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Re: Bone DensityFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Tue Dec 16 18:48:03 2003
At Tue, 16 Dec 2003, Lynn D. Montgomery, M.D. wrote: > >Happy Holidays To One and All: >I have a 29 y.o. patient who is anovulatory (folliculogram >confirmations), but has monthly periods. She recently sustained a >spiral fracture of her tibia during minimal activity and subsequent bone >scan revealed marginal density for age in her spine. > >Both orthopedist and internist are telling the patient that her >decreased bone density and subsequent fracture are the result of her >anovulation - I say no, as long as she is having her periods, she >doesn't fit the classic I haven't had the chance to check her labs and >they haven't evaluated any cause they feel they have the answer. > >I have certainly seen this in truly amenorrheic patients who are >anorexic, or extreme fitness with very low body fat percentile, but not >in regularly menstruating females who are not ovulating. > >Comments... >Lynn > >-- >Lynn D. Montgomery, M.D. >Rocky Mountain Women's Health >2835 Fort Missoula Rd., Suite 303 >Missoula, Montana, 59804 >406-549-0978 >fax 406-549-0987 >e-mail: apgar10@montanadsl.net > I would tend to agree with your impression, I would look for malnutrition, malabsorption from causes such as inflamatory bowel disease for causes of both her borderline bone density and anovulation. I guess you could do a serum estradiol level(something I never do) to show a normal level.
--
Take care, John
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