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Re: ?premature menopauseFrom: steve (steve@dhngwe2.db.healthlink.org.za)Tue Aug 3 14:36:23 1999
>... very high FSH and LH with FSH of about 70 - 80 IU/L and LH of 30 - 40 > IU/L on repeated occasions. All other hormonal profiles are normal. > She has no menopausal symptoms. > > My question is in view of her having spontaneous period albeit irregular > signifying a well estrogenised endometrium and by implication not > estrogen depleted, does she still need estrogen replacement therapy? > Is she truly menopause? What is her possible diagnosis? > Yes, she is truly menopausal. Better to call it secondary ovarian failure. She cannot be oestrogenised or the negative feedback mechanism would ensure that the FSH & LH would not be elevated. You cannot make the assumption that she is not oestrogen depleted based on the irregular bleeding. Indeed irregular bleeding may be a sign of endometrial atrophy - a good example being the irregular bleeding sometimes produced by Depo Provera. Whether or not she needs oestrogen replacement is still something for her to decide afer fully informing her of the advantages and disadvantages. I would advise her to consider it if I were you.
-- Steve Raymond Head of O & G Empangeni Hospital SOUTH AFRICA
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