WOMENS-HEALTH Messages for November, 2002: Re: Inhaled corticosteroids do have systemic action

Re: Inhaled corticosteroids do have systemic action

From: R. Daniel Braun, MD (anonymous@obgyn.net)
Wed, 20 Nov 2002 19:21:37 -0600 (CST)

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In reply to: AMS: "Inhaled corticosteroids do have systemic action"

What is wrong with oral testosterone? It is a lot cheaper than the cream and better absorbed and dose regulated.

At Wed, 20 Nov 2002, AMS wrote: >
>See New Eng Journal of medicine Vol 345 No 13 Sept 27 2001 My rheumy put
>me fosamax as a result of this and DEXA with osteopenia I get withdrawal
>effects with just a 25% reduction of ICS. Testosterone cream for
>libidoaccording to PDR 10% of topical is absorbed.
>
>Thanks for reply
>At Wed, 20 Nov 2002, R. Daniel Braun, MD wrote:
>>
>>At Wed, 20 Nov 2002, AMS wrote:
>>>
>>>My gyn just prescribed a 3% testosterone in a 2.5% hydrocortisone base.
>>>I already take high dose inhaled steroids, occasional oral prednisone in
>>>short burst and have increasing osteopenia despite fosamax. Since we
>>>are trying to decrease my total steroid dose, is there any other base
>>>for this cream. I did not realize the base was hydrocortisone until I
>>>got to the pharmacy or I would have asked her in person. She had
>>>suggested testosterone implants but I am reluctant to do something long
>>>term until I see what side effects I experience.
>>>
>>>Also - I believe I read that steroids increase SHBG (i think I got those
>>>letters in the right order) and so decrease free testosterone - so
>>>wouldn't using a hydorcortisone base reduce the effectiveness of the
>>>cream?
>>>
>>I'm not sure what is going on here. Like Why are you getting the
>>testosterone? and why can't you take it by mouth? We used to use
>>testosterone cream to treat Lichen sclerosis et atrophicus of the vulva.
>>Then we found out that high dose steroid cream worked better so we don't
>>do that any more. Very little if any testosterone will be absorbed
>>through the skin and inhaled steroids don't get into the blood stream
>>either.
>>Estrogens increase SHBG (Sex Hormone Binding Globulin)
>>
>>--
>>R
>
>--
>Amy
>

--
R.Daniel Braun, MD  FACOG   FOG
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