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Re: HRT dosing variationsFrom: Kelly Shanahan (mks@sierra.net)Sat Mar 29 20:12:20 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. .... Is she a possible candidate for progestins every third month or >> might micronized progestin help? Thank you.
Then Bob wrote:
... Assume that we've tried every form
>of progestin, and none can be tolerated. Do you continue to prescribe the In answer to the original question, you certainly can try oral micronized progesterone 100 mg BID x 14 days -- I have many patients tell me they are less moody, bloated, depressed on this (anecdotal, not RCT based evidence). Also, some women may do better on Micronor than MPA. Now, for Bob, I certainly will discuss the use of unopposed estrogen with my patients that absolutely positively do not - or will not - tolerate the progestin. I tell them of the increased risk of endometrial CA and we strike a bargain to evaluate the uterine lining annually or with any abnormal bleeding. I also tell them annual surveillence may miss a cancer. Kelly -- Kelly Shanahan, MD S. Lake Tahoe, CA
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