Dr. Mary Claire Haver

We have, like any medication, we have transdermal, we have oral, we have transmucosal, we have, you know, and it does seem to make a difference.

Are you seeing that in your practice as well?

And that's what we typically say is let's go with a totally different formulation.

Yes, if it's not tolerated.

We see, I think, a lot more of it on the progesterone side with, you know, a paradoxical reaction to progesterone, which is supposed to be a little bit sedating.

Either they'll just feel completely grogged out or they'll have a big mental health change with the oral micronized progesterone, typically.

And the synthetic versions, like the norethendrone that's in the patches,

They actually tolerate a lot better, probably because it converts to ethanol estradiol in the metabolism process.

So they get a little estrogen.

That's all very endocrine coded, you know, complicated stuff.

The good news is we have multiple ways to get this into your system to figure out what's going to work.

And sometimes we just throw spaghetti at the wall and just keep trying until we get better.

And so and never really understanding what's going on in the background.

And so I think that's what I love about the internet.

In women's health, one thing I know that social media changed was getting pain control for gynecologic procedures.

When you have millions of women screaming on the internet that they thought they were going to die during their IUD placement, where I was taught there's no reason to give any kind of pain control for an IUD.

And then I start doing them and like, wait a minute.

20% of my patients are not okay with this.

And so really fighting to make that change, which has happened.

Yeah, I agree.