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Re: Bioidentical hormone pelletFrom: ainsron (ainsron@sbcglobal.net)Tue Apr 17 12:43:52 2007
How accurate are endometrial measurements with fibroids?? I would at least do an endometrial biopsy. Cycle with or continuous Provera to control the bleeding and prevent hyperplasia. On the other hand, with an 18 wk fibroid uterus, what is she waiting for? Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Jane Helwig, MD Sent: Tuesday, April 17, 2007 10:33 AM To: Multiple recipients of list OB-GYN-L Subject: Bioidentical hormone pellet Postmenopausal patient who had no bleeding for 6 years comes in because she went to a FP physician who placed an estrogen pellet about 3 weeks ago. A few days after that the patient started bleeding, sometimes heavily, and had lower abdominal pain and cramping. She has an 18-week fibroid uterus which she had been advised to have removed prior to menopause. Sono shows "normal endometrium". She still doesn't want hysterectomy. Can these pellets be removed? I could not palpate it at the location she showed me. She was told she would need another pellet in 4-6 months so my guess is she will have estrogen stimulation of her many fibroids til then. My surgical soul says "take it out" but are there other options? Thanks!
-- Jane Helwig, MD, FACOG Private practice, 2 MDs Lancaster, SC
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