Re: Is vaginal estrogen unnaposed?
From: Ronald Ainsworth (ainsron@sbcglobal.net)
Wed Feb 25 16:00:31 2009
I had always heard the same thing Art said, decreased absorption as the epithelium matures.
--- On Wed, 2/25/09, Richard Chudacoff <rchudacoff@mylinuxisp.com> wrote:
> From: Richard Chudacoff <rchudacoff@mylinuxisp.com>
> Subject: RE: Is vaginal estrogen unnaposed?
> To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.obgyn.net>
> Date: Wednesday, February 25, 2009, 1:20 PM
> I always thought it was the other way around; as the
> epithelium thickens,
> there is an increase in vascularization, which increases
> the absorption
>
> 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:
> >
> >--000e0cd4872e1edd6a0463c3d788
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> >Content-Transfer-Encoding: quoted-printable
> >
> >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
> >
> >--000e0cd4872e1edd6a0463c3d788
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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
