Dr. Jen Gunter

When you put the risks in perspective, it's quite safe.

If you're getting benefit from it, fantastic.

And I just think there's enough good reasons to be on for people who need it that why do we have to go into this maybe category?

I think that many people have their hot flashes and their night sweats undertreated, absolutely.

I think that there are people who are suffering and their doctors either tell them erroneously, well, this is too risky to be on.

But also, we also have to acknowledge that we have a lot of people with high cardiovascular risks and that we do know that the greater the cardiovascular risk, the more concern we have about prescribing estrogen.

And so we have to kind of put that in context.

So it's always hard to sort of say like, well, what's the actual patient population?

So I would say lots of people have their hot flashes and their night sweats undertreated.

Lots of people have other symptoms that are undertreated.

We have less good data about the other symptoms.

And so, for example, joint pain is a fairly common symptom of menopause.

The studies aren't like that great when you look at them.

There aren't that many that were specifically designed to look at joint pain.

There was a study called, I think it was called Wisdom, and there's now a new Wisdom trial.

So I'm forgetting the point where we were using that.

Yeah, so this was also looking at permanent provera like the WHI, and I believe it was started during the WHI and then halted when the WHI was halted or when those results came out.

But they had a year of data, and they actually, unlike the WHI, did have younger women enrolled, and they also were really following them based on all of their symptoms.

And they found that on estrogen, something like,

I don't have the number specific, but we'll say like maybe 52, 53% had joint pain.