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Re: Persistent hot flashes. From: BJ Ligon (bjLigon@att.net) Thu Aug 19 19:02:03 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: James Connerth: "Re: Persistent hot flashes." Previous message: BJ Ligon: "Re: Herpes in Pregnancy" Maybe in reply to: Isaac Ben-Or M.D.: "Persistent hot flashes." Next in thread: James Connerth: "Re: Persistent hot flashes." Zach Newton wrote: > Mark Perloe wrote: > > > > The LH level would be a better measure of ovarian or estrogen replacement > > than FSH. > > > > Premarin is absorbed as estrone, not estradiol. In some women the premarin > > is not absorbed due to low stomach acid. > > The circulating form of estrogen, available to receptors, are the > players of importance, after hepatic passage. E2, by far the most > potent, is available and measurable in purified assay in Premarin users. > If the E2 level were reliably predictable on the basis of > dosage, assay of E2 would be pointless. Assessment of E2 selectively in > those who have dosed within 12-20 hours of harvest is useful precisely > because there is huge variability across regular users. > > Neither FSH nor LH is reallya useful marker in assessing range of > circulating E2 in management of ERT after ovarian failure or > removal. Waste of resources unless looking for ovarian remnant. > > Other estrogens are circulating besides E2 with any form of ERT. > None approaches the pharmocologic impact of E2 because of the potency > issue. No doubt, the weaker estrogens do have some impact. > > Zach Newton > Z. B. Newton, III, M.D. > Atlanta/Gyn So if client is having numerous hot flashes (waken her at night), increased vaginal dryness, and mood swings.....but FSH/LH wnl, would you start on hormone replacement therapy? BJ Next message: James Connerth: "Re: Persistent hot flashes." Previous message: BJ Ligon: "Re: Herpes in Pregnancy" Maybe in reply to: Isaac Ben-Or M.D.: "Persistent hot flashes." Next in thread: James Connerth: "Re: Persistent hot flashes."

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