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Re: DVT riskFrom: Dr. Ainsworth (ainsron@sbcglobal.net)Fri Mar 26 11:21:48 2004
Progestins are not thrombogenic and not contraindicated in a patient with Hx of DVT. The PDR recommendations against use in patients with Hx of DVT is simply a reiteration of the proscription given to estrogenic medications and has no scientific basis. If you have Speroff's text, p750, he talks about the mini-pill and the fact that no measurable impact occurs to the coagulation system, and uses a reference in the Br J Fam Plann 15:83,1989, Fotherby, "the Progestogen-only pill and thrombosis." > >42yo patient with irregular menses and >peri-menopausal DUB for 2 months, no >dysmenorrhea, also severe mood swings, night >sweats disrupting her life, crying at 'nothing', >etc (you all know the story). Hx of DVT years >ago, hospitalized on streptokinase. She haas >'factor V'. Obviously, no ET can be used. PDR >lists thrombolic events as a contraindication for >both Provera and Prometrium. Is this a case of >'hormones are bad' by the FDA or is this a real >risk? > >===== > >-- >Karen Lee, ARNP >OB/GYN Nurse Practitioner >Certified Menopause Practitioner >Mount Vernon, WA >"Courage is the opposite of the instinct to keep everything under control. It is against inertia and death, toward intensity and life. The little courages of life add up to big courage over time. Resist the offers of small safe quarters in your mind." > >*****HIPAA Confidentiality Notice***** > >The documents inside this electronic transmission contain confidential information belonging to the sender that is legally privileged. If you received this electronic transmission in error, please notify the sender immediately to arrange for return. > >
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