108: Estrogen Myths & Bioidentical Truths with Jeffrey Dach, MD (Part 2)

Aug 25, 2025

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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.

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