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Re: HRT ProblemFrom: Gerald P. Rodriguez (geraldpr@roadrunner.com)Sat Apr 27 14:27:41 1996
>Please, group, I need help on a case: > >A 43-year-old G2P2002 underwent TAH/BSO for hard indications four years ago. Since then >she has gone through every oral, vaginal cream and transdermal preparation available in >Arizona. We were unable to get her euestrogenic, judged by symptoms, physical exam or >serum estradiol levels, until we went to Depo-Estradiol q 3 weeks. By training and >experience (twenty-two years in a busy community OBG practice) I would almost rather eat >okra than have somebody on injections, but I am a realist. She suffers also from >multiple food and environmental allergies, sees an allergist for ongoing desensitization >injections. She is very slender, has perhaps 3 - 5% body fat. A few months ago, she >started getting an immediate (within 15 - 20 min) reaction around the injection site >(in the only fat pads we can find on her, on her buttocks) about 3 - 4-cm radius from >the site, erythematous, firm, not tender. This persists for several days. Her allergist >is convinced that it is not allergic. I tend to agree with him, but . . . >After the same thing occurred with every injectable we can try, the allergists suggested >that the problem is a chemical or mechanical reaction to the oil in the subQ fat/muscle. >This usually sweet lady, her husband and her gynecologist cannot deal with her(self) >when her serum E2 is down. We are now trying a very small dose every week, but I am not >hopeful, nor is she. Any suggestions? Anything (an implantable or a vaginal ring, etc.?) >available to help her? > >Thanks! > >Start all over again with traditional ERT but add some form of androgen, e.g., testosterone enanthanate by injection or Estratest. I've had better luck with the former.
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