Dr. Thaïs Aliabadi

Even when they undergo a hysterectomy and they're using estrogen patches, you always want to give them the progesterone because otherwise you stimulate these implants again because of unopposed estrogen.

That's one reason.

And also we use the progesterone, micronized progesterone,

in hormone replacement for patients who are anxious, who are not sleeping well, regardless of whether or not they have a uterus.

But endometriosis patients, their hormone replacement should always be with progesterone.

So one reason our body doesn't, you know, when we don't ovulate, we don't make that corpus luteal cyst and we don't have that progesterone being secreted.

So in PCOS, let's say, by lowering your weight, by lowering that visceral fat, but by regulating your insulin resistance,

you can increase your chance of ovulation.

And by ovulation, then you start releasing the progesterone.

So that's the best way of describing it.

But for perimenopausal women, then you need to prescribe them the micronized progesterone.

As we get closer to menopause, we become more insulin resistant, regardless of whether we had PCOS or not.

So dealing with insulin, almost all of us women, we deal with insulin resistance at some point in our life at different degrees.

But that goes to the, you know, what I was telling you when you load the gun with your genetics and you pull the trigger with epigenetics, your diet, your exercise, your sleep, your stress, all of that will affect it long term.

But you see, but now you know how to answer it.

Don't dismiss your endometriosis.

Don't dismiss your PCOS.

Know your egg count.

Make sure you freeze your eggs early if you can afford it.

You know, I mean, all the steps we talked about for the past four hours.