Hormones, Cancer Risk, and the Truth About Menopause with Dr. Corinne Menn | HFYH # 124

**Dr. Corinne Menn** (0:00)
I felt a sense of shame. And I know that sounds silly, but I was like, no one wants to hear about this. They don't, you know, I don't, they don't want to talk about like feeling dry in the vagina or less sensation, difficulty with orgasm, you know, just my skin, like no one wants to talk about that. I didn't want to talk about it. I felt alone and my doctors didn't bring it up and didn't really recognize the long-term implications as you speak about my health span.

**Dr. Vonda Wright** (0:30)
Hi, I'm Dr. Vonda Wright and this is HOT For Your Health. Join us for conversations on the bleeding edge of science, health, and culture as we bring you tech innovators, thought leaders, and the movers and shakers who are transforming science fiction into your new health reality.
Hi, everybody, it's Dr. Vonda Wright and welcome back to HOT For Your Health, where I talk to innovators, clinicians, remarkable people. And I'm so happy to be joined today by Dr. Corinne Menn. She is a board certified obstetrician gynecologist. She is one of the founding and leading doctors at My Alloy. She's long had a telehealth platform of her own where she's treating women in midlife. You are a thought leader and an expert on some of the most critical parts of the menopause conversation and so many things. So we were just talking offline about what things women have heard and what things women haven't heard. And you are always open to share with the community at large and where you speak about your own journey and health in breast cancer and now as an expert serving that population. But I think our conversation, Corinne, needs to include what you suggested, which is the other things that make women feel left out in the midlife and menopause conversation. And so things like, we can get into all these things. I think they're so critical and I'm going to learn so much. Things like endometriosis, pre-vivors, women with PCOS, and what they do on their menopause journey. The fact that even for women with no true contraindication, still only four to four to five percent of all women choose to optimize their hormones and where does that leave them? So what are the things in this basket that you hear women saying most often that we need to answer their questions?

**Dr. Corinne Menn** (2:47)
Well, I mean, I think the biggest thing is we all see the menopause movement, the moment, the train is no one's stopping it. And that's great. And there's a grassroots groundswell, I think, of patients rising up, women. We see it at conferences and speaking events and we see it on social media and the doctors who are interested in all of that.
And I think that is great. And it generally speaks to kind of the average quote unquote woman in the midlife transition. And we know that for the vast majority of these women, the benefits far outweigh the risks of menopausal hormone therapy and that they should at least have that as an option. It's not that they have to use it, right? But there are thousands, millions of women really around the world who feel left out of that conversation. They don't truly feel part of it. Yes, they can exercise and they can eat, right? But they feel like, well, but maybe hormones aren't for me or I've been told they're not for me wrongly often, right? Because there's a lack of provider education out there. And so I think there is a huge contingent left out. And everyone looks to me because I'm a breast cancer survivor and I talk to the breast cancer community about what options they have, whether it's for local vaginal hormones or how do they manage things non-hormonally, or if they deserve, which they do, a conversation individually about their breast cancer case. And if they've recovered and they're in survivorship phase, are there some of these breast cancer survivors who might consider menopausal hormone therapy? And so I speak about that a lot, but I always want to make sure we're bringing along these other left out vulnerable women and like some of the categories you spoke about, pre-vivors, right? So cancer pre-vivors. And that term is a little funny, but basically it's women who identify that they have a mutation to some hereditary cancer syndrome. And it's not just BRCA anymore, right? So as we elevate education about these hereditary cancer syndromes, more and more primary care doctors are testing patients. So more and more women are finding out they might have the CHK2 mutation or they might have Lynch syndrome and POD mutation. And there's a whole host of them. And so they may have an increased risk of ovarian cancer. And many of these women, including the BRCA carriers, have ovaries out prematurely, but they don't have cancer yet. So they are plunged into surgical menopause to do something preventatively, and then no one manages what's next. So that's another big group. So it's not just cancer survivors, it's that. And then anybody else who is facing earlier menopause and the one that we were talking about offline is the endometriosis community out there is vast, huge, and equally as misunderstood, dismissed in terms of their premature menopause, you know, issues.