[NP-Clinical] Tapering HRT

[Pat Camillo]

I totally agree......this is a highly individualized situation....there is no algorithym and never will be.......each woman presents with a very unique hormonal profile. For some, it will be relatively easy but for others it could take years! In the latter instance, my hunch is that taking HT likely suppressed and/or evened out some erratic estrogen effects caused by any number of lifestyle choices.  The only real way to help a woman is to sit down and try and figure out what might be influencing her hormones and then take it from there.........

here is one example of a woman I saw just last week......she has been to SO many holistic/natural/etc providers in the past year.......she is in her mid 40's - a time when she should have relatively high endogenous estrogen levels - and instead she has an almost atrophic vagina (still menstruating regularly). One thing under consideration is the possible effect of something she has been taking called grape seed extract......currently under study at NIH as an aromatase inhibitor (estrogen suppressant) in post menopausal women with breast cancer.

Always interesting :)

Pat

Pat Camillo PhD,RN,APN,C
Certified Nurse Practitioner in Women's Health,
Gerontology and Menopause
Carmenta Health
1 Kalisa Way Suite 103
Paramus, New Jersey 07652
(201) 265-9042
  ----- Original Message ----- 
  From: Priscilla Merrill 
  To: 'NP Clinical' 
  Sent: Sunday, January 14, 2007 10:40 AM
  Subject: RE: [NP-Clinical] Tapering HRT 


  There is no guideline or written in stone way to do it.  Some go cold turkey and do fine.  I tend to wean them down on the dose every 6 mos till I get them to the lowest possible.  If symptoms are tolerable, I then have them omit a dose each week, and then add a day each week (not consecutive days however) to omit a dose.  If they have return of symptoms that are intolerable, they go back up to next level for a week. This is the way I’ve done it and has worked well for me.  Others hear the news, stop the meds that day and do just fine.  To sum up, it’s “stop to low, go slow”.

   

  Priscilla Merrill FNP

   


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  From: np-clinical-bounces at nurse.net [mailto:np-clinical-bounces at nurse.net] On Behalf Of Mavis Hampton
  Sent: Sunday, January 14, 2007 9:45 AM
  To: 'NP Clinical'
  Subject: [NP-Clinical] Tapering HRT 

   

  Anyone have good advice on how to taper a woman from HRT when she is on Premarin and Provera? 

  What about the break through bleeding when she comes off the Provera? 

  And how do you taper if she is just on premarin alone? 

   

   



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