WOMENS-HEALTH Messages for July, 1998: Re: adenomyosis/endo/lupron

Re: adenomyosis/endo/lupron

From: Joseph R. Feste, MD (anonymous@obgyn.net)
Wed, 22 Jul 1998 07:20:07 -0500 (CDT)

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Previous message: Don Shuwarger, M.D.: "Re: Endometrial currettings"
In reply to: katy: "adenomyosis/endo/lupron"

At Sun, 19 Jul 1998, katy wrote: >
>hi
>my sister (26) has had "disfuctional bleeding for apprx.10 years. she
>has had 2 dnc's, last year had a hysterocopy
>that was inconclusive. she is currently on oral contracept.
>her doctor has strong belief that this is adenomyosis.
>a hysterectomy is not an option w/ the doctor due to young
>age. Her bleeding is very heavy with severe cramping, cycle
>is about every two weeks. The oral contracept. is not working. She
>has been proposed with new treatment - Lupron.
>She is not sure of this medication due to the potential severe side
>effects. Having a "lap" is an option to rule
>out "endo". We have a family history of thyroid disease.
>Our father had hyperthyroid (surgery to correct). I have
>hypothyroid along with alopecia totalis.Her TSH levels have been in
>normal range. Questions:
>
>Should lap be done to rule out endo before starting lupron?
>Should she pursue seeing endocrinologist?
>
>Any help would be greatly appreciated.
>Thanks,
>Katy

First of all Katy, adenomyosis is very unusual in a 26 year old and can not be the cause of the bleeding problem for ten years. She needs to see an endocrinologist first and rule out thyroid disease. Thyroid disease can cause bleeding in a young woman. If this is negative, Lupron would be a choice and it iis a good drug. The only side signifant effects are hot flashes and vagina dryness and these can be controlled by add-back therapy. She also may have some unusual congenital problem with the estrogen receptors in her uterus. This wold reguire some special hormone therapy to stimulate the receptor activity which might help. I also will use "fertility drugs' like clomid to stimulate normal ovulation which might help. Good luck and let me know if I can be of any more help.

Sincerely,

--
Joseph R. Feste, MD

Next message: anonymous@obgyn.net: "please cancel my subscription"
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In reply to: katy: "adenomyosis/endo/lupron"

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