Hi Reader,

Behind the scenes...

I have a lot of breast cancer in my immediate family.

My calculated risk of getting breast cancer before I'm geriatric is about 30%.

As my perimenopause symptoms evolve, the question I keep coming back to...is hormone therapy safe for me?

If you asked me last Fall and Winter, I would have said, "hard no."

Even though I was waking up with heat waves every couple of hours, falling off emotional cliffs, and experiencing the worst acne of my life - with random dizzy spells on the side.

As I considered my life choices, I made an OB/GYN appointment.

The doc knows my family history, and she's supportive of me trying natural therapies as long as possible. Then she read my DEXA scan results.

"I hear your concern about breast cancer," she said.

"But given what we know from current research on breast cancer risk, including the updated interpretation of the WHI Study from the early 2000s, I'm more concerned about your bone health. This DEXA scan result isn't good."​
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She has no problem being straight with me. I ask LOTS of questions and share my frustrations.

"Why is it that women are forced to choose between breast cancer and hip fractures? Is that really the best we can do with modern medicine?" I asked.

Yeah, I'm that patient 🥴

Needless to say, I didn't take the hormonal prescription she gave me - even to protect my bone health.

I sat with my life choices, as my friend Mary would say. Until May of this year.

The night sweats came back. I couldn't eat anything with salt without blowing up like a balloon with water retention.

My body and mental fatigue affected my work. And controlling my moods felt like a second full-time job. I needed more support.

At the same time, I dug into the current research on breast cancer risk and bone protection with HRT.

I love being active, hopefully for years to come. So I made the difficult choice to protect my bones and started the prescribed hormone medication. At least for now.

As a precaution, I get regular mammograms and breast MRIs every 6 months.

And honestly, while I don't love taking medication (who does?), I made peace with the decision.

But I still strongly believe lifestyle interventions for menopause symptoms are a must-do regardless of whether you're team HRT or not.

​Read why in this week's updated blog post​

If HRT isn't for you for any reason, consider a food-first approach.

Try slowly adding phytoestrogen-rich foods to your daily eating routine. Phytoestrogens are plant-based estrogen-like compounds called isoflavones found in beans, lentils, soy, flax, and herbs like red clover.

They can help reduce estrogen fluctuations during perimenopause and reduce symptoms like hot flashes, night sweats, vaginal dryness, and irregular moods.

Research suggests eating 25-50 mg of phytoestrogens per day.

This looks like:

• 1 cup of soy milk (preferably unsweetened. I'd rather have my sugar in chocolate or a cookie 😋)
• ½ cup of edamame
• 2-3 Tablespoons of miso paste
• 3-5 oz of Tofu or tempeh
• 1 Tablespoon of ground flax seeds
• ½ -1 cup of beans or lentils (start low, add gradually)

Here's a sample phytoestrogen-rich menu:

• Breakfast: overnight oats made with ½ cup of oats, 1 cup of soy milk, ½ tsp of cinnamon, ¼ cup dried cranberries, 2 TBSP hemp seeds, 1 TBSP ground flax seeds
• Lunch: brown rice Savor Bowl with roasted root vegetables, sautéed dark leafy greens or spinach, ½ cup edamame, ¼ cup toasted sesame seeds, and miso sesame dressing (1 Tbsp light miso + 1 TBSP toasted sesame oil + 1 TBSP olive oil + 1 TBSP rice vinegar + ½ tsp ground ginger)
• Dinner: Tempeh fajitas with sautéed bell peppers, onions, zucchini, and black beans wrapped in 2 whole-grain corn tortillas

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Remember to use the add-in approach to incorporate more phytoestrogen-rich foods in your diet.

Think of it as adding more variety to your meals - a key component of the gentle nutrition framework.

When you use the add-in approach, you won't feel obligated to eat phytoestrogens to be healthy in this season of life.

⚠️MOST importantly! There are many tools to support you through the menopause transition. One therapy or tool doesn't treat everyone! Don't give up on advocating for yourself until you find the tool or therapy that works best for you.

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​Which of the phytoestrogen-rich foods above are your favorites?

Hit reply! I'd love to hear how you use them 😋

Enjoy the weekend savoring food and your body!

Amanda

PS: I still strongly believe lifestyle interventions for menopause symptoms are a must-do regardless of whether you're team HRT or not. Read why in this week's updated blog post.

If HRT isn't for you, consider a food-first approach. Start slowly adding phytoestrogen-rich foods into your daily eating routine. Phytoestrogens are found in beans, lentils, soy, flax, and herbs like red clover. They can help reduce estrogen fluctuations during perimenopause and reduce symptoms like hot flashes, night sweats, vaginal dryness, and irregular moods. Research suggests eating 25-50 mg of phytoestrogens per day. Scroll up for a sample menu!