Portrait of a Woman Post-hysterectomy



	Portrait of a Woman Post-hysterectomy
		Patient: Elizabeth W.* Age: 40 Occupation: Phys. Ed. teacher/Swim coach Symptoms: Fibroids causing excessive bleeding Diagnosis: Requires abdominal hysterectomy and oophorectomy Current Treatment: None Situation: Will require estrogen therapy for sudden onset of vasomotor symptoms due to surgical menopause
	The solution for Elizabeth W... Estrasorb turns over a whole new leaf. *Hypothetical patient profile; model is used for illustrative purposes only.

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ESTRASORB is indicated for the treatment of moderate to severe vasomotor symptoms associated with menopause. Estrasorb should not be used in women with any of the following conditions: undiagnosed abnormal genital bleeding; known, suspected, or history of cancer of the breast; known or suspected estrogen-dependent neoplasia; active deep-vein thrombosis, pulmonary embolism or history of these conditions; active or recent (eg, within the past year) arterial thromboembolic disease (eg, stroke, myocardial infarction); liver dysfunction or disease. ESTRASORB should not be used in patients with known hypersensitivity to its ingredients; known or suspected pregnancy. There is no indication for ESTRASORB in pregnancy. There appears to be little or no increased risk of birth defects in women who have used estrogens and progestins from oral contraceptives inadvertently during early pregnancy (see PRECAUTIONS in full Prescribing Information).

Estrogens increase the risk of endometrial cancer. Close clinical surveillance of all women taking estrogen is important. Adequate diagnostic measures, including endometrial sampling when indicated, should be undertaken to rule out malignancy in all cases of undiagnosed persistent or recurring abnormal vaginal bleeding. There is no evidence that the use of "natural" estrogens results in a different endometrial risk profile than synthetic estrogens at equivalent estrogenic doses. (see WARNINGS, Malignant neoplasms, Endometrial cancer).
Cardiovascular and other risks. Estrogens with or without progestins should not be used for the prevention of cardiovascular disease or dementia. (see WARNINGS, Cardiovascular disorders and Dementia).
The Women's Health Initiative (WHI) study reported increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 79 years of age) during 5 years of treatment with oral conjugated estrogens (CE 0.625 mg) combined with medroxyprogesterone acetate (MPA 2.5 mg) relative to placebo (see CLINICAL PHARMACOLOGY, Clinical Studies, Warnings, Cardiovascular disorders and Malignant neoplasms, Breast cancer).
The Women's Health Initiative Memory Study (WHIMS), a substudy of WHI, reported increased risk of developing probable dementia in postmenopausal women 65 years of age or older during 4 years of treatment with oral conjugated estrogens plus medroxyprogesterone acetate relative to placebo.

It is unknown whether or not this finding applies to younger postmenopausal women. (See CLINICAL PHARMACOLOGY, Clinical Studies, Warnings, Dementia and PRECAUTIONS, Geriatric Use). Other doses of conjugated estrogens with medroxyprogesterone acetate, and other combinations of estrogens and progestins were not studied in the WHI and, in the absence of comparable data, these risks should be assumed to be similar. Because of these risks, estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.