Dr. Nirit Rosenblum

I see a lot of women coming in who are being given testosterone, both vaginally in compounded creams with estrogen and also with their systemic hormone therapy.

And I'm not quite clear, you know, sort of that it's really standard of care, particularly if you're talking about systemic hormone therapy.

So maybe

if you want to comment on any benefits or risks associated with testosterone and why you might give it either vaginally or systemically.

Yeah, I would agree.

I think that's a whole nother podcast that can be done about treatment of menopause and what is bioidentical and what is not bioidentical.

I also find that a lot of women who are given these formulations and many of them are doing them with online.

consultations with some of these websites, they really don't even know what they're getting.

They don't really understand what's in it.

They just know that it's compounded or they're told it's bioidentical.

But then when you try to ask them what's in it, they really are not aware.

And so I'm not sure they're getting the right kind of counseling or shared decision making as we've talked about.

But to your point,

Yeah, I agree.

And I think even more so those of us that are trained in urology and are now subspecialty trained, we really didn't have training in menopause in a lot of these sort of endocrine gynecologic issues.

And it's not being routinely addressed by their gynecologist.

So like Karen said, they're seeking it out elsewhere.

And perhaps more of us in this subspecialty need to think about, you know, getting certified as Karen did and maybe, you know, offering this treatment to patients.

It's not something I do routinely in my practice right now, mostly because I just don't have the time or the support staff.

I would actually be interested in doing it.