Gynecology Book

http://www.fpnotebook.com/

Sequential Estrogen ReplacementAka: Cyclic Estrogen Replacement

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  1. Protocol
    1. Estrogen taken daily
    2. Progestin taken for 2 weeks of each month
      1. First 2 weeks of month may be better remembered
  2. Estrogens Options
    1. Conjugated Estrogen (Premarin) 0.625mg qd OR
    2. Estropipate (Ogen) 0.625 qd OR
    3. Esterified Estrogen (Estratab) 0.625 qd
    4. Estradiol (Estrace) 0.5 mg PO qd OR
    5. Estradiol transdermal (Estraderm) 0.05 mg patch/week
  3. Progestin Options
    1. First line:
      1. Provera 5 mg PO qd OR
    2. Second line (refractory to Provera)
      1. Norethindrone 0.7 mg OR
      2. Micronized Progesterone 200 ug
  4. Adverse Effects
    1. Cyclic withdrawal bleed in 80-90% within 6 months

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