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Re: HRT dosing variationsFrom: J. Hellriegel (jhellrie@pce.net)Sat Mar 29 11:30:53 1997
At Sat, 29 Mar 97, Robert J. Woolley wrote: > >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 ------------------------------------------------------------ -- Or an endometrial biopsy before starting ERT and then an endometrial biopsy for any uterine bleeding and yearly.
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