Conversations on Estrogen & Progesterone Therapy
The Vagina Doctor Podcast with Duncan Turner MD
Estrogen & Progesterone in Menopause: Safety, Symptoms, and Treatment Options
Dr. Duncan Turner and nurse practitioner Sophie Mengel discuss how estrogen drops sharply in menopause and how estrogen replacement can relieve significant symptoms, while progesterone is often added for safety to protect the uterine lining and reduce the increased risk of uterine cancer from estrogen alone. They clarify that progesterone isn’t needed without a uterus, address daily vs cyclical progesterone use and patient preferences, and emphasize individualized plans and follow-up. They compare transdermal versus oral hormones, noting oral estrogen’s liver pathway can increase clot and stroke risk, and explain monitoring with annual pelvic ultrasound to assess endometrial thickness. They discuss limitations of patches, the role of compounding pharmacies for dose customization, preference for bioidentical options, and selective use of a progesterone IUD to control bleeding, protect the endometrium, and provide contraception in perimenopause amid fluctuating hormones and misleading public information.
00:00 Welcome to the Podcast
00:21 Why Estrogen Matters
01:15 Progesterone for Safety
02:12 Myths and Progesterone Only
03:39 Who Needs Progesterone
04:17 Daily vs Cyclical Dosing
05:49 HRT Benefits and Timing
07:28 Patches and Their Limits
08:18 Compounding and Delivery Options
09:17 Transdermal vs Oral Risks
10:09 Progesterone Absorption and Monitoring
11:59 Bioidentical vs Synthetic and IUDs
13:44 Perimenopause Bleeding and Insurance
16:21 Perimenopause Hormone Testing Confusion
17:58 Education and Closing Thoughts
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