Jennifer Gunter

So what is the reason you're taking it and what are your underlying risks?

So for example, if you're taking combination therapy, so an estrogen plus a progestogen,

We think that there's data to say that progesterone gives you a lower risk of breast cancer, but we don't know for sure.

The observational data is actually conflicting.

So I think it's best to go with the fact there is probably an increased risk.

The actual percentage, we probably don't know.

WHI, it's 28%.

So if you take somebody who has a lower underlying risk of breast cancer and somebody who has a higher underlying risk of breast cancer, that 28% might mean different things to those people.

And so I think it's important to have that discussion.

It's also important to have the discussion, you know, what's their risk of osteoporosis?

What's their risk of endometrial cancer?

And that's a really...

Really important thing because most of the data tells us that progesterone is not as good at preventing endometrial cancer as the progestins.

But the progestins may be associated with a higher risk of breast cancer.

And so it's really important for us to individualize what for that individual person.

And so what I say for people who want to stay on it long-term because they feel better on it, something that hasn't been quantified in studies, I would say the best thing is probably for you to be on transdermal.

because your risk of clot increases with age.

So your risk of blood clot at 50 is not the same as your risk of blood clot at 75, right?

And so probably transdermal is safer.

And probably the lower doses are safer because these higher doses that we see a lot of people on now with transdermal, these are things that have been captured in any studies except the primary ovarian or premature ovarian insufficiency data.