Why I’m Excited HRT Is Finally Getting Attention

When I started writing for CURE more than 10 years ago, I aimed to help women like me — women living with hereditary cancer risk. I wanted them to understand what happens after preventive surgeries. What happens when our reproductive organs are removed and the hormones we’ve relied on for decades suddenly vanish?

In articles such as “Are You Thinking About Removing Reproductive Organs to Prevent Cancer?,” “10 Things to Know About Prophylactic Hysterectomy and Oophorectomy” and “The Cost of Ovarian Cancer Prevention,” I’ve openly explored these questions. The physical, emotional and cognitive impacts of hormone loss are real and often overlooked. Research from 2023 underscores many of these points, showing that starting hormone-replacement therapy (HRT) early can help reduce the long-term risks that often accompany surgical menopause.

Now, 10 years later, the conversation is finally shifting. HRT is getting the attention it has long deserved; not just from doctors, but also from the media and from women who are now openly sharing their experiences. In contrast, back then, these topics were rarely discussed, and few wanted to address what happens after preventive surgery.

When I first wrote about my oophorectomy, some in the Lynch syndrome community were appalled by my honesty. A few worried my openness might discourage others from having this specific risk-reducing surgery. My goal was never to create fear. I wanted to tell the truth about what comes next, because that part of the story matters just as much as the decision to have surgery. My personal experience informed my understanding of the practical realities women face.

In “Living With Lynch Syndrome: Pick Your Hard,” I shared my choice to remove my ovaries to lower my cancer risk. I don’t regret it, but it changed my life in profound ways. Within days, I entered surgical menopause. The sudden loss of estrogen brought sleepless nights, intense mood swings, nausea, depression and moments when I barely recognized myself. This set the stage for my experience with HRT.

I began HRT immediately, yet the changes were undeniable: bone aches, disrupted sleep, emotional swings and that odd feeling of time speeding up in my body. Research from the Mayo Clinic confirms that women under 46 who lose their ovaries face higher risks of heart disease, osteoporosis, and cognitive decline if estrogen therapy isn’t initiated. Learning this helped me see that what I was experiencing wasn’t just aging — it was biology. Open conversations with doctors about HRT — including its benefits, risks and monitoring — are essential to navigating these challenges.

Early in my writing, I felt urgency because hormone loss was rarely discussed, and many women felt isolated. I received countless emails from readers sharing their fears and struggles. Their stories fueled my advocacy.

In “The Cost of Ovarian Cancer Prevention,” I highlighted that risk-reducing surgeries come with hormonal, cognitive, emotional, metabolic and physical challenges that demand attention. Yet these surgeries often outweigh the downsides for many women. They provide reassurance and a sense of control over their health. To ensure women are truly informed, essential questions must be raised before surgery.

In “10 Things to Know About Prophylactic Hysterectomy and Oophorectomy,” I encouraged women to ask key questions:

• What is my plan for hormone replacement?
• How will my hormone levels be monitored?
• How will my bone, heart and brain health be protected after surgery?

Those questions were rarely included in pre-surgical counseling a decade ago. Now, they appear in doctor visits, mainstream media and social forums. Women now support one another through surgical menopause. This broader recognition echoes larger changes in the perception and discussion of HRT that began with a shift in how the stigma was addressed.

When I first wrote about HRT, stigma was pervasive. The 2002 Women’s Health Initiative (WHI) trial had caused widespread fear. Estrogen was viewed as dangerous rather than essential. Many women suffered unnecessarily. By clarifying the studies and their limitations, we can dispel fear and foster trust. Today, new research provides a foundation for renewed optimism.

Recent research shows that starting HRT early — especially for women under 60 or within 10 years of menopause onset — is safe for most. It helps prevent osteoporosis and heart disease while easing symptoms. This evidence reassures women that HRT, when monitored appropriately, can enhance quality of life.

Today, HRT is recognized as essential. Key takeaways: It helps with more than hot flashes, supporting bone, heart and brain health for longer, healthier lives. The current conversation is evidence-based, compassionate and more detailed than ever before.

Seeing this change is deeply rewarding. For years, I wrote about the sudden loss of hormones, the fatigue, mood swings and weight changes. I described the lack of guidance from the medical community. Now, HRT is openly discussed, researched and reconsidered. That progress is overdue and lifesaving.

Most importantly, the next generation of women will have better access to information and support. They can make informed decisions about preventive surgeries and hormone health without facing unnecessary surprises or isolation. Until that day, I’ll continue writing. Our stories matter just as much as our hormones.

Yes, I’m delighted. HRT is finally part of the conversation. Women’s experiences are now shaping the narrative. Medicine is listening to what our bodies have always said: Hormones are essential to a woman’s health, especially for those of us who undergo early ovary removal to reduce hereditary cancer risk.

This piece reflects the author’s personal experience and perspective. For medical advice, please consult your health care provider.

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