Dr. Rachel Rubin

And so you're talking one medication, one dose, and we're still practicing fear-based medicine 30 years later, whatever it is, saying like, we don't practice any other medicine like this. We're like, Well, there was one study about surgery 30 years ago, and that's the way we practice medicine. We evolve, we learn new things. So what did it show? Let's talk about the good.

And so you're talking one medication, one dose, and we're still practicing fear-based medicine 30 years later, whatever it is, saying like, we don't practice any other medicine like this. We're like, Well, there was one study about surgery 30 years ago, and that's the way we practice medicine. We evolve, we learn new things. So what did it show? Let's talk about the good.

When you took estrogen and progestin or estrogen alone, you had a decreased risk of colon cancer. You had decreased risk of fractures, like significant decrease of fractures. Decrease of diabetes. Okay, that seems like a good, those seem like all good things. This is in the hormones we don't even really prescribe anymore.

When you took estrogen and progestin or estrogen alone, you had a decreased risk of colon cancer. You had decreased risk of fractures, like significant decrease of fractures. Decrease of diabetes. Okay, that seems like a good, those seem like all good things. This is in the hormones we don't even really prescribe anymore.

We saw a decrease in overall mortality, a decrease in cancer-specific mortality. And then when you looked at the cardiovascular data over time, and again, I'm a urologist, I'm not a heart expert, but you saw there was actually no difference. It actually wasn't so scary. Now, as you get older, we know birth control pills can cause blood clots.

We saw a decrease in overall mortality, a decrease in cancer-specific mortality. And then when you looked at the cardiovascular data over time, and again, I'm a urologist, I'm not a heart expert, but you saw there was actually no difference. It actually wasn't so scary. Now, as you get older, we know birth control pills can cause blood clots.

So we do worry about giving a birth control pill to grandma because you can increase blood clots. That's true. I agree with that. When it comes to breast cancer, the most fascinating data that didn't make the press conference, women who are on the estrogen alone, so they didn't have a uterus, so they didn't need the progestin therapy, had a decreased risk of getting and dying from breast cancer.

So we do worry about giving a birth control pill to grandma because you can increase blood clots. That's true. I agree with that. When it comes to breast cancer, the most fascinating data that didn't make the press conference, women who are on the estrogen alone, so they didn't have a uterus, so they didn't need the progestin therapy, had a decreased risk of getting and dying from breast cancer.

And it didn't make the news. Even in that study that put the box labeling on all the products, it's not true. So then when you looked at the estrogen and the progestin groups, there was a fear that there was an increased risk of incidence, but not mortality from breast cancer. And even when you look at that data, there is questioning of the fact that the placebo group

And it didn't make the news. Even in that study that put the box labeling on all the products, it's not true. So then when you looked at the estrogen and the progestin groups, there was a fear that there was an increased risk of incidence, but not mortality from breast cancer. And even when you look at that data, there is questioning of the fact that the placebo group

actually was more protected by breast cancer because many of them had been on hormones in the past. And when you use a correct placebo group, the lines actually go together. And so you're more of a statistics nerd than I am, but the reality is there was no difference. And so we scared an entire generation of people away from hormones because of a bad misinterpretation of statistics.

actually was more protected by breast cancer because many of them had been on hormones in the past. And when you use a correct placebo group, the lines actually go together. And so you're more of a statistics nerd than I am, but the reality is there was no difference. And so we scared an entire generation of people away from hormones because of a bad misinterpretation of statistics.

Shout it from every rooftop you can find.

Shout it from every rooftop you can find.

You are not going to get pushback from me on that. This is a disaster. I just got back yesterday from teaching at the largest internal medicine conference, ACP, the American College of Physicians, and you're talking more than 20,000 internal medicine physicians. What a wonderful thing. I was asked to give a course on female sexual dysfunction, and it was wonderful. I talked a lot about menopause.

You are not going to get pushback from me on that. This is a disaster. I just got back yesterday from teaching at the largest internal medicine conference, ACP, the American College of Physicians, and you're talking more than 20,000 internal medicine physicians. What a wonderful thing. I was asked to give a course on female sexual dysfunction, and it was wonderful. I talked a lot about menopause.

There was no other menopause content at this course. There was no courses, how to prescribe, given everything you've done, my colleagues and myself have done to bring it into just popularity. Patients are coming in asking questions, and there wasn't even a course to learn about I can't say that's true for GLP-1s or any of these lipid-lowering agents or all of the things that you've been pushing.

There was no other menopause content at this course. There was no courses, how to prescribe, given everything you've done, my colleagues and myself have done to bring it into just popularity. Patients are coming in asking questions, and there wasn't even a course to learn about I can't say that's true for GLP-1s or any of these lipid-lowering agents or all of the things that you've been pushing.

The problem is you now have a brain drain, I think, because the doctors who prescribed hormone therapy either retired or died, and there was no one they taught ahead of them. Now, I was very lucky. I had very good mentorship and incredible experience, but we are now trying to make up for lost time to train people how how to write prescriptions.

The problem is you now have a brain drain, I think, because the doctors who prescribed hormone therapy either retired or died, and there was no one they taught ahead of them. Now, I was very lucky. I had very good mentorship and incredible experience, but we are now trying to make up for lost time to train people how how to write prescriptions.