Re: Is vaginal estrogen unnaposed?
From: R. Daniel Braun (rd.braun@gmail.com)
Wed Feb 25 13:57:52 2009
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Right, this is one of the things that makes the dosing unreliable.
Dan
On Wed, Feb 25, 2009 at 3:24 PM, art fougner, md <evsono@pipeline.com>wrote:
> Dan
>
> As the vaginal epithelium thickens in response to E cream, the
> absorption decreases a bit ... an interesting feedback loop.
>
> Art
>
> At Wed, 25 Feb 2009, R. Daniel Braun wrote:
> >
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> >On Wed, Feb 25, 2009 at 11:07 AM, Christopher Jones <christopj@msn.com
> >wrote:
> >
> >> I just diagnosed a postmenopausal woman with endometrial adenocarcinoma.
> >> Her only identifiable risk factor, if any, is a history of premarin
> >> cream unnaposed by progestins.
> >>
> >> My question is
> >>
> >> 1. Do you consider giving local estrogen without progestins unnaposed?
> >
> >NO
> >
> >However, I wouldn't give vaginal estrogen to someone who shouldn't take
> >oral. The vaginal cream gets absorbed and enters the blood stream and the
> >doseage isn't controlled as well as it is with oral.
> >
> >> 2. In your patients on local estrogen for vulvovaginal symptoms, if you
> >> give a progestin what is your protocol?
> >>
> >> Thanks
> >>
> >> Chris
> >>
> >--
> >R. Daniel Braun, MD FACOG(L) ABMP CMTh
> >Professor Emeritus
> >Dept. of Obstetrics and Gynecology
> >Indiana U. School of Medicine
> >
> >--
> >R. Daniel Braun
> >
> > “Science without Religion is LAME; Religion without Science is
> BLIND"
> > Einstein 1941
> >
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> ><br><br><div class="gmail_quote">On Wed, Feb 25, 2009 at 11:07 AM,
> Christopher Jones <span dir="ltr"><<a href="mailto:christopj@msn.com">
> christopj@msn.com</a>></span> wrote:<br><blockquote class="gmail_quote"
> style="border-left: 1px solid rgb(204, 204, 204); margin: 0pt 0pt 0pt 0.8ex;
> padding-left: 1ex;">
> >I just diagnosed a postmenopausal woman with endometrial
> adenocarcinoma.<br>
> >
> >Her only identifiable risk factor, if any, is a history of premarin<br>
> >cream unnaposed by progestins.<br>
> ><br>
> >My question is<br>
> ><br>
> >1. Do you consider giving local estrogen without progestins
> unnaposed?</blockquote><div><br><br><br>NO<br><br>However, I wouldn't give
> vaginal estrogen to someone who shouldn't take oral. The vaginal cream gets
> absorbed and enters the blood stream and the doseage isn't controlled as
> well as it is with oral.<br>
> ><br> <br></div><blockquote class="gmail_quote" style="border-left: 1px
> solid rgb(204, 204, 204); margin: 0pt 0pt 0pt 0.8ex; padding-left:
> 1ex;"><br>
> >2. In your patients on local estrogen for vulvovaginal symptoms, if
> you<br>
> >give a progestin what is your protocol?<br>
> ><br>
> >Thanks<br>
> ><br>
> >Chris<br>
> ><br>
> ></blockquote></div><br>
> >FACOG(L) ABMP CMTh<br>Professor Emeritus<br>Dept. of Obstetrics and
> Gynecology<br>Indiana U. School of Medicine<br><br><br>R. Daniel
> Braun<br><br> “Science without Religion is LAME; Religion without
> Science is BLIND"<br>
> > Einstein 1941<br>
> >
> >--000e0cd4872e1edd6a0463c3d788--
> >
>
> --
> art fougner, md
> "May The Wings of Liberty Never Lose a Feather." - Jack Burton
>
--
R. Daniel Braun, MD FACOG(L) ABMP CMTh
Professor Emeritus
Dept. of Obstetrics and Gynecology
Indiana U. School of Medicine
--
R. Daniel Braun
“Science without Religion is LAME; Religion without Science is BLIND"
Einstein 1941
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Right, this is one of the things that makes the dosing unreliable.<br><br>Dan<br><br><div class="gmail_quote">On Wed, Feb 25, 2009 at 3:24 PM, art fougner, md <span dir="ltr"><<a href="mailto:evsono@pipeline.com">evsono@pipeline.com</a>></span> wrote:<br>
