Dr. Streicher’s Inside Information: Menopause, Midlife, and More

S3 Ep169: When Progesterone is Problematic: A Collaboration on a Complex Patient with Dr. Risa Kagan


Listen Later

Menopause experts rarely see patients with no medical issues. We see the patient with multiple medical problems and concerns.  In this episode, I bring in menopause expert Dr. Risa Kagan to collaborate on options for the following complex patient.
(Be sure and check out my Substack article that gets into the nuances of bazodoxifene)

Beth is 51 years old.  I’ve been flashing for 2 years with no end in sight.  I really want to try estrogen not just to help my hot flashes, but also because my mom had osteoporosis. I don’t have osteoporosis yet, but I’m worried since I’ve been told I have low bone mass.  My doctor won’t give me estrogen because my grandmother died from breast cancer. She wants me to take raloxifene to protect my bones and my breast, but that won’t help my flashes. I also would rather not take anything with progesterone since when I took it years ago to help with irregular periods, I got moody and bloated. I need some help here. “

*Options discussed include:

  • Raloxifene (Evista™)
  • A Selective Estrogen Receptor Modulator (SERM) and estrogen together
  • Paroxitene (Brisdelle™)
  • Gabapentin
  • Fezolinetant (Veozah™)
  • Fezolinetant and raloxifene together
  • Estrogen and vaginal progestogen gel (Crinone™)
  • Estrogen and a Progestogen IUD
  • Unopposed estrogen
  • Conjugated equine estrogen (Premarin™) and bazodoxifene (Duavee™)
  • *I have no financial relationship with any of the companies that sell these drugs


    For more information on this topic: 

    Episode 2:Think Your Hot Flashes Can't Kill You? Think Again!
    Episode 31 The TRUTH About Hormone Therapy: Does it CAUSE or PREVENT Breast Cancer?
    Episode 46 Finding a Menopause Clinician Who Will Listen 
    Episode 77 Fezolinetant! A New Non-Hormonal Hot Flash Drug 
    Episode 80 When Progesterone is a Problem 
    Episode 84 Non-Hormonal Prescription Drugs to Treat Hot Flashes
    Ep 111 Bone Up with Hormone Therapy with Dr. DeSapri

    Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat

    Lauren Streicher, MD is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, and the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause. She is a certified menopause practitioner of the North American Menopause Society. 

    Sign up to receive DR. STREICHER’S FREE NEWSLETTER

    Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine. 

    Subscribe and Follow Dr. Streicher on 
    DrStreicher.com

    Instagram @DrStreich
    Twitter @DrStreicher
    Facebook  @DrStreicher
    YouTube  DrStreicherTV

    Books by Lauren Streicher, MD

     Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist’s guide to eliminating post-menopause dryness and pain

    Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat

    Sex Rx- Hormones, Health, and Your Best Sex Ever

    The Essential Guide to Hysterectomy

    Put the O Back in Mojo: A Guide to Post Menopause Libido and Orgasm (available for pre-order) 




    ...more
    View all episodesView all episodes
    Download on the App Store

    Dr. Streicher’s Inside Information: Menopause, Midlife, and MoreBy Lauren Streicher, MD

    • 4.7
    • 4.7
    • 4.7
    • 4.7
    • 4.7

    4.7

    343 ratings


    More shows like Dr. Streicher’s Inside Information: Menopause, Midlife, and More

    View all
    Well Beyond 40 by JJ Virgin

    Well Beyond 40

    1,086 Listeners

    The Dr Vonda Show by Dr. Vonda Wright

    The Dr Vonda Show

    232 Listeners

    Energized with Dr. Mariza by Dr. Mariza Snyder

    Energized with Dr. Mariza

    995 Listeners

    The Peter Attia Drive by Peter Attia, MD

    The Peter Attia Drive

    8,043 Listeners

    Midlife Conversations with Natalie Jill: Fat Loss, Hormones & Health for Women Over 40 by Natalie Jill

    Midlife Conversations with Natalie Jill: Fat Loss, Hormones & Health for Women Over 40

    642 Listeners

    The Hormone Solution | Perimenopause, Menopause, HRT, Weight Loss & Women's Midlife Health by Karen Martel: Certified Hormone Specialist

    The Hormone Solution | Perimenopause, Menopause, HRT, Weight Loss & Women's Midlife Health

    342 Listeners

    Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+ by Everyday Wellness™

    Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+

    150 Listeners

    The Dr Louise Newson Podcast by Dr Louise Newson

    The Dr Louise Newson Podcast

    266 Listeners

    BETTER! Building bodies women can trust with Dr. Stephanie Estima by Dr. Stephanie Estima

    BETTER! Building bodies women can trust with Dr. Stephanie Estima

    624 Listeners

    You Are Not Broken by Kelly Casperson, MD

    You Are Not Broken

    1,146 Listeners

    Hit Play Not Pause by Hit Play Not Pause

    Hit Play Not Pause

    739 Listeners

    The Dr. Gabrielle Lyon Show by Dr. Gabrielle Lyon

    The Dr. Gabrielle Lyon Show

    1,246 Listeners

    The Metabolism and Menopause Podcast by Stephanie Crassweller

    The Metabolism and Menopause Podcast

    216 Listeners

    The Tamsen Show by Tamsen Fadal

    The Tamsen Show

    413 Listeners

    unPAUSED with Dr. Mary Claire Haver by Audacy | Mary Claire Haver, MD

    unPAUSED with Dr. Mary Claire Haver

    1,204 Listeners