Dr. Mary Claire Haver

There's never been an increased risk with natural progesterone.

I will say no one ever had this conversation or lecture with me, and I went to the top family planning program in the United States.

The way I was taught, and this is not to throw shade on my wonderful, wonderful professors, but it was pick a pill, any pill, they all work the same.

When I got into practice, I was like, they don't all work the same.

And I started looking into this and I started realizing that they target different receptors.

Some of them metabolize into each other.

So levonorgestrel is one that we see all the time.

It's used in IUD.

It's used in birth control pills.

Well, many of the other types of progestins just metabolize into levonorgestrel.

So if you're like, oh, I'm going to try a different one.

Well, it's just going to turn into levonorgestrel in the body.

And so knowing, you know, why would somebody do well with the Nexplanon, knowing that the type of progestin in the Nexplanon, that's the subdermal implant, is identical to the progestin that's used in the vaginal ring contraceptive, right?

So if someone didn't do well on this method, I'm not going to give them the vaginal ring necessarily.

And so getting really familiar with the progestins just opened up this whole world.

So I love taking these histories and then figuring out, and I've had a really good success helping people find a progestin that works for them.

It's not.

I will say that when I was taking my complex family planning board.

So, you know, what's nice is when that became a subspecialty certification for those of us that didn't do a fellowship, we could actually just take the exam and then get certified in it.

This was something that came up and we were teaching each other about it.