In today’s episode, we tackle a situation many of us in the menopause and cancer community face: What do you do when doctors’ opinions divide?

It’s a common experience to receive conflicting advice from healthcare professionals, and that can be confusing, frustrating and scary especially when you’re navigating menopause after a cancer diagnosis.

I am joined by author and breast cancer survivor Rosamund Dean who has made this experience herself. We are going to mull over what we can do to navigate a challenging situation like this.

We will talk about:

• Why doctors may disagree on treatment plans and how to understand those differences.
• How to advocate for yourself when medical advice feels unclear or overwhelming.
• The importance of second (or third) opinions and how to approach them with an open mind.
• Practical strategies for researching treatment options and weighing the pros and cons.
• Community insights from women who’ve faced similar challenges, sharing what helped them make informed decisions.

Episode Highlights:

00:00Intro.

05:47 Five months of chemo, mastectomy, radiotherapy, capecitabine.

09:41 Early menopause increases bone health concerns.

11:48 Oncologist encourages seeking second opinions for treatment.

17:40 Menopause isn't always initial focus when treating cancer.

22:53 Meeting about ovary removal due to family history

34:13 Healthy diet: Vegetables, minimal processed, quality meat.

38:28 We all muddle through uncertainty together.

Connect with us:

For more information and resources visit our website: www.menopauseandcancer.org

Or follow us on Instagram @menopause_and_cancer

Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

Rosamund’s book ReConstruction is here: https://www.amazon.co.uk/Reconstruction-rebuild-breast-cancer-diagnosis/dp/0008585202

Rosamund’s Substack is here https://rosamunddean.substack.com/

A big thanks to our trusted sponsor, The Better Menopause. I’m excited to share their amazing product, The Better Gut with you. Most women don’t realize that gut health and menopause symptoms are intrinsically linked—keeping your gut happy is the foundation for overall health, through all stages of life. The Better Gut is a daily capsule packed with a unique, science-backed probiotic blend designed to survive stomach acid, reach your gut alive and help improve symptoms such as bloating, hot flushes and anxiety.

Go check them out - The Better Gut is a big help for many https://thebettermenopause.com/products/better-gut?selling_plan=690396627248

Has anyone here experienced raised cholesterol levels as a result of menopause since cancer treatment or as a result of being on an aromatase inhibitor?

I’m horrified that so many of us are getting high cholesterol and nobody has warned us this may be something to look out for.

In this episode, I invite longevity dietician Barbie Boule onto the show to discuss the topic of cholesterol, particularly about cancer survivors and menopause. We address the confusion surrounding cholesterol and its importance and Boule addresses strategies that can help - from medication to diet.

This conversation also covers the role of saturated fat and fibre in cholesterol management, the potential use of supplements, and the limitations of herbal preparations.

Overall, the episode provides practical advice and encourages listeners to take control of their metabolic health.

A big thanks to our trusted sponsor, The Better Menopause. I’m excited to share their amazing product, The Better Gut with you. Most women don’t realize that gut health and menopause symptoms are intrinsically linked—keeping your gut happy is the foundation for overall health, through all stages of life. The Better Gut is a daily capsule packed with a unique, science-backed probiotic blend designed to survive stomach acid, reach your gut alive and help improve symptoms such as bloating, hot flushes and anxiety.

Go check them out - The Better Gut is a big help for many https://thebettermenopause.com/products/better-gut?selling_plan=690396627248

Episode Highlights:

00:00 Intro.

04:18 Menopause disrupts metabolism, and requires close health monitoring.

06:24 Evaluate medication's benefits versus potential side effects.

15:03 Adopt mini-habits, limit saturated fats, improve cholesterol.

17:23 Balanced, colourful eating with phytonutrients is beneficial.

28:08 Cancer treatments impact cholesterol; awareness is crucial.

Connect with us:

For more information and resources visit our website: www.menopauseandcancer.org

Or follow us on Instagram @menopause_and_cancer

Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

You can find Barbie Boule here https://barbieboules.com/

Thank you to The Better Menopause for sponsoring this episode.

Can’t fall asleep? Waking up in the middle of the night? Can cancer treatment-induced menopause cause you sleep issues? Do you have insomnia?

Dr. Zoe Schaedel, a sleep and menopause expert, discusses the impact of cancer and menopause on sleep and offers insights into managing sleep problems.

