-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Gyn: Premature Menopause (surgical) and Bioidentical hormones From: art fougner, md (evsono@pipeline.com) Mon Jan 17 19:48:37 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: 32 week PROM Recent Herpes outbre" Previous message: Charlie Chambers: "Re: Gyn: Premature Menopause (surgical) and Bioidentical hormones" In reply to: Garry E. Siegel, M.D.: "Gyn: Premature Menopause (surgical) and Bioidentical hormones" Next in thread: Henry Gregor: "Re: Gyn: Premature Menopause (surgical) and Bioidentical hormones - Re Art's info" Reply: Henry Gregor: "Re: Gyn: Premature Menopause (surgical) and Bioidentical hormones - Re Art's info" Caveat emptor. Menopause. 2004 May-Jun;11(3):356-67. Bioidentical hormone therapy: a review. Boothby LA, Doering PL, Kipersztok S. Columbus Regional Drug Information Center, Columbus, GA, USA. lisa.boothby@crhs.net OBJECTIVE: The terms "natural" or "bioidentical" hormone therapy (NHT) are used to describe hormone treatment with individually compounded recipes of certain steroids in various dosage forms, including dehydroepiandrosterone, pregnenolone, testosterone, progesterone, estrone, estradiol, and estriol. Based on the results of a person's salivary hormone levels, the final composition of the compounded dosage form is individualized to that specific person. Proponents claim that NHT is better tolerated than manufactured products. This paper is intended to review the concept of NHT and to determine whether there is sufficient scientific evidence to support its use. DESIGN: A literature search was performed in Medline using the following MeSH terms and key words: drug combinations; progestational hormones; hormone replacement therapy; endometrium; estrogen replacement therapy; climacteric; menopause; estradiol; estrogens; progesterone; drug monitoring; and drug compounding. Current Contents, International Pharmaceutical Abstracts, Cochrane Database of Systematic Reviews, Lexis Nexis, Google, Medscape, MD Consult, and clinicaltrials.gov were searched with key words. RESULTS: There are a few observational studies and clinical trials comparing conventional hormone therapy with bioidentical hormone therapy. Studies generally lacked adequate study design, including small sample sizes and comparison of inequivalent doses, to prove safety and efficacy. Little evidence was found to support individualized hormone dosing based upon saliva hormone concentrations. CONCLUSION: Evidence suggests that, although individualized hormonal products may decrease some symptoms of menopause, it seems they have no proven advantage over conventional hormone therapies and their use is not supported by evidence regarding pharmacokinetics, safety, and efficacy. art At Mon, 17 Jan 2005, Garry E. Siegel, M.D. wrote: > >Advice on how to handle please: > >23 YO P0 > >Age 16 had unilateral S and O for torsion by good REI in town. > >1.5 years ago presented with an acute abdomen and torsion; ovary very >blue at lapscope and even at laparotomy (even did a frozen section at 5 >AM--infarcted ovarian tissue)--had other ovary and tube removed. > >Now on OCPs for HRT, so to speak. > >I got a nice email this past week asking if she needed to come in and >talk, or talk by phone, or just email about 2 topics. > >1. I have found a doctor who has done research on Bioidentical >hormones. They are better, less side effects, yada yada. She's not on >my insurance, but could you work with me (and her) for blood tests, etc. > >2. I am considering IVF in the future; will you work with Dr Local REI >(to whom I refer frequently, partner of 1st REI) for bloodwork, etc. > >My reply: > >1. What is the doctor's name/specialty--answer--Dr. I don't know of, >General Practitioner. > >So, it is pretty obvious that the patient has found someone who likely >profits from visits/tests and maybe drug sales--who knows. > >Normally, I would really want to have no part with Dr. I don't know GP, >and am happy to do whatever for the REI. > >I've asked her to come in to talk. > >What should I tell her? > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > -- art fougner, md "If you don't know where you are going, you will wind up somewhere else." Lawrence Peter Berra Next message: Efrain Ramirez: "Re: 32 week PROM Recent Herpes outbre" Previous message: Charlie Chambers: "Re: Gyn: Premature Menopause (surgical) and Bioidentical hormones" In reply to: Garry E. Siegel, M.D.: "Gyn: Premature Menopause (surgical) and Bioidentical hormones" Next in thread: Henry Gregor: "Re: Gyn: Premature Menopause (surgical) and Bioidentical hormones - Re Art's info" Reply: Henry Gregor: "Re: Gyn: Premature Menopause (surgical) and Bioidentical hormones - Re Art's info"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Thu Oct 2 04:47:39 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.