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Re: Hot flashes/phytoestrogens From: KELLY SHANAHAN (mks@sierra.net) Sun Jan 26 14:06:47 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr Vivienne Souter: "Hereditary thrombophilias" Previous message: CrystalVan@aol.com: "Re: Breech/vtx twins ( was What would ya'll do, new case )" >This sounds real "California" to me. Seriously: > >1. Are these woman rendered amenorrheic, a la Prempro, after a lead in >adjustment time? > >2. I have been rather unimpressed with Prempro (or other continuous >combined Rx) in women who are perimenopausal, or just into menopause, in >terms of many of them not being amenorrheic after 4 to 6 months. Do you >have a comment on that? >Garry E. Siegel, M.D. >Roswell, Ga. Garry Since I'm not a native Californian I won't take offense at your first comment :-) Using continuous combined(CC) "natural" HRT is similar to using CC "big drug company" HRT. Most women will become amenorrheic after several months. I usually give my perimenopausal/early-into-menopause patients the options of cyclic HRT (natural or otherwise). They're used to having a period so it may be less of a hassle to have predictable bleeding than unpredictable. I discuss both ways and let the patient choose. I use Premphase or a non-equine estrogen daily + Provera 5mg x 12 days or natural estrogens daily + miconized oral progesterone 200mg x 12 day (with the natural stuff I tend to dose it BID upon the recommendations of the pharmacists). After a year or so, after discussion, I'll try to switch the patient to a CCHRT regimen. Hope this is helpful -- Kelly Shanahan S. Lake Tahoe, CA Next message: Dr Vivienne Souter: "Hereditary thrombophilias" Previous message: CrystalVan@aol.com: "Re: Breech/vtx twins ( was What would ya'll do, new case )"

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