Estrogen and Breast Cancer: A Contemporary Perspective | Empowering Midlife Wellness with Dr. Susan

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Estrogen and Breast Cancer: A Contemporary Perspective | Empowering Midlife Wellness with Dr. Susan

Рет қаралды 5,667

Күн бұрын

This past two decades has brought so much confusion about menopausal hormone replacement and breast cancer risk, but we now are entering a modern time with a much better understanding of how all this works.
Today I'm going to review how this controversy ever started and what the modern understanding is regarding estrogen and breast cancer. You may be surprised that we are now flipping the script and realizing that estrogen not only has no effect on increasing breast cancer risk, but actually reduces the risk of dying from breast cancer if it's started early. Not only that, but estrogen also undeniably reduces the risk of colon cancer, osteoporosis, and particularly cardiovascular disease when it is started shortly after menopause.
We no longer recommend taking hormone replacement only for treatment of hot flashes and night sweats, or stopping it after any defined time period. The health benefits of starting it as soon as possible after menopause and taking it for life outweigh any risks for most women.
A Contemporary View Of Menopausal Hormone Therapy - LINK To The Article - rb.gy/yoaouu
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 as 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 for several consecutive years. Dr. Susan is also an ICF-certified life and leadership coach, multiple-time marathoner and Ironman triathlete, and mother of 3 young adults.
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Пікірлер: 125

@laluna1223 3 ай бұрын

I was diagnosed with Stage 1A HR+, HER2- in February of 2020. Lymph nodes were negative and margins clean. Fast forward to December of last year…again I found a small lump very near where my last lump was. No surprise, Stage 1A, HR+, HER 2 - again. Add to that debilitating post menopausal symptoms during surgery and radiation, I was depressed, had anxiety not to mention a multitude of other symptoms. My medical oncologist recommended that I take an aromatase inhibitor. I told her respectfully, no. I can’t compound my post menopausal symptoms further. This was 4 weeks ago…I’m happy to say that I found a wonderful provider that listened to me and am taking HRT. I’m also getting a ctDNA test done every six months, with ultra sound and a mammogram going forward for my preventative treatment. I’m feeling normal, can have a conversation, and am sleeping again. I too, think quality of life matters when making very important decisions. So, thank you Dr Susan for the invaluable information that you provide to your community. It has helped me advocate for myself, when no other provider would listen.

@lauraooten7057 3 ай бұрын

You are blessed to find a Dr that will help you I cannot find any doctor that will help me.

@randiking5275 3 ай бұрын

I agree with you, so much! I was happily on bioidentical HRT for 10 years and was diagnosed in February with stage 1a invasive lobular carcinoma. Everyone is saying no to HRT forever. I haven't slept in months and really feel terrible. It's difficult to find a provider willing to have this conversation. I am so happy to hear you are feeling better!!

@emilymorris5988 3 ай бұрын

Same with me. I had breast cancer in 2018 after being on ERT for several years. I have been off estrogen since thar time. I am doing okay, but I do have osteopenia. From what this video states, HRT is safe even for breast cancer survivors, but there are no doctors that would agree with this. Where would one find a provider who agrees it is safe?

@LouisePutnam-hf5hf 3 ай бұрын

I’d love to know the physicians name because no doctors will listen to me

@jantrevino9345 3 ай бұрын

@@emilymorris5988I'm in the same situation. I suffer from insomnia and sleep is a big battle for me. 70 year old female. I was on bio for three years, then synthetic for three years. Then a small spot of stage 1 breast cancer was discovered. My doctor won't even try bioidentical hormones. The cancer was four years ago and outside of my insomnia, I'm doing well. My bone density test came out okay.

