Re: Surgical menopause

From: Alexandra Borisova, MD (treatment@mtu-net.ru)
Mon May 12 02:57:52 2003


Dear Dr. Douglas Krell, This pt has no hot flushes. I thought ERT is not the best option for her as it may cause recurrence of pelvic endometriosis. I am hesitating about offering her BDM. She is only 44 y.o. Except for recent surgery, she has no risk factors for osteoporosis. So, it is hardly that BDM will show us she has osteoporosis now. What kind of benefit will we gain by doing BDM now? We know she is at risk for osteoporosis because of her recent surgery. So, why not to offer her prophylaxis for osteoporosis without doing BDM now and do this investigation in a year ? Thank you.

At Mon, 12 May 2003, Douglas Krell wrote: >
>Dear Dr. Borisova,
>I would not put this woman on Fosamax. At 5 months post surgical menopause
>she may not have lost a lot of bone yet although women may typically lose
>from 6-10% of bone mineral density within the first year. If she is having
>severe vasomotor symptoms and unless there are contraindications, you could
>safely put her on estrogen replacement therapy in addition to her Calcium
>and Vitamin D. You would reliably return her bone turnover to pre-menopausal
>levels within a few months.
>I think that a baseline bone densitometry would be helpful. I would repeat
>the densitometry in 3-5 years on estrogen therapy.
>Douglas Krell MD
>

>>>----- Original Message -----
>From: "Alexandra Borisova, MD" <treatment@mtu-net.ru>
>To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.medispecialty.com>
>Sent: Monday, May 12, 2003 12:37 AM
>Subject: Surgical menopause
>
>> Gr2P2, 44 y.o. woman had total hysterectomy with bilateral
>> salpingo-oophorectomy for severe endometriosis five months ago. She is
>> non-white (from India), had no fractures in past medical history. She
>> has been prescribed Calcium and vit D.
>> Do you think it is justified to do bone densitometry on her now?
>> Do you think it is justified to put her on Fosamax?
>>
>> Thanks in advance,
>>
>> --
>> Alexandra Borisova, MD, PhD
>> American Hospital Group
>> Russia, Moscow.
>>

--
Alexandra Borisova, MD, PhD
American Hospital Group
Russia, Moscow.




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