Sleep disturbances are common among cancer survivors and menopausal women, with up to 70% experiencing sleep problems. While sleep hygiene practices can be helpful for improving sleep, they may not be enough to treat sleep disorders like insomnia.

Dr. Schaedel highlights the importance of diagnosing insomnia and exploring psychological treatments like cognitive behavioural therapy for insomnia (CBTI). She also discusses the role of medication, such as sedating antidepressants and newer treatments like Daridorexant, in managing sleep problems. Additionally, she addresses the impact of melatonin, magnesium, food, caffeine, alcohol, and other supplements on sleep.

You can see Dr Schaedel here in her menopause clinic https://www.mylahealth.co.uk/dr-zoe-schaedel or here in her sleep clinic https://goodsleep.clinic/

The resource Dr. Schaedel mentions is here: https://www.petermac.org/component/edocman/pm-0002-design-v22-web/viewdocument/562?Itemid=0

Here is the Sleepio resource https://www.oxfordhealth.nhs.uk/healthyminds/wp-content/uploads/sites/17/2019/10/Sleepio-info-for-clients.pdf

Thank you to our sponsors for this episode, The Better Menopause. Their new Good Sleep multi-vitamin supplement isn’t just any multivitamin—it’s a thoughtfully crafted blend of Vitamin D, B12, Ashwagandha, and Magnesium, all designed to help you relax and unwind. Created by a company that truly cares about our community, this supplement is the perfect addition to your nightly routine. Go here for more info https://thebettermenopause.com/

Episode Highlights:

00:00 Intro.

06:43 Insomnia diagnosis leads to evidence-based treatment.

15:40 Therapy for insomnia examines and challenges thoughts.

22:54 Short-term medication can help but isn't ideal.

24:24 New medication for chronic insomnia, less drowsiness.

30:04 Certain foods may potentially help improve sleep.

33:51 Potential vitamin deficiencies could impact health, including sleep.

Connect with us:

For more information and resources visit our website: www.menopauseandcancer.org

Or follow us on Instagram @menopause_and_cancer

Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

The sixth episode in the HRT after breast cancer series features Lisa Colclough and Helen Widner, two breast cancer patients who decided to go down two very different routes. Helen decided to start testosterone pellet therapy whilst being on aromatase inhibitors, whilst Lisa decided to restart her HRT soon after her breast cancer treatment.

This mini-series explores hormone replacement therapy (HRT) after breast cancer, a controversial and emotive subject. The conversation focuses on the further understanding of risks and benefits of HRT (hormone replacement therapy) or also MHT (menopause hormone therapy), the emotional impact on patients, and the different views among medical professionals.

The goal is to provide understanding for patients seeking HRT after breast cancer and insight for doctors on how to move forward without robust evidence. Dani Binnington, host of the Menopause And Cancer podcast, and founder of the not-for-profit organisation Menopause And Cancer has spoken to hundreds of women who feel like they are in a void and have nowhere to turn to in discussing this difficult topic. Welcome to our HRT after breast cancer series.

In this episode we discuss:

What was the hardest part about menopause for each of them?

We explore why Helen and Lisa thought about using hormone replacement therapy after their breast cancer diagnosis.

Lisa discusses not being heard as a patient and why she was made to take action without her doctor’s support.

Helen discusses the hurdles to accessing testosterone pellet therapy in the UK.

Episode Highlights:

00:00 Intro.

05:13 Postmenopausal risk versus benefits of aromatase inhibitors.

08:36 Difficulties with tamoxifen, switched to HRT.

11:58 Brain fog impacted daily life, resembling dementia.

28:47 Desire for informed discussion about medical decisions.

35:45 Research led to considering testosterone implants with AI.

Connect with us:

For more information and resources visit our website: www.menopauseandcancer.org

Or follow us on Instagram @menopause_and_cancer

Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

The fifth episode in the HRT after breast cancer series features Tamzin, who many years after her breast cancer treatment for a hormone receptor-positive cancer decided to take HRT.

Tamzin Rasmussen, a psychologist and psychotherapist from Australia has been proactive in participating in her medical treatments. Tamzin explores her decision to pursue hormone replacement therapy (HRT) after breast cancer treatment and the challenges she faced in discussing it with healthcare professionals. She discusses the importance of collaborative consultations and the need for healthcare practitioners to make room for nuance and uncertainty in treatment decisions.

