15 Ways to Change the World

According to me

Hello, Substack! Another day, another list of urgent matters I’m fired up about. These aren’t just complaints—they’re calls to immediate action, grounded in science and my experience as a urologist, sex medicine specialist, and hormonal health advocate. Some are systemic, some are cultural, but all need immediate attention. Let’s jump right in and address these urgent matters. Because literally, we can’t wait for other people to save us, can we?

Photo by NOAA on Unsplash

1. Hormones After Breast Cancer Should Be a Choice

I’m pro-choice for hormones after breast cancer. If you’ve survived breast cancer and your quality of life has taken a hit, you deserve the option to discuss hormone therapy. The data doesn’t support the fear that hormones automatically trigger recurrence. We let survivors drink alcohol (a known carcinogen), so why not give them informed options about estrogen, progesterone, and testosterone? It’s about respect, bodily autonomy and empowerment. And of course, vaginal estrogen for all survivors, and even while on active treatment. Discuss with your oncologist, but ACOG has a position statement on this.