Dr. Rachel Rubin

And they've been wildly interested and successful.

And it's working when you teach them sort of how to do it.

And so I teach them that there's really five things to consider.

And you can do some of them by themselves.

You can do them all together.

But really, you as a patient have, I would say, five hormone things on your menu.

It's

whole body systemic progesterone, especially if you have a uterus, you have to protect that from uterine cancer if you're going to use estrogen.

Now, some people say it helps with sleep and it helps with mood and some people without a uterus take it.

Whole body testosterone therapy, which is global consensus that it helps with libido and is approved in Australia and New Zealand.

And so if it's safe enough for them, give me a break.

It should be safe enough for our

our americans so that's whole body three estrogen progesterone and testosterone that's three things then there's vaginal hormones which are needed even in the setting of systemic hormones and should and can be used without systemic hormones vaginal hormones prevent urinary tract infections help with the genitourinary syndrome of menopause and are safe for everybody on earth to take and the

fifth thing which is sort of extra credit and y'all are so smart you learned about it today on this podcast is that vestibule and so sometimes even with vaginal hormones that area around the urethra still be a little spicy and so if you're still having pain with penetration even though you're on vaginal hormones you may need to put a little topical on that vulvar vestibule or switch to a vaginal dhea to help with that vestibule so that's extra credit

So when I teach doctors and other clinicians on this course, we go through each of these modules and we really talk about, okay, well, when you're counseling a patient, what are you afraid of, right?

That's how I teach hormone therapy is I want every doctor and clinician who writes prescriptions say, well, can I use it in this patient?

Can I use it in that patient?

How about a 64-year-old who has this, that, and the other?

And my answer back to that is, what are you afraid of?

Are you afraid of stroke, blood clots, heart attacks, dementia?