HJBR May/Jun 2025

HEALTHCARE JOURNAL OF BATON ROUGE I  MAY / JUN 2025 29 1985 approach might need updating. We’ve all been there, right? Despite advances in research, many pro- viders still hesitate to embrace new meno- pause treatments. 3 The result? Patients con- tinue to suffer unnecessarily while waiting for the system to catch up. 4 THE UGLY: A BROKEN SYSTEM FAILING WOMEN Here’s where it gets interesting, and by interesting, we mean problematic. We’re facing a tsunami of women seeking special- ized menopause care, and expecting OB- GYNs and PCPs to handle this alongside their existing workload is like asking them to juggle flaming torches while performing a C-section. It’s neither realistic nor safe. 5,6 Let’s talk about everyone’s favorite hor- mone boogeyman: estrogen. You know, that molecule that’s been getting more bad press than a celebrity scandal. The common mis- conception is that “estrogen causes breast cancer.” Ah yes, the medical equivalent of “pop rocks and soda will make your stomach explode.” We’ve all heard it. Maybe we’ve even said it — don’t worry, your secret’s safe with me. This belief has been passed around medical conferences like a plate of stale cookies, causing countless clinicians to hesitate and countless women to suffer unnecessarily. 7 THE EVIDENCE-BASED TRUTH Hold onto your prescription pads, because here’s the plot twist: The totality of randomized clinical trial evidence — yes, the kind that makes statisticians weak in the knees — actually shows that use of estro- gen alone significantly reduces breast can- cer incidence. 8 Let that sink in. It’s like finding out that everything we learned about ulcers being caused by stress was wrong. Remember that paradigm shift? Good times. Why does this matter? This isn’t just an academic “well, actually”moment. This mis- conception has real-world implications for patients who have been white-knuckling their way through menopause symptoms because everyone, including their health- care providers, is terrified of estrogen. It’s time we update our clinical narratives. Because continuing to perpetuate this myth is about as helpful as recommending blood- letting for anemia. Remember: Evidence-based medicine means being willing to change our minds when the evidence points us in a new direc- tion, even if that direction makes us ques- tion everything we thought we knew about estrogen. BREAKTHROUGHS IN MENOPAUSE CARE Let’s talk about breakthroughs in meno- pause care. And by breakthroughs, we mean the kind of slow-but-steady revelations that make research statisticians lightheaded, not the “We’ve discovered a miracle cure” type of headlines that make us all roll our eyes in unison. Remember how we all thought estrogen was the villain in our medical drama? Plot twist: It turns out it’s more of a misunder- stood hero. This revelation didn’t happen overnight — it’s been more like watching paint dry, if the paint was made of peer- reviewed studies spanning two decades. THE “WAIT, WHAT?” MOMENTS Breast cancer risk — here’s something that might make you spit out your coffee. Estro- gen doesn’t just “not cause” breast cancer, as we discussed earlier, but it can actually decrease breast cancer risk by 23% in some cases. 9 Yes, you read that right. It’s like find- ing out that everything you knew about estrogen was about as accurate as your first- year medical student diagnoses. Heart disease — hold onto your stetho- scopes, because this one’s a doozy. Estrogen has been found to decrease the risk of heart disease, you know, just the leading cause of death in women. 10 No big deal. Except it is a big deal, and we should probably stop whis- pering about it in the hospital corridors. Perhaps the real breakthrough isn’t in any single study, but in our collective “aha” moment, realizing that what we’ve been teaching about estrogen for years might have been about as accurate as a Magic 8 Ball’s medical advice. These aren’t just academic footnotes, they’re game changers for clinical prac- tice. Or at least they should be if we can get everyone to actually read the memo. Still waiting on some colleagues who apparently missed the last two decades of research updates… Remember: Sometimes the biggest break- throughs aren’t dramatic discoveries but the slow accumulation of evidence that finally tips the scales of medical wisdom. Even if it does make us question everything we learned in medical school. Again. A PHYSICIAN’S PERSPECTIVE: LEARNING FROM EXPERIENCE Let me tell you about the day my ego took a spectacular nosedive. There I was, thinking I was reasonably up to date on medical knowledge when Crystal decided to turn our evening into an impromptu board review session on hor- mone replacement therapy. As she presented one study after another, I felt like I was watching my clinical certain- ties crumble. Some of these papers dated back to my residency years, when I was sup- posedly learning everything about medicine while surviving on coffee and three hours of sleep. Here’s the part that really stings: Despite all those CME credits, and despite the jour- nal subscriptions cluttering my inbox, somehow, I had missed an entire body of research that fundamentally challenged what I thought I knew about menopause care. If there’s any comfort in this professional face-plant, it’s knowing I’m not alone. Many of us were taught certain “truths” about menopause care that turned out to be about as current as a flip phone. The real ques- tion is: Howmany other physicians are still operating on outdated information? Perhaps the most important lesson here