Jennifer Gunter

So, you know, if somebody's on a 25 or 37 and a half microgram patch long-term, there's, you know, we probably have very, we have very little data to say that would be something that's harmful.

And if somebody feels better, then that's the reason to do it.

But also if someone says, I'm low risk of osteoporosis, I took it for six years.

I don't have any hot flashes.

I want to see if I need it for hot flashes.

I'm going to support somebody coming off too.

I'm going to support them in either direction.

So I would need more information.

I would want to know what benefits she's hoping to get from it.

Because if it was for cardiac prevention or dementia, I would say, well, there would be no reason to do that.

And I would say that, you know, based on WHI and based on keeps, which we have, you know, good long-term data on, that we could say that the risk of starting menopausal hormone therapy in the 60s might be slightly elevated from a cardiac, might not.

It's kind of on the border.

In the 70s, for sure.

the risk for dementia starts to increase around the age of 65 from the data that we get.

So if I have somebody who's 61, who's been struggling with hot flashes for 10 years, and she could, you know, when she went through menopause at 51, and she couldn't get any doctor to prescribe it for her, and she's at low risk from a cardiac standpoint, of course, I'm going to offer that woman a patch.

If she's telling me she wants to take it to prevent dementia, and that's the only reason, I'm going to have a different discussion because I'm going to say this isn't going to do that for you.

Yeah, but that's medical care in general, right?

information that's kind of off track now um i just like to say there's lots of amazing you know menopause providers out there and lots of people doing a really good job and i would say the menopause society does a really good job at distilling you know the best of the evidence and i'm just going to put a plug in for ACOG has a book coming out i think in january or february written by like

the true giants in the field, so.

Well, I think that it's hard.