Episode Details

Hormone therapy after breast cancer is one of the most nuanced and emotionally charged conversations in women’s health.

For decades, many women have been told the answer is simply: no.

No discussion.
No nuance.
No consideration of quality of life, sexual health, bone health, brain health, or the individual woman sitting in the exam room.

But what does the research actually say?

In this episode of Pleasure in the Pause, I welcome back Dr. Susan Hardwick-Smith, board-certified gynecologist and certified menopause practitioner, for a grounded, evidence-informed conversation about hormone therapy after breast cancer.

This is not a conversation about ignoring risk.

It is a conversation about understanding risk clearly, asking better questions, and making informed decisions in partnership with your physician.

About our guest: Dr. Susan Hardwick-Smith is a Board-Certified Gynecologist and certified menopause practitioner specializing in women's midlife wellness, hormone optimization and sexual wellness. She is the founder of Complete Midlife Wellness Center in Houston, TX, and the best-selling author of "Sexually Woke- Awaken the Secrets to Your Best Sex Life in Midlife and Beyond." She also hosts the popular podcast "Empowering Midlife Wellness." Dr. Susan is the recipient of the Texas Super Doctor award over a dozen times, as well a multiple time recipient of H-Texas magazine's Top Doctor and Top Doctor for Women awards. She also has been chosen as one of Houston's "3 best rated" gynecologists several consecutive years. Dr. Susan is also an ICF certified life and leadership coach, multiple time marathoner and Ironman triathlete, and mother of 3 teenagers. 

Highlights from our discussion include:

• What the Women’s Health Initiative actually found — and why the headlines created so much confusion
• Why breast cancer type matters when discussing hormones
• What the research shows about hormone therapy and breast cancer recurrence
• Why some women on aromatase inhibitors may still be able to discuss options like progesterone, testosterone, and vaginal estrogen with their doctor
• How to prepare for a more informed conversation with your physician
• Why collaborative decision-making matters in women’s healthcare
• The importance of considering quality of life, sexual health, bones, heart, and brain health — not just risk 

My hope is that this episode helps you feel more informed, more empowered, and more confident asking questions about your own body and care. 

If you're seeking to reclaim your pleasure and vitality, join Gabriella at⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.pleasureinthepause.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for this enlightening journey into the heart of female pleasure and empowerment.

Resources:

Dr. Susan Hardwick Smith: https://drsusan.com/ 

Instagram: https://www.instagram.com/drsusanofficial/ 

Bluming review article in Cancer journal (2022): https://pubmed.ncbi.nlm.nih.gov/35594465/ 

Menopause Society consensus paper (January 2026): https://www.imsociety.org/statements/position-papers-and-consensus-statements/ 

Hormone Replacement Therapy After Breast Cancer: It Is Time Avrum Z. Bluming, MD LINK -