Dr. Rachel Rubin

I knew you would like this analogy.

I knew you would like this analogy.

I think it's a really important question, and we see this clinically all the time. If you give somebody, say, micronized progesterone or a synthetic progestin, say, in birth control, you will see a wide variety of reactions to these different medications.

I think it's a really important question, and we see this clinically all the time. If you give somebody, say, micronized progesterone or a synthetic progestin, say, in birth control, you will see a wide variety of reactions to these different medications.

And so I would say it has to probably do with the GABA receptor in the metabolites of progesterone and how the receptors in the brain use these molecules. And so I think we just don't know enough. You know, I tell my patients all the time, I wish... Oh my gosh, we have so much work to do in women's health. We have so much research we need done.

And so I would say it has to probably do with the GABA receptor in the metabolites of progesterone and how the receptors in the brain use these molecules. And so I think we just don't know enough. You know, I tell my patients all the time, I wish... Oh my gosh, we have so much work to do in women's health. We have so much research we need done.

This is why I come on this platform, not because I want to be on this platform, but I need smart people to be listening to this, to ask the research questions and to do this research. Because clinically, we see this all the time. I will... put up that menstrual cycle with my patients and say, when do you start to have symptoms? Are you having symptoms when your estrogen is falling?

This is why I come on this platform, not because I want to be on this platform, but I need smart people to be listening to this, to ask the research questions and to do this research. Because clinically, we see this all the time. I will... put up that menstrual cycle with my patients and say, when do you start to have symptoms? Are you having symptoms when your estrogen is falling?

Are you having symptoms when your progesterone is falling? And can we hack this system to help you feel better? And how are you going to respond to it? Because when we give someone micronized progesterone, I would say a third of the patients love it and guzzle it like it's candy. And they're the happiest people in the world. Helps their sleep, reduces anxiety. Oh, my God. Changes their life.

Are you having symptoms when your progesterone is falling? And can we hack this system to help you feel better? And how are you going to respond to it? Because when we give someone micronized progesterone, I would say a third of the patients love it and guzzle it like it's candy. And they're the happiest people in the world. Helps their sleep, reduces anxiety. Oh, my God. Changes their life.

Oh, it's absolutely life changing. A third of the patients are like, I don't really notice. It doesn't bother me. I'm fine. But if you tell me I need to take it, I'll take it. If you tell me I need to take it to protect my uterus, no problem. And then you've got a third of patients who are very sensitive. And even within that third, it is extreme.

Oh, it's absolutely life changing. A third of the patients are like, I don't really notice. It doesn't bother me. I'm fine. But if you tell me I need to take it, I'll take it. If you tell me I need to take it to protect my uterus, no problem. And then you've got a third of patients who are very sensitive. And even within that third, it is extreme.

I mean, we see progesterone allergies where people have horrible reactions to it makes me too sleepy. It makes me feel bloated. I don't like this. And so I don't as a clinician and an interested researcher, like I don't know exactly enough to be able to spot who those people are ahead of time.

I mean, we see progesterone allergies where people have horrible reactions to it makes me too sleepy. It makes me feel bloated. I don't like this. And so I don't as a clinician and an interested researcher, like I don't know exactly enough to be able to spot who those people are ahead of time.

So I think this is a really important question in the sense of what is the risk of taking hormone therapy in that patient? And what is the risk of not taking hormone therapy in that patient? And so I think it's super interesting because we love talking about the risks of medication, but we don't spend a lot of time talking about the risks of not taking medication.

So I think this is a really important question in the sense of what is the risk of taking hormone therapy in that patient? And what is the risk of not taking hormone therapy in that patient? And so I think it's super interesting because we love talking about the risks of medication, but we don't spend a lot of time talking about the risks of not taking medication.

So if we think about that woman as she gets older, she certainly will have the microbiome and genital and urinary changes of not having hormones. So as a urologist, this is actually one of the couple things that will kill her.

So if we think about that woman as she gets older, she certainly will have the microbiome and genital and urinary changes of not having hormones. So as a urologist, this is actually one of the couple things that will kill her.

As you lose hormones in the genitals, which are very hormone sensitive, the bladder is very hormone sensitive, you change the microbiome, you decrease the acidity of the tissue, the bad bacteria grow, your risk of urinary tract infections increase drastically. So she may get recurrent urinary tract infections or pelvic pain.

As you lose hormones in the genitals, which are very hormone sensitive, the bladder is very hormone sensitive, you change the microbiome, you decrease the acidity of the tissue, the bad bacteria grow, your risk of urinary tract infections increase drastically. So she may get recurrent urinary tract infections or pelvic pain.