In the conclusion of this two-part conversation, Dr. Jenn Simmons and Dr. Jeffrey Dach go deeper on bioidentical hormones, long-term estrogen deprivation (LTED), and why “have” vs. “had” breast cancer matters when discussing HRT. They examine apoptosis after LTED, the role of estrogen in genomic stability, and how overdiagnosis from screening can drive unnecessary treatment. They also cover practical prevention pillars—iodine, DIM, selenium, and vitamin D—and what thoughtful, individualized care can look like for women navigating menopause and survivorship. In This Episode, You Will Learn: How reintroducing estrogen can trigger apoptosis in specific contexts Why “have” vs. “had” breast cancer changes the HRT conversation How screening, overdiagnosis, and rising mastectomy rates intersect The difference between natural progesterone and synthetic progestins How iodine, DIM, selenium, and vitamin D factor into prevention programs What estrogen metabolites (2-hydroxy vs 4-hydroxy) and COMT mean for risk Where integrative oncology and repurposed therapies fit into patient-centered care Episode Timeline Highlights 00:00:51 LTED explained: estrogen reintroduction & apoptosis 00:06:48 How long is “long-term” deprivation? What the studies suggest 00:10:29 “Have” vs. “had” breast cancer—why words matter for HRT decisions 00:12:48 Integrative oncology, repurposed drugs & fasting in cancer care context 00:17:41 Who may be a candidate for HRT after curative treatment? 00:20:11 Autopsy data, DCIS, and the problem of overdiagnosis 00:27:10 Why finding smaller tumors doesn’t always change overall survival 00:29:29 The unintended rise in mastectomy rates with screening 00:47:33 Is it ever too late for HRT? Benefits into the 60s and 70s 00:50:02 Osteoarthritis, sleep, mood—systemic effects of estrogen deficiency 00:54:15 Metabolites & methylation (COMT) 00:58:22 Prevention stack: iodine, DIM, resveratrol, NAC 00:59:31 Selenium’s role & vitamin D optimization 01:03:04 Risk-reduction strategies & individualized care 01:10:40 Closing reflections & resources 💬 If this episode resonates, please rate, review, and subscribe on Apple Podcasts, Spotify, or wherever you listen. And share Part 2 with someone who needs a nuanced, evidence-curious take on hormones, survivorship, and women’s health. To talk to a member of Dr. Jenn's team and learn more about working privately with RHMD, visit: https://jennsimmons.simplero.com/page/377266?kuid=327aca17-5135-44cf-9210-c0b77a56e26d&kref=vOKy0sAiorrK To get your copy of Dr. Jenn's book, The Smart Woman's Guide to Breast Cancer, visit: https://tinyurl.com/SmartWomansBreastCancerGuide To purchase the auria breast cancer screening test go here https://auria.care/ and use the code DRJENN20 for 20% Off. Connect with Dr. Jenn: Website: https://www.realhealthmd.com/ Facebook: https://www.facebook.com/DrJennSimmons Instagram: https://www.instagram.com/drjennsimmons/ YouTube: https://www.youtube.com/@dr.jennsimmons
