Re: Is vaginal estrogen unnaposed?
From: Rafael Haciski (haciski@earthlink.net)
Wed Feb 25 16:57:47 2009
Vaginal absorption is excellent, but variable. When I need to push to
the limit, I will monitor with serum E2 levels. As long as levels are
low I am not concerned about uterine stimulation.
1 gm twice weekly will not do much to the levels. If I need a bigger
bang, I may push to as much as daily, but then watch levels. If high,
drop down.
Sent from my iPhone
On Feb 25, 2009, at 18:02, Ronald Ainsworth <ainsron@sbcglobal.net>
wrote:
>
> 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:
>>>
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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
