Guest guest Posted November 22, 2009 Report Share Posted November 22, 2009 Hi everyone Please remember that each of us has a right to speak freely, so long as we avoid abuse, racism, or being off topic. Putting something reasonable in the subject heading of the post should make obvious to people what the topic is about. If you don’t want to read the emails / message thread (for whatever reason) then don’t read. It is as simple as that. It can be very difficult to get good accurate information from knowledgeable healthcare providers. We welcome information sharing, or references to good information. For example – only recently have I read about this (please read below). No topic is off topic. Please learn to listen or be tolerant other people’s opinions. You don’t have to agree with them. Shireen Mohandes London, England Management of POF needs to address the two major following medical issues that are applicable to primary ovarian insufficiency in general and not specific for BPES, as no data specific to BPES are available: Hormone replacement therapy (HRT). The American Society for Reproductive Medicine and the International Menopause Society recommend estrogen replacement therapy for women with primary ovarian insufficiency (amenorrhea and a menopausal serum FSH concentration). Although no data from randomized trials guide the use of hormonal therapy in women with BPES and POF, a reasonable regimen would be 100 ìg of transdermal estradiol and 10 mg of oral medroxyprogesterone acetate daily for the first 12 days of each month. Women should keep a menstrual calendar and have a pregnancy test promptly in the case of late menses [ 2009]. A pelvic ultrasound examination and measurement of bone mineral density are indicated at the time of diagnosis of ovarian insufficiency. Women with primary ovarian insufficiency should be encouraged to maintain a lifestyle that optimizes bone and cardiovascular health, including engaging in regular weight-bearing exercise, maintaining an adequate intake of calcium (1200 mg daily) and vitamin D (at least 800 IU daily), eating a healthy diet to avoid obesity, and undergoing screening for cardiovascular risk factors, with treatment of any identified risk factors. Infertility. No therapies have been shown to restore ovarian function and fertility. Some couples are averse to adoption and to reproductive technologies and are content not to become parents or to accept the unlikely but real chance that the infertility will resolve spontaneously (see Natural History). For couples who decide to pursue parenthood actively, the options are adoption, foster parenthood, embryo donation, and egg donation. The rates of pregnancy with egg donation appear to be similar among older and younger women. Women with primary ovarian insufficiency who become pregnant as a result of oocyte donation may have an increased risk of delivering infants who are small for gestational age and of having pregnancy-induced hypertension and postpartum hemorrhage, but these findings are controversial [ 2009]. The issue of POF is emotionally charged and should be discussed with the patient with this in mind. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 22, 2009 Report Share Posted November 22, 2009 Thank you Shireen! This is a support group and we should all feel free to be able to discuss or ask for support on a particular issue relating to BPES. I may not always agree with what somebody is posting but I like reading them because there are many perspectives/new research etc and I may just learn something new that can aide our family, in particular my daughter who is nine and is the only one in our family with BPES. Thank you to everybody who has the courage to ask for help and for those of you who share your experiences...I truly appreciate you. Sincerely, Debbie Weston From North Georgia mountains! > > Hi everyone > > Please remember that each of us has a right to speak freely, so long as we > avoid abuse, racism, or being off topic. Putting something reasonable in the > subject heading of the post should make obvious to people what the topic is > about. If you don't want to read the emails / message thread (for whatever > reason) then don't read. It is as simple as that. > > It can be very difficult to get good accurate information from knowledgeable > healthcare providers. We welcome information sharing, or references to good > information. For example - only recently have I read about this (please read > below). > > No topic is off topic. > > Please learn to listen or be tolerant other people's opinions. You don't > have to agree with them. > > Shireen Mohandes > > London, England > > Management of POF needs to address the two major following medical issues > that are applicable to primary ovarian insufficiency in general and not > specific for BPES, as no data specific to BPES are available: > > Hormone replacement therapy (HRT). The American Society for Reproductive > Medicine and the International Menopause Society recommend estrogen > replacement therapy for women with primary ovarian insufficiency (amenorrhea > and a menopausal serum FSH concentration). Although no data from randomized > trials guide the use of hormonal therapy in women with BPES and POF, a > reasonable regimen would be 100 ìg of transdermal estradiol and 10 mg of > oral medroxyprogesterone acetate daily for the first 12 days of each month. > Women should keep a menstrual calendar and have a pregnancy test promptly in > the case of late menses [ > <http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene & part=bpes#bpes.REF. > nelson.2009.606> 2009]. > A pelvic ultrasound examination and measurement of bone mineral density are > indicated at the time of diagnosis of ovarian insufficiency. Women with > primary ovarian insufficiency should be encouraged to maintain a lifestyle > that optimizes bone and cardiovascular health, including engaging in regular > weight-bearing exercise, maintaining an adequate intake of calcium (1200 mg > daily) and vitamin D (at least 800 IU daily), eating a healthy diet to avoid > obesity, and undergoing > <http://www.ncbi.nlm.nih.gov/bookshelf/?book=gene & part=glossary & rendertype=d > ef-item & id=screening> screening for cardiovascular risk factors, with > treatment of any identified risk factors. > > Infertility. No therapies have been shown to restore ovarian function and > fertility. Some couples are averse to adoption and to reproductive > technologies and are content not to become parents or to accept the unlikely > but real chance that the infertility will resolve spontaneously (see > <http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene & part=bpes#bpes.Natu > ral_History> Natural History). > > For couples who decide to pursue parenthood actively, the options are > adoption, foster parenthood, embryo donation, and egg donation. The rates of > pregnancy with egg donation appear to be similar among older and younger > women. Women with primary ovarian insufficiency who become pregnant as a > result of oocyte donation may have an increased risk of delivering infants > who are small for gestational age and of having pregnancy-induced > hypertension and postpartum hemorrhage, but these findings are controversial > [ > <http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene & part=bpes#bpes.REF. > nelson.2009.606> 2009]. > > The issue of POF is emotionally charged and should be discussed with the > patient with this in mind. > Quote Link to comment Share on other sites More sharing options...
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