For as long as I have worked in women’s health, I have heard the same script. Estrogen “feeds” breast cancer. The safest thing we can do is block it, hard and for as long as possible. Aromatase inhibitors, tamoxifen, and the other endocrine drugs are framed as our best hope.

A woman finishes five years of endocrine therapy. She did everything that her oncology team told her to do. She took the pill every day. She lived with the hot flashes, the aching joints, the foggy brain, the sleepless nights. She was told this treatment would lower her chance of the cancer returning.

And then, years later, it comes back anyway.

I hear this story more often than most women are ever told to expect. And when it happens, the question we ask is almost always the wrong one. We ask…..

For as long as I have worked in women’s health, I have heard the same script. Estrogen “feeds” breast cancer. The safest thing we can do is block it, hard and for as long as possible. Aromatase inhibitors, tamoxifen, and the other endocrine drugs are framed as our best hope.

On paper, it sounds neat and logical. In real women’s lives, it has never fully added up for me.

I keep coming back to one stubborn fact. When you step back and look at absolute risk reduction, not just the relative percentages, the benefit of years of estrogen blockade is far more modest than the message implies. Many women do everything right, stay on these drugs for years, and still recur. I hear those stories every week.

Most women with a BRCA gene variation have been told some version of the same story: your hormones are dangerous, your ovaries are a ticking time bomb, and the safest path is to take them out early and stay away from estrogen for the rest of your life.

I understand why that story exists. The fear is real. The cancer risk is real. The decisions women have to make in their 30s and 40s are difficult.

But the more I read the actual science, the harder it is to hold that story without asking some more questions. Because the same estrogen women are told to fear may also be one of the things their cells use to fix themselves, and to keep their energy systems running.

Lately, our inboxes have been flooded.

Women are reading things on social media that are frightening them, confusing them, and in some cases making them want to stop their progesterone.

So instead of trying to answer one DM at a time, I decided to bring two of the people I trust most in this space — Carol Petersen, RPh and Phyllis Bronson, PhD — to the table to talk it through together.

If you have ever had your testosterone checked and been told the number was “normal,” or “too high,” or “out of range,” there is something important you were probably not told.

The blood test is not measuring what most women think it is measuring.

It is measuring one slice of testosterone. A small one. And the lab range printed next to that number was built for a different purpose than guiding hormone treatment. Once you understand what the test actually shows, the whole conversation about dosing, safety, and “normal” levels changes.

If you have been told that endocrine therapy, such as tamoxifen or an aromatase inhibitor, is the only answer after breast cancer, you are not alone. Many women leave oncology visits with a treatment plan, a prescription, and very little discussion about anything else.

What you eat, how you move, how you sleep, your metabolic health, your stress levels, your muscle mass, your inflammation, your alcohol intake, your insulin levels, your relationships, and your overall internal environment are often barely mentioned, if they are mentioned at all. Lifestyle is rarely presented as part of cancer biology in a meaningful way. It is even more rarely discussed as part of recurrence prevention.

That's what I want to talk about. The neighborhood. The terrain.

If you have spent any time in the menopause corner of the internet, you have probably heard it by now. Several well-known voices on social media and popular podcasts are promoting the use of Duavee for women to prevent breast cancer, for women with DCIS, or for women who simply want to stay "safe." And just like that, a quiet little pill becomes the next thing every woman is told she should be on to prevent breast cancer.

Today I want to zoom out even further.

Because here's the truth I keep coming back to in my work. Cancer cells don't just go rogue. They don't drop out of the sky. A cancer cell is a cell that finally couldn't keep up. It couldn't repair itself, couldn't make enough energy, couldn't keep its signaling clean. And it lived in a body that, for many reasons, had stopped being a healthy place to live.

That's what I want to talk about. The neighborhood. The terrain.

Every week, I hear from women who have been told some version of the same sentence:

"Your cancer was ER-positive, so estrogen caused it."

"You can never go near estrogen again."

"Stay on this anti-estrogen drug for the next five, ten, or fifteen years, or your cancer will come back."

I understand the fear behind those statements. I really do. But the more I read the science, the more I see that this story is incomplete. And women deserve the full story.

If you have been told that "the pill is safe," or that the hormonal IUD is just a tiny, local dose, you are not alone. Most women hear some version of this. And for some women, the pill or the IUD really may be the right tool. But there is a longer conversation that does not always make it into the visit.

Our last webinar sparked incredible discussion, and more questions than we could possibly answer in one session.

Join us for this special follow-up Q&A where Dr. Phyllis Bronson, Carol Petersen, RPh, and Jill Chmielewski, RN, tackled your top questions about progesterone. Whether you attended the first session or are joining us for the first time, this webinar will provide even deeper insight into the hormone that’s often misunderstood but is essential to women’s health.

Every week, I talk to women who feel totally overwhelmed by all the noise about menopause, midlife, and longevity. There are soooooooo many opinions out there. Some of the messaging is bossy, some fear-based, and a lot of it tells you to take this supplement, try that protocol, or wear some new device, “or else” your body will fall apart.

If your periods have started to feel unpredictable or all over the place in your 40s, it's not just random. It's actually part of the perimenopause transition. There are real physical reasons for this, based on how your hormones interact with each other. Once you understand these patterns, it all starts to make a lot more sense.

Our last webinar sparked incredible discussion, and more questions than we could possibly answer in one session.

Join us for this special follow-up Q&A where Dr. Phyllis Bronson, Carol Petersen, RPh, and Jill Chmielewski, RN, tackled your top questions about progesterone. Whether you attended the first session or are joining us for the first time, this webinar will provide even deeper insight into the hormone that’s often misunderstood but is essential to women’s health.

Over the past year, I’ve been rethinking my skincare routine. I’ve long used Qet Botanicals, a line I truly love for its clean, effective formulations (thank you, Lisa, the owner!), but lately, I’ve felt the pull to layer in a few additional targeted ingredients to support my aging skin in a more intentional way.

Most providers mean well. But when it comes to progesterone, they're often missing a critical piece of the puzzle, one that affects how women feel, how they sleep, how their brains function, and how their bodies age.

We had such a great chat today—thanks to all who joined! Dr. Phyllis Bronson holds a doctorate in biochemistry. Her ongoing research involves studying the biological impact of molecules on mood and emotion. We discussed a wide range of topics, including progesterone sensitivity, transdermal progesterone, the importance of achieving adequate progesterone dosing, and we debunked many of the progesterone myths circulating on social media.Put first paragraph here

Confused about which type of estrogen replacement therapy is best? You are not alone. It's a hot topic in the world of menopause medicine.

If you were to survey menopause practitioners from around the globe and ask them their preferred type of estrogen replacement therapy, you'd get many different answers.  That’s because practitioners who prescribe hormone replacement therapy (HRT) come from various training backgrounds and have vastly different experiences treating patients with HRT. 

This webinar features guest experts Dr. Phyllis Bronson and Carol Peterson, who emphasize the importance of progesterone and address misinformation about it. We discuss the distinctions between real progesterone and synthetic progestins, the different forms of progesterone administration, and the significance of progesterone levels compared to estrogen levels. The conversation covers the safety and benefits of bioidentical progesterone, its role in women's health, and its impact on men's health. The importance of personalized dosing, the challenges in determining progesterone dosages, and the effect of progesterone on various health issues are also highlighted.

No one knows for sure what causes breast cancer to develop, although cancer stem cells (a kind of cell that has nothing to do with estrogen) are thought to play a role. Cancer causes are complex and related to many issues including inflammation, stress, exposure to radiation, viruses, chemicals, and other factors.