S3 Ep169: When Progesterone is Problematic: A Collaboration on a Complex Patient with Dr. Risa Kagan
Author
Lauren Streicher, MD
Published
Thu 27 Feb 2025
Episode Link
https://audioboom.com/posts/8452963
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.
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
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.
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.