<blockquote class="gmail_quote" style="border-left: 1px solid rgb(204, 204, 204); margin: 0pt 0pt 0pt 0.8ex; padding-left: 1ex;">Dan<br>
<br>
As the vaginal epithelium thickens in response to E cream, the<br>
absorption decreases a bit ... an interesting feedback loop.<br>
<br>
Art<br>
<br>
At Wed, 25 Feb 2009, R. Daniel Braun wrote:<br>
><br>
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<div><div></div><div class="Wj3C7c">><br>
>On Wed, Feb 25, 2009 at 11:07 AM, Christopher Jones <<a href="mail
to:christopj@msn.com">christopj@msn.com</a>>wrote:<br>
><br>
>> I just diagnosed a postmenopausal woman with endometrial adenocarcinoma.<br>
>> Her only identifiable risk factor, if any, is a history of premarin<br>
>> cream unnaposed by progestins.<br>
>><br>
>> My question is<br>
>><br>
>> 1. Do you consider giving local estrogen without progestins unnaposed?<br>
><br>
>NO<br>
><br>
>However, I wouldn't give vaginal estrogen to someone who shouldn't take<br>
>oral. The vaginal cream gets absorbed and enters the blood stream and the<br>
>doseage isn't controlled as well as it is with oral.<br>
><br>
>> 2. In your patients on local estrogen for vulvovaginal symptoms, if you<br>
>> give a progestin what is your protocol?<br>
>><br>
>> Thanks<br>
>><br>
>> Chris<br>
>><br>
>--<br>
>R. Daniel Braun, MD FACOG(L) ABMP CMTh<br>
>Professor Emeritus<br>
>Dept. of Obstetrics and Gynecology<br>
>Indiana U. School of Medicine<br>
><br>
>--<br>
>R. Daniel Braun<br>
><br>
> “Science without Religion is LAME; Religion without Science is BLIND"<br>
> Einstein 1941<br>
><br>
</div></div>>--000e0cd4872e1edd6a0463c3d788<br>
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><br>
><br><br><div class="gmail_quote">On Wed, Feb 25, 2009 at 11:07 AM, Christopher Jones <span dir="ltr"><<a href="mailto:<a href="mailto:christopj@msn.com">christopj@msn.com</a>"><a href="mailto:christopj@msn.com">christopj@msn.com</a></a>></span> wrote:<br><blockquote class="gmail_quote" style="border-left: 1px solid rgb(204, 204, 204); margin: 0pt 0pt 0pt 0.8ex; padding-left: 1ex;"><br>
>I just diagnosed a postmenopausal woman with endometrial adenocarcinoma.<br><br>
><br>
>Her only identifiable risk factor, if any, is a history of premarin<br><br>
>cream unnaposed by progestins.<br><br>
><br><br>
>My question is<br><br>
><br><br>
>1. Do you consider giving local estrogen without progestins unnaposed?</blockquote><div><br><br><br>NO<br><br>However, I wouldn't give vaginal estrogen to someone who shouldn't take oral. The vaginal cream gets absorbed and enters the blood stream and the doseage isn't controlled as well as it is with oral.<br><br>
><br> <br></div><blockquote class="gmail_quote" style="border-left: 1px solid rgb(204, 204, 204); margin: 0pt 0pt 0pt 0.8ex; padding-left: 1ex;"><br><br>
>2. In your patients on local estrogen for vulvovaginal symptoms, if you<br><br>
>give a progestin what is your protocol?<br><br>
><br><br>
>Thanks<br><br>
><br><br>
>Chris<br><br>
><br><br>
></blockquote></div><br><br>
>FACOG(L) ABMP CMTh<br>Professor Emeritus<br>Dept. of Obstetrics and Gynecology<br>Indiana U. School of Medicine<br><br><br>R. Daniel Braun<br><br> “Science without Religion is LAME; Religion without Science is BLIND"<br><br>
> Einstein 1941<br><br>
><br>
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><br>
<font color="#888888"><br>
--<br>
art fougner, md<br>
"May The Wings of Liberty Never Lose a Feather." - Jack Burton<br>
</font></blockquote></div><br>
MD FACOG(L) ABMP CMTh<br>Professor Emeritus<br>Dept. of Obstetrics and Gynecology<br>Indiana U. School of Medicine<br><br><br>R. Daniel Braun<br>
<br> “Science without Religion is LAME; Religion without Science is BLIND"<br> Einstein 1941<br>
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