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Re: HRT

From: anonymous@obgyn.net
Tue, 16 May 2000 16:33:27 -0500 (CDT)

At Tue, 16 May 2000, Tracy wrote: >
>I had a hysterectomy 3 months ago and was initially put on .625
>Premarin, I continued to have hot flashes on that amount and it was
>increased to 1.25 at 6 week check up. I felt fine for the last few
>months and now am noticing vaginal dryness (even with arousal) making
>sex difficult and a reoccurence of hot flashes. Do I need to increase
>my estrogen? My doctor said he would like to keep me on the lowest dose
>possible, why would he say that? I am 38.
>
>--
>Tracy
>

this is a regular problem, and adding more oral estrogen is unlikely to help. I prefer to add a little topical estrogen cream directly to the vagina once or twice a week. It works great, there is little systemic absorption, and my patients swear by it. 

--
William D. McIntosh, MD, FACOG
Clarksville, TN


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