Dr. Mary Claire Haver

And I was so excited because I already knew about it.

And it started getting more discussed.

But I am not sure even in our residency if we're getting this.

But I talk about it when I give Grand Rounds and when I give my progestin lectures because I get really excited about this.

It's important.

Yeah, so this is really tricky.

If we're using it for birth control purposes, it has to have a progestin.

But if we're using it for menopausal hormone therapy, if you have a uterus, we have to do something to protect your uterus.

So we can do trial and error of different ones.

What I oftentimes find, I will say, is that because drospirinone has a very different molecular structure than the other progestins, it usually is kind of my go-to when everything else has failed.

And it's been shown in PMDD, for example, premenstrual dysphoric disorder.

It's the only FDA approved medication for that because all the other birth controls don't work.

It became my go-to.

Yeah, because they act like progesterone in the brain.

So instead of being like, I'm only going to have progesterone, you know, two weeks a month, now you've got it four weeks a month when you're taking a traditional birth control.

And that's why drosperinone works better.

I would say the progestogens in general, one is that they're dangerous.

I mean, I think that, you know, everything we do is a balance of risks and benefits.

The fact that people think they all work the same, they don't.

They work differently.