@alicechampagne7091 3 ай бұрын

Thank you VERY much for this video! When you mentioned the 2 decades of women who were not encouraged to take hormones due to the misinterpreted study, you were speaking to my generation. Thankfully, my doctor prescribed a low dose of hormones when I went through menopause at my insistence…even though my mother died of breast cancer at age 67. Back then, a very low dose was recommended and for only as long as the worst symptoms were occurring. I stayed on them until at age 59 an unclear (but normal) mammogram scared me into stopping. After 6 years of being off and a new doctor who specializes in hormonal therapy, I’m back on hormones. What a difference! My quality of life is much improved.

@Juliet875 3 ай бұрын

I'm on Estradiol along with Testosterone, and Progesterone. Yes, the benefits of Estradiol are so important. Excellent Video, Thank You!

@creatinghanley 3 ай бұрын

How do you feel on the testosterone?

@Juliet875 3 ай бұрын

Honestly, I love it. I have so much more energy. My workouts have improved and it's great for your libido.@@creatinghanley

@marymcguire7228 3 ай бұрын

What kind of testosterone? Cream? Oral? TIA

@ouitamata 3 ай бұрын

In what format are you taking the Estradiol?

@brendadaviswilson9243 3 ай бұрын

None of the women I know with Cancer were on HRT I’m so glad the word is getting out

@jantrevino9345 3 ай бұрын

60 Minutes came out with segment about this. They reported that in the UK, they are trying to pass a bill that would allow women to use hrt without cost to the women.

@jantrevino9345 2 ай бұрын

BBCLondon also came out reporting that the WHI study was flawed and how so many women have suffered because of that report.

@loriswan2556 3 ай бұрын

I was on estrogen and promethium for 15 years, felt wonderful! Thank you for confirming my choices did NOT cause my BC. I have a healthy lifestyle, exercising, diet, etc. Now 66 and diagnosed with stage 2 Er + Pr + A( strongly 66%) They want me to take AI to block estrogen after radiation and lumpectomy I don’t want to do AI therapy as I know that what little estrogen I will produce will help me. I think that you provided a good argument for me to discuss with my oncologist not to take Aromatase inhibitors. Can you discuss this???? Thank you, this information is SO hard to find 🙏🏻

@barbaratankersley7117 3 ай бұрын

Dr.thank you for telling us Can you Imagine the suffering I done in the year 2001 I had colon rectal cancer in the operation tha also took my Ovaries I was burning up.day and night Night sweating is terrible I started talking HRT at age 68 years old over 20 years after my surgery I will take my HTR to the grave with me Thank you keep up.the very favorable information

@Jen-M. 3 ай бұрын

glad you are speaking out about a subject that's been pushed under the rug

@tlsvatos3451 2 ай бұрын

I’m 59. I was on HRT for 6 years and then my doctor informed me that I needed to stop it as it increased my risk of cancer, so for nearly three years I have been miserable. I have an appointment with a new OB/GYN menopause specialist in a few days and I’m very much looking forward to getting back on hormones to improve my quality of life and decrease my risk of serious diseases! Thank you!

@user-gh3bz9no2d 3 ай бұрын

Fellow Kiwi here, thanks for this information. Very lucky that Bio Identical HRT is fully funded here in NZ and easy to get.

@Jolly12 16 күн бұрын

Sending gratitude.

@donnazaken Ай бұрын

Excellent! Thank you so much for getting this very important information out there. So many women are suffering needlessly. I am a nurse practitioner. I, too believed what was told to us from that study but then I took a comprehensive integrative course on bio-identical hormone replacement therapy which changed my mind. I started on BHRT at age 67 and am sooo happy I did. It has changed my life. Women need to find a Functional medicine practitioner who specializes in women's health. Those practitioners should know and understand that it is safe. I have been able to reverse osteoporosis with weight bearing exercises 3 x a week and bone health supplements.

@susandrake7180 3 ай бұрын

Have you seen the youtube video titled: HRT for Primary Prevention in the Menopausal Transition - Peter Greenhouse 19 Nov 2023, where at aprox minute 19:00, he suggests the healthy user bias can't account for the large decrease in risk of dying while on hrt of breast cancer. The whole video is amazing. He's in the UK.

