Bonus Episode: Fear and HRT

Episode Summary:
In this solo episode, I explore one of the most debated areas of care for BRCA mutation carriers: hormone replacement therapy (HRT). While evidence—including the 2016 North American Menopause Society (NAMS) Practice Pearl—supports the use of systemic HRT for many BRCA carriers after risk-reducing surgery, fear and cultural stigma around hormones continue to shape medical recommendations.

I discuss why some doctors may still discourage HRT for BRCA2 carriers, not because of strong scientific evidence, but because of lingering emotional and cultural fears around breast cancer risk. We look at how those fears are absorbed by patients, and how that shapes the lived experience of navigating hereditary cancer risk.

This episode is not about giving medical advice. Instead, it’s about naming the emotional and psychological dynamics at play—because when we can name them, we reclaim some agency in how we meet uncertainty.

You can read the NAMS Practice Pearl “Use of Systemic Hormone Therapy in BRCA Mutation Carriers” here:

https://pubmed.ncbi.nlm.nih.gov/27504919/

What You’ll Hear in This Episode:

• The scope of my practice as a therapist and why this podcast is not medical advice

• A summary of the NAMS Practice Pearl on HRT and BRCA mutations (2016)

• Why cultural and emotional fear still drives hesitation around HRT recommendations

• How patients absorb the weight of provider fear and avoidance

• A depth perspective on agency, uncertainty, and cultivating internal security

Disclaimer:
This podcast comes from the perspective of a licensed therapist and focuses on emotional, relational, and psychological aspects of hereditary cancer risk. It is not medical advice. Please consult your healthcare providers for medical guidance.