Are you a postmenopausal woman, a breast cancer survivor, or someone navigating the complexities of hormone replacement therapy (HRT)? Have you been denied HRT, told you’re too old, or removed from treatment due to outdated recommendations? If so, this podcast episode might be a game-changer for you.
I’m sharing these insights for women like my 79-year-old mother-in-law—vibrant, active, and thriving—who was taken off her hormone therapy against her wishes due to outdated recommendations. This is for her and anyone else who has been denied the opportunity to make an informed choice.
In a recent episode of the You Are Not Broken podcast, Dr. Kelly Casperson interviewed Dr. Corinne Menn, a board-certified OB-GYN and certified menopause specialist. Together, they tackled the myths, challenges, and evolving science of menopause, HRT, and breast cancer survivorship.
Dr. Corinne Menn’s Journey: A Survivor’s Perspective
Dr. Menn’s story is both personal and professional. Diagnosed with estrogen receptor-positive breast cancer at age 28 during her OB-GYN residency, she underwent extensive treatment, including bilateral mastectomy, chemotherapy, and ovarian suppression. This thrust her into premature menopause multiple times—with little to no guidance on managing her symptoms.
Her experience motivated her to specialize in menopause care for breast cancer survivors. “Each menopause was worse than the last, and I was given no resources or guidance. I had to educate myself to help others.”
Debunking the Myth: Does Estrogen Cause Breast Cancer?
A major theme of the episode is the persistent fear of estrogen. Dr. Menn and Dr. Casperson address key misconceptions:
Postmenopausal Cancer: Most breast cancers are diagnosed after menopause when estrogen levels are at their lowest.
Pregnancy Paradox: Pregnancy results in extremely high estrogen levels but does not increase breast cancer risk.
Hormone Receptor Positive ≠ Cause: Estrogen receptor-positive cancers have receptors for estrogen but were not necessarily caused by it.
Dr. Menn explained: “It’s wrong to suggest that estrogen, something our bodies naturally produce, is toxic. The data simply doesn’t support that narrative.”
Hormone Therapy After Breast Cancer: The Evidence
The fear of HRT after breast cancer stems from outdated studies and misconceptions. Dr. Avram Blooming’s work, including his book Estrogen Matters, has been pivotal in challenging these fears.
Dr. Casperson cited research summarized in the Breast Cancer Research and Treatment Journal (2022), which reviewed 25 studies on HRT after breast cancer diagnosis:
Only one study (the Habits Trial) showed a slight increase in local recurrence, not mortality, and had significant methodological flaws.
The overwhelming majority of studies demonstrated no increased risk of breast cancer recurrence or mortality.
Dr. Menn emphasized: “There’s no absolute contraindication. Risk-benefit discussions should be individualized, not based on fear or blanket policies.”
What About Vaginal Estrogen?
For survivors experiencing vaginal dryness, painful intercourse, or urinary symptoms, vaginal estrogen is a safe and effective option. Yet many oncologists refuse to prescribe it due to misinformation. “I see top academic centers telling women vaginal estrogen will cause cancer—it’s simply not true,” said Dr. Menn. This lack of care leads to unnecessary suffering.
As Dr. Casperson noted, “We’re treating the cancer, but ignoring the whole human. Survivors are more likely to die of heart disease, osteoporosis, or dementia than breast cancer.”
Why Addressing Menopause in Survivors is Crucial
Beyond symptom relief, untreated menopause increases risks for:
Heart Disease: The leading cause of death among breast cancer survivors.
Osteoporosis: Premature menopause raises fracture risks.
Cognitive Decline: Estrogen is linked to brain health and reduced dementia risk.
Relationship Strain: Vaginal dryness and sexual dysfunction impact intimacy and quality of life.
Dr. Menn emphasized: “Survivors deserve care that addresses their whole health—not just their cancer.”
The Path Forward: Advocating for Comprehensive Care
Dr. Menn and Dr. Casperson stressed the need for nuanced, patient-centered care:
Start with Symptoms: Treat menopausal symptoms impacting quality of life.
Weigh Risks and Benefits: Medicine is never black and white. Decisions should be individualized.
Find the Right Provider: If your doctor dismisses your concerns, seek a second opinion or a menopause specialist.
“Managing menopause after breast cancer is complex, but it’s possible to do it safely and effectively. Women deserve options, not fear-based medicine,” said Dr. Casperson.
Resources for Breast Cancer Survivors
Books: Estrogen Matters by Avram Blooming and Carol Tavris.
Support Organizations: Young Survival Coalition, North American Menopause Society.
Telemedicine Services: Read more here.
Why This Podcast Matters
This podcast isn’t just about breast cancer or menopause—it’s about empowering women with science-based knowledge to advocate for themselves. With over 25 studies supporting the safety of HRT for breast cancer survivors, it’s time to challenge outdated guidelines and prioritize women’s overall health and quality of life.
As Dr. Menn stated, “We’re leaving millions of survivors untreated, creating unnecessary suffering.”
Listen Now
For an in-depth conversation on menopause, HRT, and breast cancer, listen to the full episode of You Are Not Broken with Dr. Kelly Casperson and Dr. Corinne Menn. Share this podcast with someone who needs it—it could be the most important health conversation of the year.