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Re: Gyn: Amenorrhea From: Andrew Folley (agfolley@hotmail.com) Thu Sep 28 10:16:53 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Terrence.Jones@kp.org: "Re: OT-completely" Previous message: Rafael Haciski: "Re: Gyn:  Amenorrhea" In reply to: Garry E. Siegel, M.D.: "Gyn: Amenorrhea" Next in thread: Terrence.Jones@kp.org: "Re: Gyn: Amenorrhea" Garry I would say she is still PCO and anovualtory. Sounds as if she is close to fitting into Metabolic Syndrome. I imagine she is hypertensive as well. She remains at risk for endometrial hyperplasia/cancer as is evidenced by 16mm endomtrial thickness. As a minimum, I would think an endometrial assessment with office biopsy would be in order. If no withdrawl bleeding with the second round of provera. (ie give her higher dose 20 to 40mg daily for 12 to 14 days then I would consider either a D and C for assessment or a protracted coures of progesterone ie megace 40mg daily for 3 months and see how herre endometrium is a t that time. andrew >From: garrys@mindspring.com (Garry E. Siegel, M.D.) >Reply-To: ob-gyn-l@obgyn.net >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Subject: Gyn: Amenorrhea >Date: Wed, 27 Sep 2006 17:19:24 -0500 > >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 Next message: Terrence.Jones@kp.org: "Re: OT-completely" Previous message: Rafael Haciski: "Re: Gyn:  Amenorrhea" In reply to: Garry E. Siegel, M.D.: "Gyn: Amenorrhea" Next in thread: Terrence.Jones@kp.org: "Re: Gyn: Amenorrhea"

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