Dr. Jen Gunter

What we could say is, well, brain fog is kind of a complex thing.

We don't even really have a good definition of it.

Maybe.

Depends on, you know, if you're having super irregular periods, it's a very, you know, it's a common symptom that's described.

There's other causes too, like anemia and other things.

So would it be reasonable to try menopause hormone therapy, especially if you're not sleeping well?

Because not sleeping well, absolutely...

sure it's reasonable to try but we also shouldn't maybe neglect looking at your thyroid and making sure you don't have diabetes and checking these other things right so that again there's that difference between the the nuances of the discussion and saying it's definitive and i would say being definitive you wouldn't if you said i'm taking menopause hormone therapy to treat brain fog and perimenopause because a influencer told me it's going to do that that's not

informed consent because we don't have any studies so you can say well you know you can try it and it might help you and i'm absolutely not opposed to it but you know let's say okay we're going to try it and if you're not improved in three months then we're going to say the trial was unsuccessful you know decide what's the best dose and so those are the nuanced conversations that you know when you have 30 years of experience talking with patients about about the medication um and it's always interesting you know whenever i talk like this i will get people saying well you're opposed to menopause hormone therapy

What are you even talking about?

No, I just want people to make decisions with all of the information.

Well, I would say that you may be harnessing the placebo effect initially, but we know that tends to wear off.

And so then what happens?

Does that lead to people escalating doses into increasingly unsafe levels?

I've definitely seen that for some people who come in on these massive doses.

heavy bleeding, you know, risk of endometrial cancer, other types of things, right?

Maybe risk of blood clots.

So there's that.

And we also know that the more people pay for something, the greater the placebo response.

That's actually, there's a fascinating study looking at Parkinson's disease.