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Estrogen supplementation of premenopausal womanFrom: Betsy Hyde (elishyde@connix.com)Thu Jul 31 15:59:56 1997
A 40-ish year old woman was referred to me (by her nephrologist) for initiation of HRT for prevention of osteoporosis. Menstruating fairly regularly. She and multiple family members have polycystic kidneys. Her renal function is pretty normal. Her mother has very strong history of osteoporosis, with numerous fractures starting in late 40's-early 50's. She is a blonde non-smoker, takes Ca plus vit D, does weight-bearing exercises and is of normal weight. I sent her for a DEXA scan which showed osteopenia at all sites, but no osteoporosis. Her FSH was 3, and her serum estradiol 125. The nephrologist was pretty insistent that she be started on estrogen. Given non-menopausal female with normal serum estradiol, neither I nor any of the gyns in my practice could see much reason for estrogen replacement. Both the nephrologist and the patient are now mad! Any thoughts? Would Fosamax be useful in this case?
-- Betsy Hyde CNM Branford, CT Midwife in private OB/CNM practice Assistant Clinical Professor, Yale University
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