Dr. Mary Claire Haver

They just don't bleed.

It's a wonderful side effect of that particular formulation.

The problem is there's no generic.

It's one standard dose.

It doesn't work for everyone.

But I just want everyone to know that there is an option.

Are vaginal or alternative progesterone routes better for endometrial protection?

We don't really know if they're better for endometrial protection.

When our patients are having progesterone intolerance, meaning they're having side effects, they feel dizzy.

I was on Cronone for fertility and I had horrible dizziness in the operating room.

Like I was a resident doing all these fertility treatments and I used a certain progestogen.

And it made me loopy.

So I get it.

Some people have about, we think 10 to 15% will have an adverse reaction to progesterone.

So you can go vaginal progesterone and kind of skip that first pass effect in the liver and it gets absorbed straight into the bloodstream.

You just take the regular oral estradiol pill that has a gel cap and you can put it in the vagina.

Like when you go to bed and it will dissolve overnight, you'll be able to absorb your progesterone that way.

Some patients do really, really well with that.

So that is an option.

But no one has measured like oral versus vaginal approach for endometrial protection.