is >there indication for long term ERT/HRT here? > >For the vigorously healthy, I passionately recommend ERT/HRT, absent a >medical reason or patient objection. > >Trend mentioned in subject line is toward increased use of transdermal >delivery in the belief that >avoidance of first hepatic passage could reduce multiple risk concerns >fostered by induction of hepatic enzyme >systems with oral route. > >-- >Zach Newton >Z. B. Newton, III, M.D. >Atlanta/Gyn > -- "Life is neither the notes nor the silence between the notes, but the music that arises out of sound and silence felt as a living whole. Stop choosing...between chaos and order, and live at the boundary between them, where rest and action move together..." David Whyte Next message: Steve & Eryl Raymond: "Re: Labia Minora Fusion" Previous message: Efrain Ramirez: "Re: Labia Minora Fusion" In reply to: Zach Newton: "ERT/HRT- personal prescribing trend" Next in thread: Steve & Eryl Raymond: "Re: Gyn: PCO"

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