What Women Deserve to Know About Breast Cancer, Menopause & Hormones
On Tuesday, October 28, 2025, a group of women gathered at Limitless Fitness personal training gym in Epping, NH for a conversation they weren’t having elsewhere. The panel, titled Beyond the Pink Ribbon, brought together three local experts for a frank, evidence-based discussion on what happens when breast cancer, menopause, and hormone health intersect.
Led by Dr. Noor Al-Humaidhi and PA Brittany Marden of Lifestyles by Noor in Exeter, NH, and Dr. Eva Lizer of the Breast Center of New England in Lee, NH, this event addressed the challenges women face in midlife, including confusing advice about hormones, fear around breast cancer risk, and the physical and emotional impact of treatment-induced menopause.
Family History & Risk: "Does my mom's breast cancer mean I'm next?"
Dr. Eva Lizer explained that when women come in with a family history of breast cancer, their risk isn't automatically the same as their relatives. Risk scores consider a range of inputs: genetics, age, breast density (A - D), reproductive history, and more. "We use tools like Tyrer-Cuzick to determine someone's risk. If your lifetime risk is high enough, you might qualify for an MRI in addition to a mammogram."
She emphasized that women often misunderstand risk because it's either oversimplified or poorly communicated: "We don’t always explain what goes into it. Your mom having breast cancer doesn’t always mean you’re high risk."
A topic that came up repeatedly during the panel was dense breast tissue, something many women have heard about but don’t fully understand. Dr. Lizer noted, “Dense breasts are very common, but they can make cancers harder to detect on mammograms. It’s not necessarily bad, but it is something to factor into your risk score.”
She explained how many women are left anxious and confused when they get a letter about breast density after their screening. “It’s all about context. Dense breasts plus other risk factors may require different screening approaches. But by itself, it’s not a diagnosis.”
Hormone Therapy: Myths vs. Research
Dr. Noor Al-Humaidhi noted that women frequently tell her: "I can’t take hormones because my mom had breast cancer."
"We hear that all the time," said Brittany Marden. "And that just isn’t supported across the board by the research."
A central moment of the panel came when the 2002 Women’s Health Initiative (WHI) study was discussed, the moment that fundamentally changed how hormone therapy was viewed in the medical field and by the public.
Dr. Noor explained how confusion around hormone therapy and breast cancer risk started:
“We’ve talked about the Women’s Health Initiative study and that headline they gave, the press conference they had… it was all because the estrogen and progesterone group had a 24% increased incidence of breast cancer — but that was something called relative risk. What it really equated to in absolute risk was one additional case per 1,000 over five years compared to the placebo group. And we're not even using the same hormones they used in that study. So it just is not applicable.”
Panelists also pointed to a broader issue in healthcare today: that most of modern medicine is built around the physiology of a 70kg man — with research, pharmacy dosing, and risk models often failing to account for the hormonal complexity of women.
“Menopause research is chronically underfunded. Scientific literature loves when everything is the same. But in a female body, especially with our menstrual cycle, nothing is stagnant. Things are changing all the time. The industry decided it was too hard to study women because of those hormonal fluctuations. They essentially excluded us, saying we weren’t consistent enough to measure, instead extrapolating data to women. But women are not small men.”
That history continues to shape today’s gaps in care and the dismissal many women feel when seeking answers in midlife. Brittany encouraged women in attendance to seek out high-quality resources like The Menopause Society and books like Estrogen Matters and The New Menopause to get accurate information and context about their options.
Dr. Noor clarified the difference between systemic hormone therapy (which affects the whole body) and local vaginal estrogen — which does not significantly raise estradiol levels in the blood and is considered safe for most women, including breast cancer survivors. “Vaginal estrogen can be a game changer, not just for comfort or dryness, but for preventing UTIs in older women. We see it help so many patients who’ve been suffering unnecessarily.”
Treatment-Induced Menopause: Left Without Support
"Women diagnosed with breast cancer are thrown into menopause and poorly served," said Dr. Noor. "They're sent out with no help and told to just be thankful they're not dead from breast cancer. It’s like they should somehow suffer more."
Brittany echoed the issue from her experience in gynecologic oncology: "So many women come in with vaginal dryness or pain after surgical or chemo-induced menopause, and they’ve been told estrogen is a no-go. But the tissue changes they experience are serious, and they’re suffering."
Dr. Lizer noted that most patients don’t even know survivorship clinics exist. “People need more than treatment. They need PT for scars, support for lung and heart issues from radiation, and long-term care that accounts for their risks after treatment.”
Bone Density & Strength Training: The Overlooked Pillars
Dr. Noor emphasized that the majority of women with a breast cancer diagnosis won’t die from it. "They’ll die from something like a fracture, something that could have been prevented with better attention to bone density."
DEXA scans were mentioned multiple times as a critical but underutilized screening tool for bone loss, especially in women entering menopause or undergoing treatment that affects hormone levels.
Dr. Noor stressed that if bone loss is caught early, women can make lifestyle changes, and in some cases, pursue treatment, to prevent fractures down the road.
Brittany added that strength training plays a crucial role: "We need to optimize women, not compromise. Resistance training supports hormone balance, metabolism, mental clarity, and protects bone health."
Thriving After Survival: Redefining What’s Possible
“Women who survive breast cancer are often told they should just be grateful,” said Dr. Noor. “But gratitude shouldn’t mean silence. It shouldn’t mean we ignore their quality of life.”
This theme came up repeatedly, that surviving isn’t the same as thriving, and women need the tools, support, and permission to take control of their health again.
Patients want to know what’s next. How do they regain strength, libido, sleep, clarity — especially when what used to work no longer does?
Brittany said, “We get women who feel like their body changed overnight. They’re exhausted. They’re discouraged. And they’ve been told to just deal with it. But there’s a lot we can do — and it starts with education, support, and the right kind of care.”
Dr. Lizer encouraged women to advocate for themselves and not accept outdated advice. "You can ask questions. You can get a second opinion. And you can ask for care that meets you where you're at."
Final Takeaways
Risk is personal. A family history of breast cancer doesn’t tell the whole story.
Dense breasts are common, but only one part of your risk picture.
Vaginal estrogen is safe for most women and can drastically improve quality of life.
Menopause caused by treatment is real and needs proactive care.
DEXA scans and strength training are essential for long-term bone health.
Women deserve more than survival — they deserve to thrive.