Dr. Rachel Rubin

0.01% estradiol. And we typically use a VersaBase or a methylcellulose base.

0.01% estradiol. And we typically use a VersaBase or a methylcellulose base.

No, but I would love to see that studied.

No, but I would love to see that studied.

It can be usually a methylcellulose or a VersaBase. There's a base called Elage that a lot of people are using right now. Again, I am not a compounding junkie in any way. This is a miraculous compound that literally will, if you have a patient who's on vaginal estrogen, systemic estrogen, systemic testosterone. I said, Peter, I still have pain with sex. It still kind of hurts.

It can be usually a methylcellulose or a VersaBase. There's a base called Elage that a lot of people are using right now. Again, I am not a compounding junkie in any way. This is a miraculous compound that literally will, if you have a patient who's on vaginal estrogen, systemic estrogen, systemic testosterone. I said, Peter, I still have pain with sex. It still kind of hurts.

It's always the vestibule.

It's always the vestibule.

Isn't it fun?

Isn't it fun?

So we have this idea in menopause medicine called the timing hypothesis.

So we have this idea in menopause medicine called the timing hypothesis.

The window or the timing hypothesis. So the question of the timing hypothesis is what are you afraid of? What are we worried about? We're worried about blood clots. We don't want to hurt people. We're worried about cancer. We're worried about blood clots. We're worried about heart disease. But the question is, is does the hormone therapy that we use apply to the data that we have?

The window or the timing hypothesis. So the question of the timing hypothesis is what are you afraid of? What are we worried about? We're worried about blood clots. We don't want to hurt people. We're worried about cancer. We're worried about blood clots. We're worried about heart disease. But the question is, is does the hormone therapy that we use apply to the data that we have?

And I would argue it doesn't. And so there is a level of we don't know what we don't know. But even the timing hypothesis using PremPro, which was the medicine used in the WHI, is under question. So Susan Davis from Australia just wrote a big paper questioning the timing hypothesis and say, actually, when you look at the data really closely, doesn't really hold muster.

And I would argue it doesn't. And so there is a level of we don't know what we don't know. But even the timing hypothesis using PremPro, which was the medicine used in the WHI, is under question. So Susan Davis from Australia just wrote a big paper questioning the timing hypothesis and say, actually, when you look at the data really closely, doesn't really hold muster.

We shouldn't really be forcing people to say you cannot start hormone therapy after 60. So I think this is where shared decision-making really comes into play of what are we treating? Do you care about your bones? Do you care about your sexual health? Do you care about your mental health? And do you want to see if hormone therapy helps with these things?

We shouldn't really be forcing people to say you cannot start hormone therapy after 60. So I think this is where shared decision-making really comes into play of what are we treating? Do you care about your bones? Do you care about your sexual health? Do you care about your mental health? And do you want to see if hormone therapy helps with these things?

Now, hormone therapy is indicated for three reasons. Vasomotor symptoms, hot flashes, night sweats, that sort of thing. prevention of osteoporosis, which to me is a green light. So anyone should be offered hormone therapy because who wouldn't want to prevent osteoporosis? And the thing I just talked about a lot is the genitourinary syndrome of menopause.

Now, hormone therapy is indicated for three reasons. Vasomotor symptoms, hot flashes, night sweats, that sort of thing. prevention of osteoporosis, which to me is a green light. So anyone should be offered hormone therapy because who wouldn't want to prevent osteoporosis? And the thing I just talked about a lot is the genitourinary syndrome of menopause.