Menopause Masterclass: HRT Safety, Patch Absorption, Progesterone Intolerance, and Bone Density

In this episode of unPAUSED, Dr. Mary Claire Haver answers your most asked questions about hormone therapy, menopause symptoms, and how to advocate for yourself when your doctor doesn't have answers. She walks through who actually qualifies for HRT, what the real contraindications are versus conditions that simply require a different delivery method, and how to think about continuing estrogen, progesterone, and testosterone therapy after 60. Dr. Haver explains the estrogen patch absorption problem, with research showing that up to 20 percent of women on transdermal therapy never reach physiologic estradiol levels regardless of dose. She breaks down SHBG, the protein that can bind your hormones and render them inactive even when your numbers look adequate on paper, and walks through what optimal estradiol levels look like for bone density and osteoporosis prevention specifically. Guest links: * The 'Pause Wellness https://thepausewellness.com/ * The ‘Pause Life https://thepauselife.com/?srsltid=AfmBOoqNHlkfDy6-ZvUItyvLEdJ28-COZ4zZJ_GWy3vXk_gKuSJIzU4S * Dr. Mary Claire Haver (Instagram) https://www.instagram.com/drmaryclaire/ * Dr. Mary Claire Haver (YouTube) https://www.youtube.com/@drmaryclaire * The Menopause Empowerment Guide https://thepauselife.com/pages/menopause-empowerment-guide-sign-up Books: * “The New Perimenopause,” by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book * "The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/New-Menopause-Mary-Claire-Haver/dp/1785045547 * “The Complete Bone and Joint Health Plan: Help Prevent and Treat Osteoporosis and Arthritis,” by Jocelyn Wittstein https://www.amazon.com/Complete-Bone-Joint-Health-Plan/dp/1682689417/ref=sr_1_1?crid=HPQ5BWAZBCBM&dib=eyJ2IjoiMSJ9.sMwoRz3j-u1faMbWg-K48uPdbYESkLBPBCFyFXI49I8zJx6BOTQDzdY1tJ23KFMSWgAefWg-0em68VkvnpqB8EmMfzLWN-RmvoYX_iHKj0G9zMCqfN-rhRpQ-uoBcIttgYo87otSPc3Ve0bTQsZE4IL5ENODtZsBjSju5HapZLIwII58OWZ1l5JvQ0v0Gny_iaIGAxm30VEc6gLNqpGxLZnMH2K37iTUURRwULJtS3A.Iz6_s4wdOjyrRhRN-DdZM9YBeXg0ZYvS4tODAyOQ1Oc&dib_tag=se&keywords=The+Complete+Bone+and+Joint+Health+Plan%3A+Help+Prevent+and+Treat+Osteoporosis+and+Arthritis&nsdOptOutParam=true&qid=1773536409&s=books&sprefix=%2Cstripbooks%2C298&sr=1-1 Resources: * Women’s Health Initiative https://www.whi.org/ * Estradiol (University of Rochester Medical Center) https://www.urmc.rochester.edu/encyclopedia/content?ContentID=estradiol&ContentTypeID=167 * Meet Dr. Heather Hirsch https://womenshealthmedicine.com/#:~:text=She%20is%20a%20NAMS%2Dcertified,live%20empowered%20and%20healthy%20lives. * Alloy Health https://www.myalloy.com/ * Midi Health https://www.joinmidi.com/ * Menopause Quiz https://thepauselife.com/pages/new-menopause-quiz-lp * Lab Test Checklist https://thepauselife.com/pages/lab-checklist-download * Blueprint to close the women's health gap https://www.mckinsey.com/mhi/our-insights/blueprint-to-close-the-womens-health-gap-how-to-improve-lives-and-economies-for-all For full show notes, please visit: https://bit.ly/unPAUSEDMaryClaireHaver 00:00:00 – Welcome to Ask Me Anything #2 00:02:15 – HRT & Breast Cancer Risk, Fibroids, Polyps and Endometriosis 00:05:00 – When Hormone Therapy Is Contraindicated 00:08:05 – Is It Safe to Stay on Hormones After 60? 00:10:45 – How to Know if Your Hormone Doses Are Right 00:13:00 – Why Estradiol Patches Don’t Work the Same for Everyone 00:15:20 – Dr. Haver’s Personal Bone Health & Longevity Routine 00:22:05 – Low Hormone Levels, SHBG & Persistent Symptoms Explained 00:27:20 – Is Bleeding Normal When Starting HRT? 00:29:20 – Progesterone Intolerance & Alternative HRT Options 00:32:20 – When Women Should Consider Testosterone Therapy 00:41:00 – Bone Health, Weight Gain, Sleep Apnea & Menopause Changes 00:44:10 – Bladder Leaks, Pelvic Floor Therapy & Urinary Health 00:48:10 – Supplements That Support Menopause, Bone & Brain Health 00:57:00 – Longevity, Trauma, Lifestyle & Finding the Right Doctor 01:06:05 – Dr. Haver Explains The New Perimenopause Never miss an episode—sign up for The ’Pause Life Newsletter: https://thepauselife.com/pages/newsletter Medical Disclaimer: The information, including opinions and recommendations, on this platform is meant for informational and educational purposes only. Mary Claire Media, LLC, the unPAUSED podcast, and The ’Pause Life are not medical organizations. Medical advice or medical diagnosis cannot be provided to you through the platform, any associated website, or customer portals. Using this platform does not establish a patient-physician relationship.