Dr. Rachel Rubin

But it is true for men and testosterone. We often find the topicals do not. Some they absorb beautifully and you get these beautiful levels and they feel great. And then you do have a population that just doesn't absorb well through the skin. And unfortunately, we don't know who those people are. I always tell patients, here's the menu and we're going to tinker.

But it is true for men and testosterone. We often find the topicals do not. Some they absorb beautifully and you get these beautiful levels and they feel great. And then you do have a population that just doesn't absorb well through the skin. And unfortunately, we don't know who those people are. I always tell patients, here's the menu and we're going to tinker.

We have to tinker to get it right for you because you're not like anybody. And so patches, a lot of people have heard of patches. They like patches. They make twice weekly patches and they make once weekly patches. I find the twice weekly patches are much better tolerated and my patients like them better. What's nice about patches is you have a wide variety of doses that you can play around with.

We have to tinker to get it right for you because you're not like anybody. And so patches, a lot of people have heard of patches. They like patches. They make twice weekly patches and they make once weekly patches. I find the twice weekly patches are much better tolerated and my patients like them better. What's nice about patches is you have a wide variety of doses that you can play around with.

When I start patients on hormones, I typically choose like a medium to medium low version because if you go too high initially, they get breast tenderness and they get really annoyed with you and then you have to backtrack. So I always like titrate up a little bit as we need to. So patches are nice, but for some people, they don't stick well. For some people, they don't absorb well.

When I start patients on hormones, I typically choose like a medium to medium low version because if you go too high initially, they get breast tenderness and they get really annoyed with you and then you have to backtrack. So I always like titrate up a little bit as we need to. So patches are nice, but for some people, they don't stick well. For some people, they don't absorb well.

For some people, they feel that they kind of drop off. If you change it twice a week, they feel like they're getting a little lower.

For some people, they feel that they kind of drop off. If you change it twice a week, they feel like they're getting a little lower.

Yeah. And there are people who are allergic to the adhesives. We see that as well. So some people, they love patches. Again, you have to have a menu. If you're going to a doctor and they give you one type of hormone therapy and that's the only type, please run. They need to know the menu because it's not a one size fits all. So there's gels and there are a number of different gels.

Yeah. And there are people who are allergic to the adhesives. We see that as well. So some people, they love patches. Again, you have to have a menu. If you're going to a doctor and they give you one type of hormone therapy and that's the only type, please run. They need to know the menu because it's not a one size fits all. So there's gels and there are a number of different gels.

There's gels like the brand name is Diva Gel goes on your thigh. There's Estrogel, which goes on your arm. There's Eva Mist, which is a spray, sort of an aerosolized spray that goes on your arm. Gels can be really nice because it's every day. So it's dosing every day. The challenge is sometimes they take a little bit to dry.

There's gels like the brand name is Diva Gel goes on your thigh. There's Estrogel, which goes on your arm. There's Eva Mist, which is a spray, sort of an aerosolized spray that goes on your arm. Gels can be really nice because it's every day. So it's dosing every day. The challenge is sometimes they take a little bit to dry.

So if you're a busy person and you want to rub something on and you want to run out of there, I find gels, not everybody wants to do something every day. You got to get to know the people. What do you like to do? What's your routine? You have to get it into their routine. And sometimes you got to work up to it. And sometimes I have patients, they'll use patches.

So if you're a busy person and you want to rub something on and you want to run out of there, I find gels, not everybody wants to do something every day. You got to get to know the people. What do you like to do? What's your routine? You have to get it into their routine. And sometimes you got to work up to it. And sometimes I have patients, they'll use patches.

But when the summertime hits and it's hot and muggy, they'll switch to the ring or they'll switch to a gel.

But when the summertime hits and it's hot and muggy, they'll switch to the ring or they'll switch to a gel.

Oh, so I love the ring. There's two types of ring. Now, this is important because your pharmacist sometimes messes this up. So there are two FDA approved rings. Now, a ring, just like a birth control ring, you set it and forget it. You put it in the vagina. The vagina does not feel it like a tampon. You don't feel it. And it just stays in for three months at a time.

Oh, so I love the ring. There's two types of ring. Now, this is important because your pharmacist sometimes messes this up. So there are two FDA approved rings. Now, a ring, just like a birth control ring, you set it and forget it. You put it in the vagina. The vagina does not feel it like a tampon. You don't feel it. And it just stays in for three months at a time.

You just kind of push it in there and it just settles in and finds a place. By the way, if you have penetrative sex, most people don't take it out. They don't feel it. Nobody's bothered by this thing. So this ring goes in there, stays in for about three months. Now there is a fem ring, which is a high dose ring, which means if you have a uterus, you need progesterone to protect the uterus.

You just kind of push it in there and it just settles in and finds a place. By the way, if you have penetrative sex, most people don't take it out. They don't feel it. Nobody's bothered by this thing. So this ring goes in there, stays in for about three months. Now there is a fem ring, which is a high dose ring, which means if you have a uterus, you need progesterone to protect the uterus.