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Re: OB: progesteroneFrom: Braun, R. Daniel (rbraun@iupui.edu)Thu Jun 25 14:12:27 1998
See the LIFE work of Arpad Czapo of St. Louis. Progesterone does indieed do the things you say, but you need to have very high tissue levels in the uterus to do it. These are not attainable with any means that we know of in vivo. In vitro, you can get those concentrations in a water bath and indeed stop uterine contractions. Dan
-----Original Message-----
>From: DoctorJoe@aol.com In a message dated 6/23/98 9:04:43 PM, you wrote: <<There is probably one patient every year or two who *insists* on progesterone to prevent a miscarriage when she's spotting, or because she had it in a successful pregnancy elsewhere after a miscarriage. After a frank discussion, I will generally give it. I make this decision with the patient, and I make it so as to not lose or alienate a patient over an treatment that is likely harmless, and, frankly is prescribed commonly by others.>> Just to keep the thread going a bit: Isn't progesterone known to at least SOMEWHAT relax the uterine smooth muscle? So there is likely at least SOME effect of progesterone, when used early (like for spotting) or later (like for uterine irritability or contractions). However, from a RCT standpoint, the effect is likely small or modest, and the conditions being treated so diverse and poorly understood, that any study is likely not to show any clear benefit, especially a small to medium sized study. So if it's harmless (and in my experience, it acts somewhat as a sedative...), what's the problem? Joe P.
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