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Re: HRT dosing variationsFrom: Robert J. Woolley (wooll005@gold.tc.umn.edu)Fri Mar 28 23:59:37 1997
In message <199703290622.AAA21872@talk.obgyn.net> writes: > 50 yo W female, smoker, rheumatoid arthritis, states progesterone > component of her HRT makes her depressed. No menses for 4 yrs. Previous > concomitant estrogen-progestin had been reduced to progestin on days > 1-14. Is she a possible candidate for progestins every third month or > might micronized progestin help? Thank you. Let me extend this a bit, to a hypothetical. Assume that we've tried every form of progestin, and none can be tolerated. Do you continue to prescribe the estrogen? Her smoking gives her two reasons to need it even more than a non-smoker (heart disease and osteoporosis), and the absolute risk of endometrial Ca induced by unopposed estrogen is small (though the relative risk is substantial). If you do proceed with estrogen, do you recommend hysterectomy first? Endometrial ablation? ---------------------------------------------------------------------------
--------------------------------------------------------------------------- Bob Woolley -- --------------------------------------------------------------------------- St. Paul, Minnesota
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