@anndavis1668 Ай бұрын

I think a study needs to be done on the benefits versus negatives of taking tamoxfen after treatment for stage 1 oestrogen positive cancer. It is being recommended by onchologists. I know, because l'm that patient. However i've made the decision to take my hrt, bodyidentical oestrogen and progesterone. It was difficult to go against the onchologist, and an extra stress that a patient doesnt need. Thank you for your honest information. It helps enormously

@patriciadrank6543 3 ай бұрын

I am way beyond menopause. I'd like to understand why women in their seventies cannot start on natural hormone replacement if they have osteoporosis. Would you please cover this topic?

@drsusan 2 ай бұрын

I agree it's not correct to say you can't take hormones at any age, but certainly would be unlikely to get much benefit since unfortunately, most of the benefit occurs in the beginning, but I have a lot of patients taking hormones and their and older!

@cleanqueen75 3 ай бұрын

I had a young obgyn lady tell me she sees women come in bleeding and then diagnosed with ovarian cancer from taking estrogen. I call bs on that!

@drsusan 3 ай бұрын

Yes agreed. Ovarian cancer has nothing to do with hormone replacement

@Suzette-gb7uj 3 ай бұрын

I had some break-through bleeding until we got my progesterone to the right level. I did have a surgical biopsy to make sure I did not have uterine cancer. I did not, I do not, I will be on HRT for as long as I live.

@debbiedavidson4877 3 ай бұрын

I’m 74 and still having hot flashes and night sweats…no estrogen after the study bc my sister had a form of breast cancer 25 years ago. At this point can I go back on estrogen?

@drironmom6815 3 ай бұрын

I’m a MD who ity mothe back on bioidentical estrogen, testosterone, and progesterone when she was in her 80’s. Now she’s 93 and still teaching water aerobics! Find a doctor who will also give you testosterone (female doses of testosterone give you strength and energy) and natural progesterone.

@cleanqueen75 3 ай бұрын

I’ve been on testosterone, estrodial and progesterone since 2012. I’m 67. I finally found an obgyn that when I have my yearly Pap smear I don’t get lectured about how they will give me cancer.

@missgaia12 3 ай бұрын

Thank you, doctor, for informing us with such generosity.... 🌻🌻

@SaraLaidlawASBINC Ай бұрын

Oh, how I wish I had known this 11 years ago!! Stage1 BC 2013, a tiny tumor lying against my chest wall. A friend found her’s with a MRI, so I insisted on an MRI. I wish I had never found it. Lymph nodes fine. 30 days of Radiation. Then anti-estrogen for six years. They tried for 10 years, but some sort of extremely expensive test on my tumor showed no benefit to continuing. NOW I find out I have Stage 4 osteoporosis, “severe” chance of breaking my back and hips. Vag atrophied, horrible sleep, skin went south. If I had only known… I’m so angry. I’m only 63. My husband used to call it my “happy patch” as it was the happiest I’ve ever been. I was more upset about losing my patch than I was about the surgery and radiation. I’ve been calling and calling locally and no one will even consider HT once I mention breast cancer.

@Jennifer-jf7nx 3 ай бұрын

Can you do some research on how dangerous mammograms are for you? I read a really good book about that and how other countries do not use them

@Juliet875 3 ай бұрын

I'm curious too. They are banned in Switzerland. I heard they are saying the compression/squeezing of the mammogram damages the gland that leads to tumors and too many false positive results. I believe they do MRI and Ultrasound.

@laluna1223 3 ай бұрын

I’m not aware of this…what is the name of this book, please. I would like to know.

@drsusan 3 ай бұрын

Actually minuscule amount of radiation - no evidence that it's dangerous :)

@emilymorris5988 3 ай бұрын

many, many women are diagnosed by mammogram for breast cancer, including myself. I would have not known if I had not have a routine mammogram. They are not dangerous, but can be lifesaving.

