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Hormonal Replacement TherapyFrom: Garry E. Siegel (garrys@atl.mindspring.com)Tue Dec 31 19:42:13 1996
I am soliciting opinions about the appropriate amount and duration of Progestins in spontaneously menopausal women. I was raised with the gold standard of medroxyprogesterone acetate (aka Provera, hereafter MPA), 10 mg. for 10 days. I have seen 10 mg. for 12 or 13 days as the standard, and have also seen info that the duration, not the actual doseage, is more important--such as using MPA 5 mg. for 14 days along with continous estrogen, ala Premphase. I normally have always used continous Estrogen anyway (thanks to Chairman Emeritus Charles Flowers of U. of Alabama). Anyway, a woman on Premarin 1.25 mg. daily and Provera 2.5 mg. daily for many years just came for her first visit and saw my Nurse Practitioner, who refilled her prescriptions. She now is having breast soreness, and has hot flashes on lower doseages of Estrogen, and thus resists lowering her dose. Is she on enough MPA to prevent endometrial hyperplasia? I have not seen anything that comments on using continous combined therapy (ie Prempro or the equivalent) with higher doses of Premarin than 0.625.
-- Garry E. Siegel, M.D. Roswell, Ga.
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