Dr. Mary Claire Haver

Remember how I talked about how progesterone can be turned into estrogen, right?

And so if, you know, if progesterone can be metabolized into estradiol, well then norethindrone can be metabolized into ethanol estradiol.

How did I not know this?

This is not common knowledge, but the key, so let's talk about it.

Have you heard of ad-back therapy?

So if you gave Lupron and you give ad-back therapy, what are the ad-back therapies that you give?

Yeah.

Estradiol and or agestin.

So why?

The question is why?

So the goal of ad-back therapy is to mitigate the side effects of something like Lupron that puts you into menopause, hot flashes, bone loss.

Well, why would giving a progestin minimize?

It's a very reasonable thing.

None of us were taught that, but it makes sense, right?

Why would this progestin somehow magically be the only one?

Because it converts into ethanol estradiol.

And so it mitigates hot flashes.

It can prevent bone loss.

It also stabilizes the lining of the uterus, partly through its progestin action, but partly through its ethanol estradiol action as well.

Provera is another one we use.