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Resolution of her symptoms required several interventions and immunotherapy for allergy. I will discuss only the EFA therapy. Because of the reported response of premenstrual mastodynia to EPO, pyridoxine, and magnesium [68], the patient was started on 3 gm per joint health day of EPO, 100 mg per day of pyridoxine, and 300 mg per day of magnesium as the oxide. During the first month of treatment, there was slight improvement in mastodynia and dysmenorrhea. During the second joint health month, she experienced a major exacerbation of both symptoms and in addition noted the development of increased perimenstrual pigmentation of her joint health upper lip. I suspected that EPO in this patient was increasing the formation of PGs derived from AA, since PGF2. is a major mediator of dysmenorrhea and PGE2 is a positive feedback modulator of estrogen formation in the ovary.
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