Most practitioners in this field develop their own particular strategies and may have varying views for example on the levels of E2, which they choose for timing repeat implants. There is a great deal of variability between laboratories in oestradiol assay results. Your local pathologist should inform you about the specificity of their assay. It is generally better to use the same laboratory for each patient. Salient Points 50mg oestradiol implants at approximately 6 monthly intervals preceded by E2 measurement are generally well tolerated, efficient and safe.
Implants are generally more suitable for the hysterectomised woman.
Implants need to be implanted deeply into the subcutaneous fat. Tachyphylaxis is rare with this dosage. Regular screening mammography is essential in management of all women on hormone replacement therapy including implants. For women who complain of moderate to severe loss of libido, a testosterone implant may be effective when used in conjunction with oestradiol. Implants are of particular value in women who have had an hysterectomy and cannot tolerate or remember to take oral therapy.