@Jennifer-jf7nx 3 ай бұрын

@@laluna1223 the book is called NO Mamograms.. by Ben Johnson

@tdrrivera3677 3 ай бұрын

Ty for ur time educating us thru menopause! 💞

@anne-louisegoldie 3 ай бұрын

Thank you so much. Couldn't be clearer 💛

@inquisitive-surmenogirl 3 ай бұрын

Could you please do a video discussing if those of us in surgical menopause (no uterus, no ovaries) should or should not add progesterone to our estradiol replacement as I’m so confused on whether I should or should not as I’m hearing conflicting things.

@drsusan 3 ай бұрын

You don't need progesterone for uterine cancer prevention, but it can still be helpful for other things like sleep moods anxiety, so I have many patients who choose to take it but it's optional

@inquisitive-surmenogirl 3 ай бұрын

@@drsusan Thank you for the reply. I love watching your videos. I really wish you would do one on progesterone specifically with regard to forms, doses & in depth on if us in surgical menopause with no intact uterus & no intact ovaries put ourselves at a higher risk of things by adding progesterone or not. I’m reading/hearing very conflicting opinions on it so I honestly don’t know whether I should add progesterone or not. I feel overall fairly good on estradiol patches however I have fluid retention, struggle with weight & have lower back/hip pain that all started after my surgery & once I started on estradiol patches. One dr said progesterone would not help any of that it only helps sleep for some ladies. So I have no idea if I should or should not add progesterone.

@christinemack2153 3 ай бұрын

Looking forward to watching!

@christinemack2153 3 ай бұрын

Thank you, Dr. Susan!!!

@michelefinizio6520 3 ай бұрын

Thank you so much your a God sent I've been on estradiol patches for 5 years I get blood work every 3 months this past blood work showed that my Estrone was on the high side which my Dr. was a little concerned about and put me on dim she said I don't want you getting breast cancer and I started to cry cuz I'm going through a lot of health issues to begin with I couldn't imagine coming down with breast cancer on top of that so I am taking DIM 200 mg so I'm praying that my bad estrogen goes down

@Suzette-gb7uj 3 ай бұрын

@michelefinizo6520 my doctor has me taking CDG EstroDIM, and also rosemary oil to reduce estrone. I also did 23&Me health screening, and I do not have the BRCA1/BRCA2 variants that they tested in my DNA. It’s just one more thing that helps me believe I am making the right choice for me. Also, do you have close female relatives that have had breast cancer?

@michelefinizio6520 3 ай бұрын

@@Suzette-gb7uj thank you I'm taking 200 mg of DIM. Do you take rosemary oil internally cuz I do have rosemary oil and I smell it and I put it in my hair and on my father's side my aunt had breast cancer

@Suzette-gb7uj 3 ай бұрын

@@michelefinizio6520 the rosemary oil is ingested orally.

@divergentmind2023 3 ай бұрын

thank you so much

@jenniferwinograd 3 ай бұрын

Thanks.

@mariaatzeva9629 2 ай бұрын

I found Grape seed extract can be used as Aromatase Inhibitor

@MsFrancoise01 2 ай бұрын

Apart from their breast cancer conclusion, do they mention the other interesting conclusions of taking estrogen in their study?

@LoriJ1962 15 күн бұрын

I suffered from hot flashes and insomnia for 15 years and was terrified to take estradiol. I’m taking it now finally (at 62) and my hot flashes are gone. The estradiol and progesterone together are also helping my sleep - it’s not perfect but better. I have two questions: did I begin taking hormones too late to get any of the more overall health related benefits (reduced risk of CVD, colon cancer etc)? Also, I was taking .05 estradiol dosage and started getting persistent breast tenderness so dropped back down to .025. Breast tenderness is gone but occasional hot flashes/night sweats are back. Is the breast tenderness a bad thing if it’s tolerable? I don’t like it but I do like sleeping and not having night sweats.

@nancyv4431 3 ай бұрын

Thank you for telling the truth. Women have been misled for too long.