This mini-series explores hormone replacement therapy (HRT) after breast cancer, a controversial and emotive subject. The conversation focuses on the further understanding of risks and benefits of HRT (hormone replacement therapy) or also MHT (menopause hormone therapy), the emotional impact on patients, and the different views among medical professionals.

The goal is to provide understanding for patients seeking HRT after breast cancer and insight for doctors on how to move forward without robust evidence. Dani Binnington, host of the Menopause And Cancer podcast, and founder of the not-for-profit organisation Menopause And Cancer has spoken to hundreds of women who feel like they are in a void and have nowhere to turn to in discussing this difficult topic. Welcome to our HRT after breast cancer series.

In this episode we discuss:

• Why the decision to start hormone replacement therapy after a breast cancer diagnosis is a complex and personal one
• Why it is important for patients to have an open and informed discussions with their medical team to make treatment decisions that align with their goals and values
• Why healthcare practitioners should make room for nuance and uncertainty in treatment discussions and consider the individual needs and preferences of each patient
• Tamzin explains the benefits she started to experience when starting HRT despite her cancer diagnosis

Episode Highlights:

00:00 Intro.

04:13 Chemotherapy triggered abrupt menopause, causing side effects.

07:33 Chemotherapy was awful, but brought relief.

14:31 Took break, switched medications, adjusted for effectiveness.

22:24 Cancer treatment induced menopause.

31:13 Women afraid of discussing HRT openly.

34:49 Oncologist approves oestrogen treatment for bone density.

37:23 Improved sleep, increased energy, and better stamina.

40:14 Conversation about bone health and medication concerns.

43:57 Consider decision slowly, discuss with informed practitioners.

48:38 Realising joy and richness in life's changes.

Connect with us:

For more information and resources visit our website: www.menopauseandcancer.org

Or follow us on Instagram @menopause_and_cancer

Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

The walking challenge I mention is here for you: https://move-with-menopause-and-cancer.raiselysite.com/

The fourth episode in the HRT after breast cancer series features Dr. Louise Newson, who has faced criticism for her willingness to prescribe HRT to breast cancer patients. At the same time, she has been described as a lifesaver by many of the women she treats.

Dr. Louise Newson is a GP who has transformed the landscape for menopausal women worldwide. She became a member of the Royal College of Physicians in 1998 and a Fellow of the Royal College of GPs in 2016. She is also a menopause specialist and a member of the UK Government’s Menopause Taskforce.

This mini-series explores hormone replacement therapy (HRT) after breast cancer, a controversial and emotive subject. The conversation focuses on the further understanding of risks and benefits of HRT (hormone replacement therapy) or also MHT (menopause hormone therapy), the emotional impact on patients, and the different views among medical professionals.

The goal is to provide understanding for patients seeking HRT after breast cancer and insight for doctors on how to move forward without robust evidence. Dani Binnington, host of the Menopause And Cancer podcast, and founder of the not-for-profit organisation Menopause And Cancer has spoken to hundreds of women who feel like they are in a void and have nowhere to turn to in discussing this difficult topic. Welcome to our HRT after breast cancer series.

In this episode we discuss:

• Dr. Newson’s passion for empowering women to navigate the menopause
• How it felt when Dr. Newson prescribed HRT to a breast cancer patient for the first time
• The role of shared-decision making
• Holding uncertainty between the doctor and the patient
• Empowering women to make informed decisions about their health is crucial in improving their quality of life

Episode Highlights:

00:00 Intro.

03:09 Challenges of hormone replacement therapy after cancer.

06:38 Doctor offers hormonal treatment to patient post-surgery.

12:00 Alternative options suggested for women's health without HRT.

20:45 Adjuvant treatment side effects and drug holidays.

23:40 Discussing oestrogen management for cancer survivors post-menopause.

30:28 Lack of research on women's health risks.

44:04 Advocate for women's health and research needs.

47:03 Effective communication between patients and doctors crucial.

Connect with us:

For more information and resources visit our website: www.menopauseandcancer.org

Or follow us on Instagram @menopause_and_cancer

Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

The walking challenge I mention is here for you: https://move-with-menopause-and-cancer.raiselysite.com/

The third episode in the HRT after breast cancer series features Dr. Tina Peers who discusses her decision to take HRT after her own breast cancer diagnosis and the decision-making process involved when prescribing it to patients.

