What are your guys favorite "go to" oral contraceptives and regimens when discharging a stable heavy vaginal bleeder? There are so many choices and it can become confusing on which ones to Rx . Will any of them do the job? Do you start them 1 tab per day or do you double up first few days etc? Do you give them just 1-2 weeks worth of do you give 30 days worth? Also if they are already on oral birth control can we tell them to double the dose for a few days? I rarely rx oral contraceptives and when I do feel slightly uncomfortable since I don't do it often. Thanks!
Excellent piece. This has always been an area of discomfort for me...confusion about the when and why of hormone Rx and which ones to Rx...two questions despite listening 4 times....with the brick and mortar analogy why does adding an estrogen supplement stop bleeding if it results in more building of a wall without mortar....wouldn't that just create more bleeding since the unstable wall is just getting bigger? Second what is the whole issue with the endometrial bx. Most of the time I can not reach an OB at 3 am who will say anything other than...if she is "stable" dont start anything and have her call the office in the morning to arrange follow up" Not to comforting. I would prefer to start the hormones...does starting OCP actually hinder the endometrial bx accuracy?
To join the conversation, you need to subscribe.
Sign up today for full access to all episodes and to join the conversation.
Adam N. PA-C MS - October 2, 2016 3:17 PM
What are your guys favorite "go to" oral contraceptives and regimens when discharging a stable heavy vaginal bleeder? There are so many choices and it can become confusing on which ones to Rx . Will any of them do the job? Do you start them 1 tab per day or do you double up first few days etc? Do you give them just 1-2 weeks worth of do you give 30 days worth? Also if they are already on oral birth control can we tell them to double the dose for a few days? I rarely rx oral contraceptives and when I do feel slightly uncomfortable since I don't do it often. Thanks!
Sean G., M.D. - October 17, 2016 2:37 AM
Excellent piece. This has always been an area of discomfort for me...confusion about the when and why of hormone Rx and which ones to Rx...two questions despite listening 4 times....with the brick and mortar analogy why does adding an estrogen supplement stop bleeding if it results in more building of a wall without mortar....wouldn't that just create more bleeding since the unstable wall is just getting bigger? Second what is the whole issue with the endometrial bx. Most of the time I can not reach an OB at 3 am who will say anything other than...if she is "stable" dont start anything and have her call the office in the morning to arrange follow up" Not to comforting. I would prefer to start the hormones...does starting OCP actually hinder the endometrial bx accuracy?