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Re: AmenorrheaFrom: Elrod, Darryl G Maj 48 MDOS/SGOBO (Darryl.elrod@LAKENHEATH.AF.MIL)Thu Sep 28 05:06:02 2006
Not that she probably doesn't need to be on metformin, but I didn't think of a fasting insulin of 12 as being very high. I've seen plenty in the 40-80 or higher range. I remember reading somewhere that 20 was a good cutoff for being abnormal. Would a month of OCP not likely get her to menstruate? Glen //SIGNED// D. Glen Elrod, Maj., USAF, MC Obstetrician/Gynecologist Chief of Obstetrics 48 MDOS/SGOBO RAF Lakenheath, England Telephone DSN: 314-226-8130 Comm: +44 (0) 1638 52 8130 Notice of Confidentiality Under the Privacy Act of 1974, you must safeguard all information reflected on this e-mail and, if applicable, all attachments. Disclosure of information is IAW AFI 33-119, AFI 33-127, AFI 37-131, AFI 37-132, AFI 33-219, and PL 93-579" This e-mail message including any attachments is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. Any questions pertaining to disclosure should be directed to the privacy officer. -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Wednesday, September 27, 2006 11:19 PM To: Multiple recipients of list OB-GYN-L Subject: Gyn: Amenorrhea 46 YO P2002 with amenorrhea for 4 years. A bit heavy-set, has a habitus not inconsistent with PCOS, as well as a bit of facial hair and oily skin. Multiple FSH levels have been less than 10. She was found to have an elevated fasting insulin of 12, but a glucose of around 85, a year or so ago, along with elevated lipids. She has been referred to an internist and is on Metformin and Vytorin for lipids, yet still hasn't menstruated. She failed a Provera challenge last year, and had a scan showing a 16 mm endometrium. I am repeating the Provera now. I will do some homework, but any thoughts are welcome. Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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