Dr. Tina Peers is a women's health specialist who began her career as a general practitioner in the early 80s. She became a Consultant in Contraception and Reproductive Health, and has expert knowledge in treating patients with long Covid, Histamine Intolerance, Mast Cell Activation Syndrome and of course the menopause. She is a colleague of Dr. Nick Panay, whom she met while working at Chelsea and Westminster Hospital, seeing complex menopause cases.

This mini-series explores hormone replacement therapy (HRT) after breast cancer, a controversial and emotive subject. The conversation focuses on the further understanding of risks and benefits of HRT (hormone replacement therapy) or also MHT (menopause hormone therapy), the emotional impact on patients, and the different views among medical professionals.

The goal is to provide understanding for patients seeking HRT after breast cancer and insight for doctors on how to move forward without robust evidence. Dani Binnington, host of the Menopause And Cancer podcast, and founder of the not-for-profit organisation Menopause And Cancer has spoken to hundreds of women who feel like they are in a void and have nowhere to turn to in discussing this difficult topic. Welcome to our HRT after breast cancer series.

In this episode we discuss:

• How general healthcare treats the issue and not the root cause of many conditions, leaving many patients to suffer without the answers they seek.
• Dr. Peers discusses how her deep knowledge of helping patients with a rare disease helped her understand the importance of thinking outside the box.
• Why Peers decided to take HRT despite her breast cancer diagnosis.
• What does shared decision-making look like in practice?
• How to counsel women who might want to consider HRT after breast cancer?

Episode Highlights:

00:00 Intro.

04:46 Shifted focus to women's health, led services.

08:01 Breast cancer treatment.

18:08 Seeking help led to meeting superb gynaecologist.

20:36 Seeking HRT without GP approval.

25:27 Benefits of HRT: cardiovascular, bone, cognitive, longevity

33:09 Specialist clinic supports post-breast cancer HRT patients.

Connect with us:

For more information and resources visit our website: www.menopauseandcancer.org

Or follow us on Instagram @menopause_and_cancer

Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

The walking challenge I mention is here for you: https://move-with-menopause-and-cancer.raiselysite.com/

The second episode in the HRT after breast cancer series features oncologist Prof. Richard Simcock who will discuss potential pathways for using HRT after breast cancer despite the lack of robust data.

Prof Simcock is a consultant clinical oncologist at University Hospitals Sussex NHS Foundation Trust, where he provides clinical care to people with breast cancer. He is also the consultant medical adviser for our friends at the charity Macmillan Cancer Support and an Honorary Professor at Brighton and Sussex Medical Schools.

This mini-series explores hormone replacement therapy (HRT) after breast cancer, a controversial and emotive subject. The conversation focuses on the further understanding of the risks and benefits of HRT (hormone replacement therapy) or also MHT (menopause hormone therapy), the emotional impact on patients, and the different views among medical professionals.

The goal is to provide understanding for patients seeking HRT after breast cancer and insight for doctors on how to move forward without robust evidence. Dani Binnington, host of the Menopause And Cancer podcast, and founder of the not-for-profit organisation Menopause And Cancer has spoken to hundreds of women who feel like they are in a void and have nowhere to turn to when discussing this difficult topic.

Welcome to our HRT after breast cancer series.

In this episode we discuss:

• Why limited data and the changing landscape of breast cancer treatment make it challenging to provide definitive answers about HRT after breast cancer.
• How could we move forward without robust data?
• The challenges doctors face in prescribing HRT after breast cancer.
• How the establishing of a registry could provide doctors with confidence in prescribing HRT and contribute to the global sum of knowledge on the topic.
• Understanding and quantifying risk is crucial in the HRT conversation, and patient decision aids can help visualise the potential benefits and risks.
• Empowering patients with information and involving them in shared decision-making can help them make informed choices about their treatment options.
• Advancements in breast cancer treatment, such as selective oestrogen receptor degraders, offer hope for future options with fewer side effects.

Episode Highlights:

00:00 Intro.

06:22 Empower patients to understand and manage treatments.

13:36 Risk is a complex and multifaceted issue.

19:20 Understanding benefits and risks, patient-doctor relationship.

24:37 Health professionals collaborate for consensus on best practices.

31:59 New drugs to manage hot flushes effectively.

Connect with us:

For more information and resources visit our website: www.menopauseandcancer.org

Or follow us on Instagram @menopause_and_cancer

Join our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

The walking challenge I mention is here for you: https://move-with-menopause-and-cancer.raiselysite.com/