--
Richard Chudacoff, MD, FACOG
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of art
fougner, md
Sent: Wednesday, February 25, 2009 12:25 PM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Is vaginal estrogen unnaposed?
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>
>
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>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
