Acta clinica Croatica, Vol. 58. No. 1., 2019.
Other
https://doi.org/10.20471/acc.2019.58.01.21
Individualization of Custom Compounded Hormone Therapy in a Patient with Chemotherapy Induced Premature Ovarian Insufficiency and Impaired Liver Function – Case Report
Damir Franić
; Outpatient Clinic Ob&Gyn, Rogaška Slatina, Slovenia; School of Medicine, University of Maribor, Maribor, Slovenia
Matjaž Sever
; Department of Hematology, University Medical Centre Ljubljana, Ljubljana, Slovenia
Andrej Janež
; Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
Maja Franić-Ivanišević
; Department of Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia
Mojca Jensterle
; Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
Abstract
Although the use of commercially manufactured hormone therapy (HT) to treat menopausal symptoms has declined during the past 12 years, the use of custom compounded HT seems to have increased. A 39-year-old woman with refractory anemia sustained premature ovarian insufficiency following allogeneic stem cell transplantation. After systemic biologic treatment (azacitidine) and corticosteroid therapy, besides extreme climacteric symptoms (Green Climacteric Scale, 59) and impaired quality of life, she also had elevated liver enzymes. Therefore, she was not a candidate for oral HT. Treatment was started with 17-beta estradiol patch 0.5 mg (Climara) together with micronized progesterone intravaginally, 2x100 mg (Utrogestan) for 3 months. She was not satisfied, so the custom compound HT started with 17-beta estradiol 0.5 mg gel 2x/day and micronized progesterone in liposomal gel 100 mg/daily. She was much better but she complained of low libido, decreased sex drive and emotional instability, so 1% testosterone gel was added. Now she was completely satisfied, Green Climacteric Scale was 8 and liver enzymes were normal. In conclusion, custom compound HT has the possibility of tailoring and adjusting therapy to the individual need, which has been the everlasting goal in menopause medicine and should be a good option for special clinical cases.
Keywords
Custom compounded hormone therapy; Individualization; Premature ovarian insufficiency
Hrčak ID:
220913
URI
Publication date:
1.3.2019.
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