@user-ko6vs9zl5m 2 ай бұрын

What is your opinion on taking Tamoxifen after stage 1 hormone positive breast cancer? Thank you

@leanasavenkova6045 3 ай бұрын

Thank u! How can we educate doctors???

@drsusan 3 ай бұрын

It's happening slowly

@judithbrighton3040 3 ай бұрын

Have you ever discussed atypical cells in the breasts and increased risk of HRT (bioID)? Thanks for all you do?

@drsusan 3 ай бұрын

I haven't specifically discussed this, but that topic falls into the same category- obviously needs to be followed closely, but the same logic applies

@loriswan2556 3 ай бұрын

How do I find the links to the PDF files you mentioned that you would link? I would like to print them? Thank you

@drsusan 3 ай бұрын

Please look in the show notes

@belindasputore1945 2 ай бұрын

Hello dr Susan I am a healthy 70 year old. I was really well on HRT (Kliovance) for approx 20 years when last years mammogram showed lobular calcification insitu in left breast so I chose to stop HRT but for the full year I have had muscular skeletal pain, UTIs, dry skin. Because of how poorly I feel and that the lesion was not cancer I am considering starting BHT- estrodial transdermal patch and progesterone tablet ( I still have my uterous)I am having bone density test tomorrow. I am wondering if I should ask gp for app with heart specialist before resuming HRT. Is there anything else I should consider? BRCa1/BRCA2 test? Thank you for all the information you provide

@curiousjojo4life 3 ай бұрын

Dr. Susan, I am enjoying your channel. However, why are you promoting filling the breast tissue with radiation to check for cancer in the breasts and to even say get a mammogram every year? This suggestion you make does not align with what you share. I am truly curious as to why you do not recommend breast thermography to help screen for breast cancer? No radiation being delivered to the breast tissue, it is much gentler and provides better detailed screening. It is not covered by insurance, the cost is about $130-$150. Otherwise,I love what you shared today, thank you.

@drsusan 3 ай бұрын

In fact, mammography is a minuscule amount of radiation that has never been shown to be harmful - so annual mammography is very safe and has never been shown to cause any harm from radiation. I will make a video about that. Thank you for the inspiration.

@curiousjojo4life 3 ай бұрын

@@drsusan thank you for the clarification. When you make the video, it would be awesome if you would link the studies in the description. I appreciate all your work and the clarification. 🙏🏼💯💖

@NataschaO 3 ай бұрын

Why would a substance derived from a pregnant mare's urine be more disgusting than, for example, chicken eggs, which people eat all the time? Or cow's milk?

@drsusan 2 ай бұрын

In the 2 wrongs don't make a right category . Very familiar with veganism I have been plant based most of my life !

@NataschaO 2 ай бұрын

@@drsusan ❤❤❤

@user-ep9pl4ps5y 3 ай бұрын

I thought the biggest risk If you have a uterus and you are post menopausal is endometrial cancer. If you have a hysterectomy the HRT has little risk.

@drsusan 3 ай бұрын

Progesterone prevents uterine cancer. So women with a uterus need to take it . That makes uterine cancer risk lower than without hormones

@Kimcopeland1962 3 ай бұрын

I’m 62 past the 10 yr mark of menopause. Is it ok to take estrogen through the pellets or patch?? I was on the patch for past yr no problem then took one injection of the pellets for estrogen and I started to bleed. What is your recommendation for me.

@jantrevino9345 3 ай бұрын

Has there been any studies on what does cause breast cancer?

@margot6041 3 ай бұрын

It's a variety of reasons, genetics, environmental ( atomic bomb), and some reasons are unknown.

@cogirl1465 3 ай бұрын

Agree, nobody knows, but in Japan I think they have a lower risk because of the soy consumption.

@jantrevino9345 3 ай бұрын

@@cogirl1465and from what I've read, their soy is not tampered with like soy in the US.

