Breast health and hormone health belong in the same conversation. This Breast Cancer Awareness Month, I want women to feel confident asking two questions. Am I up to date on breast screening? And what are my options for feeling better through menopause?
Too many women treat these as separate topics, or avoid the second because of the first. In my practice, I meet women who have spent years with hot flashes, night sweats, poor sleep, and brain fog because they were told to push through it. Many never asked about hormone therapy because they were afraid of it.
Where the fear came from
For more than 20 years, fear and confusion about hormone therapy have left many women unsure where to turn. Much of that traces back to 2002, when early results from the Women’s Health Initiative were widely reported as proof that hormone therapy was dangerous. Estrogen products carried a boxed warning, the FDA’s most serious label warning, from then on.
The women in that study were, on average, in their early 60s and many years past menopause. That detail matters. Women deserve a clearer explanation of what the evidence actually says.
What the FDA changed
Recent FDA labeling changes give us an opportunity to revisit that conversation. In November 2025, the FDA began removing the boxed warning language on cardiovascular disease, breast cancer, and probable dementia from menopausal hormone therapy labels. The agency pointed to evidence that the risks seen in older women do not apply in the same way to women who start therapy before age 60 or within about 10 years of menopause.
That does not mean hormone therapy is right for every woman, or that it carries no risk. It means the conversation can start from accurate information instead of fear.
Individualized care
Unfortunately, there are not enough providers skilled in menopause care, and a label change does not close that gap on its own.
My specialty is individualized hormone care, including bioidentical options. Bioidentical hormones are structurally identical to the hormones the body makes. Some are FDA-approved, and some are compounded for an individual patient. I want women to understand their choices and work with a clinician who can explain the benefits and risks and customize a treatment that is right for them.
That starts with the full picture: symptoms, personal and family history, breast health, cardiovascular risk, and lab work. Hormone care is a relationship, not a one-time prescription.
Breast screening matters, too
Mammograms can find cancer earlier, when it may be easier to treat. Current national guidelines recommend that most women begin regular screening at age 40, and women with a family history may need to start earlier. If you are due, schedule yours. If you are worried, talk with your care team. You deserve support.
For women on hormone therapy or considering it, staying current on screening is part of the plan.
Why this is personal
As a woman, I value being proactive about my own health. As a physician, I feel privileged to help other women do the same.
This October, make room for your questions. Your breast health matters, and your quality of life matters, too.
About Dr. Melinda Silva
Melinda Silva, MD, ABAARM, FAARM, is a board-certified physician in integrative and regenerative medicine with more than 28 years of clinical experience. She is the founder of Silva MD Anti-Aging & Wellness, with offices in Chula Vista and Pacific Beach, San Diego, and the author of Aging Gracefully and Strong: ABCs of YOUthful Living.
This article is for general education and is not medical advice.
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