Re: HRT and vaginal bleeding
From: Richard Chudacoff (rchudacoff@mylinuxisp.com)
Tue Oct 30 09:40:45 2007
Phillipa
This is a list for medical practitioners, not patients. There is a great
forum on OBGYN.net for patients
--
Richard Chudacoff, MD, FACOG
Las Vegas International Center for Advanced Gynecologic Care
(Specializing in minimally and non-invasive surgery)
2481 Professional Court
Las Vegas, NV 89128
TEL: 702-485-8893
FAX: 702-974-0945
http://www.lasvegasgyncenter.com
http://www.exablateoflasvegas.com
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Phillippa
Meyer
Sent: Tuesday, October 30, 2007 6:29 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: HRT and vaginal bleeding
Hallo there - I have just discovered your site. I have been on
Angelique for the last 20 months. I have felt so good on it, really it
made a huge difference in my life. About a year ago, I did begin
spotting, much to the surprise of my GP because its something that just
should'nt happen with Angelique andon an examination by my gynae,
everything appeared to be in order. I was absolutely fine until
recently, starting about 6 weeks ago, I begain to feel really
uncomfortable again. Very pre-menstrual, tender breasts, bloated,
subtle weight gain and yesterday, I began a period - not heavy, but
certainly enough to be in no doubt! I am quite concerned and thought I
would wait a few days to see what happens and then make an appointment
to see my doctor.
t Tue, 21 Nov 2006, Rafael Haciski wrote:
>
>The dearth of responses surprised me somewhat.
>
>There is no secret formula - I use continuous estrogen and
>progesterone therapy, preferring transdermal approach, if agreeable
>with the pt. Less frequently I use one of the combination oral
>preparations (FemHRT, Activella) - some pts just do not do well with
>transdermal approach. Being a fan of drosperinone, I am looking
>forward to the new Angelique.
>
>I have not used cyclic HRT in years, just because of bleeding, even
>though it is regular/cyclic.
>
>--
>Rafael Haciski MD FACOG
>Palmetto, FL
>
>On Nov 21, 2006, at 3:59 PM, Atkinson, Samuel M wrote:
>
>> I have sat on a reply for a week. I must say that the collective
>
>> 20 %. In the first paper on combination estrogen and progesterone
>>
>> By sezar axsel (sic) at South Ala, she reported that 50% were
>> amenorrheic at 6 months. Every one quickly forgot that the other
>> 50 % were having irregular bleeding. Wyeth certainly didn’t
>> advertise that 50% were still bleeding on Prem Pro . If your
>> patients are 100% without bleeding you need to publish your magic
>> formula. Personally, I give estrogen continuously. After three
>> to four months I then add Provera for 14 days. If they bleed I
>
>> not accepted as normal and I do an endo sampling at the most, once
>
>> ca and let them continue the 3-4 periods a year. I certainly do
>> not make them stop. I do not use prempro for the multitude of
>> things published about it in the WHI even though it was bad
>> statistics.
>>
>> Sam Atkinson
>>
>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>> Rafael Haciski
>> Sent: Sunday, November 12, 2006 9:37 PM
>> To: Multiple recipients of list OB-GYN-L
>> Subject: HRT and vaginal bleeding
>>
>> Something does not compute!
>>
>> I was just reading the blurb about the new HRT med, Angelique
>> (estradiol and drospirenone), and there is Dr. Archer quoting that
>> there is a 20% incidence of vaginal bleeding while taking HRT. I
>> find that surprising, because NONE of my postmenopausal women on
>> HRT have vaginal bleeding. Am I missing something? What is the
>> collective experience in administering HRT as far as bleeding is
>> concerned?
>>
>> I have always considered postmenopausal bleeding an alarming
>> situation that needs investigation thus I accept no bleeding at
>> all, and adjust meds to achieve that.
>>
>> And while on the subject of drospirenone, they tout the progestin
>
>> put natural progesterone in the pill?
>>
>> Rafael Haciski MD FACOG
>>
>> Palmetto, FL
>>
