I very much enjoyed Dr. Jerrilynn Prior’s article entitled “Symptomatic Menopause--What Are the Safe and Effective Options?” in the October 2005 edition of your journal. I have three questions.
Question 1-Does Dr. Prior recommend the addition of a progestin for women with an intact uterus using vaginal estrogens for dryness/dysparunia?
Question 2-In figure 1, she suggests that women with disturbing hot flushes combined with osteoporosis take transdermal estradiol along with daily micronized progesterone at a dose of 300 mg. In the text of her article, she states that this dose of OMP is equivalent to 10 mg of MPA. This seems like a higher dose of MPA than most would use for daily dosing. Is this correct?
Question 3-Is there evidence to assure us that unopposed progestin therapy (as she suggests as treatment for severe vasomotor symptoms without osteoporosis) is safe?
Again, thanks very much for the informative article.
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