Dr. Mary Claire Haver

Common sense will tell you it's getting right to the uterus immediately.

So none of us hesitate to use it and worry about endometrial protection.

I've never had a patient who did it that way who had any endometrial hyperplasia.

What do I do if progesterone causes reflux, mood changes, or poor tolerance?

You don't tolerate progesterone.

Look for alternatives.

Duivi is an option, switching to a progestogen, something like CombiPatch.

I was on CombiPatch for a couple of years.

It's not a bad medication.

Using one of the progesterone alternatives may be an option for you.

Or doing a Mirena IUD or a Lilleta.

you know, one of the progestin-containing IUDs could be a great option for you.

Are creams, pessaries, or other delivery methods effective and safe?

Listen, so I think what you're really asking are compounded options as safe as FDA-approved option, because we have creams, we have the rings or pessaries all available in FDA-approved options.

Those have been tested, and I can tell you with confidence that they ran those through clinical trials and

And we know the safety efficacy of those types.

But if you're getting them from a compounder, and I use compounding, I think it's a great option to have for a lot of things.

But my go-to for HRT is the FDA-approved options that you would pick up at CVS.

When should testosterone be added?

Okay.