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Re: Persistent hot flashes. From: Dan Logen (pdl@whidbey.net) Tue Aug 17 21:50:48 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Suman: "Re: magnesium sulphate for treatment of eclampsia" Previous message: Sue Turner: "hydrotherapy/waterbirth" Maybe in reply to: Isaac Ben-Or M.D.: "Persistent hot flashes." Next in thread: Geffrey Klein, MD: "Re: Persistent hot flashes." The estradiol level of 156 shows that she doesn't need more estrogen. I doubt that a different product will help. When was the estradiol drawn with reference to ingestion of the estrogen? I usually have it drawn at about 8 hours. If this was an early morning level just prior to next dose, she actually may be getting too much estrogen. I have had one patient that paradoxically felt better when she lowered her estrogen replacement down to a level which gave her an estradiol in the therapeutic level (50-150). She had been at around 350 and still had hot flashes. Another thought is to have her take her estrogen at bedtime. This might give her higher levels at night. Also might consider measuring serum Testosterone and DHEA-s levels and replacing if low. I'm not sure that these are connected to hot flashes, but replacement may improve general well being if they are documented low. -- Dan Logen Private Practice OB-GYN Mt. Vernon, WA "Isaac Ben-Or M.D." wrote: > > > > I will appreciate your opinions about the next case. > > > > 49 yo wf P2002 complaining of postmenopausal constitutional symptoms > > (hot flashes, night sweats, insomnia, etc.), inspite of management with > > premarin 1.25 per day. addition of bellargal did not improve her > > condition. > > > > estrotest (full strength ) and the patch used in the past , have not > > helped either. > > > > she had TAH and BSO 12 years ago for "bleeding". she suffers from > > depression and is managed by a psychiatrist on a weekly basis. she is > > taking prozac 40 mg per day. > > > > FSH is 4.8 and estradiol: 156. > > > > Today I switched her to estratab. > > > > Any suggestions? > > > > Isaac Ben-Or, M.D. > > Peninsula Ob/Gyn, > > Salisbury, Maryland. Next message: Suman: "Re: magnesium sulphate for treatment of eclampsia" Previous message: Sue Turner: "hydrotherapy/waterbirth" Maybe in reply to: Isaac Ben-Or M.D.: "Persistent hot flashes." Next in thread: Geffrey Klein, MD: "Re: Persistent hot flashes."

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