@jantrevino9345 3 ай бұрын

Reason I ask, is that I was on bioidentical hormones for three years. Retired and for budget fear, I switched to synthetic and was on synthetic for three years. (. Medroxyprogestone was the progesterone used.). A little spot of stage 1 breast cancer discovered. I had a lumpectomy and radiation. That was four years ago and I have been okay. But, doctor's around here will not prescribe bhrt for me claiming that it causes cancer.

@margot6041 3 ай бұрын

@jantrevino9345 The oncologists don't want BC survivors to have estrogen or progesterone if their tumor was estrogen positive or progesterone positive. This status means the cancer "likes" those 2 hormones, which act as a fuel. I was told estodial, vaginally at lower doses, is ok for me. My BC lobular invasive carcinoma was both estrogen and progesterone positive. I hope your doctors gave you a full profile of your tumors features.

@margot6041 3 ай бұрын

Are there studies on women with estrogen positive BC history and use of estradiol systemically?

@drsusan 3 ай бұрын

Yes. Good start would be to read "estrogen matters." Dr. Bluming (author) and others have done these studies

@stef3565 3 ай бұрын

Do you know anyone in the FTW area you could recommend? Preferably one who is reading articles and staying more current. Thanks!

@drsusan 3 ай бұрын

Menopause.org is a good resource

@muldoon9007 2 ай бұрын

Hi Doctor Susan! So glad I found you. I am 3 months cancer free. Double Mastectomy and Stage 1A with no lymph node cancer found. Hooray. My surgeon saw me after being off bio identical low dose .25 cream bi-est for only 2 weeks. I was a mess! This was just prior to surgery. After surgery, she agreed that I could resume with as small a dose as possible, following the pathology report results. While I took compounded estrogen for twenty years after hysterectomy, I am finding that the consistency of the quality is not what it should be. It is costing $200.00 every 3 months for vaginal cream and topical cream. I can no longer tolerate the vaginal estriol for some reason and it isn't effective anyway. I was started on Yuva-fem 10 microgram, 2x per week recently and it is just okay not great. I am supposed to begin Divi gel this week .25 per day. I am feeling so estrogen deficient since surgery. Not sleeping, still burning, inflammation galore which means a lot of muscle pain and my memory has left the building, oh yes and dry skin everywhere. I agree so much, Doctor, with your statement about quality of life. I am 72 and after losing my breasts but with an excellent outcome, "Enough"! I an to feel good!

@hg-tm6gn 3 ай бұрын

Doctor, I hope you see this message! Do you have a list of obgyns that do this sort of work? I was specifically looking for someone out in Temecula, Ca or near by!

@anar.guzman8504 3 ай бұрын

Dr Mary Claire Haver has a list of friendly menopause doctors. Check her KZfaq channel

@drsusan 3 ай бұрын

Menopause.org is a great resource

@user-ll1lx8ev9e 3 ай бұрын

Hello Dr. Susan, can the loss of hair loss be minimized while on Biote. My hair has been falling off at scary amounts. I have been on the treatment since November of last year and lately I have been noticing a great amount of hair loss. I’m concerned but I really don’t want to stop my treatment either. May you have any advice or recommendations please?

@drsusan 3 ай бұрын

Would be happy to see you and discuss !

@karolinerosengren2013 3 ай бұрын

Hi doctor Susan I have just been to my doctor for getting HRT treatment Is it possible to book a zoom meating with you to discuss my prescripted hormones to have your opinion on the dosage and my labtests? I am particularly interested with my prescripted Androfeme 1% cream dosage 0,75 ml per day I am 37 years old and my labtest showed my testosterone is 0,5 nmol/l I still have my periods but short circle only 21 days and menstruation for about 3 days only I am also prescripted Evorel 75 microgram patches but wouldnt Estradot be better for me considering I still have my periods …? Kindest regards

@drsusan 3 ай бұрын

Appointments@drsusan.com

@user-iq4bx5bz1k 3 ай бұрын

Hello I’m on estrogen and progesterone for 8 months. My breast get tender sore swell up a bit every month like a cycle , is that normal . Does this settle. Is this considered inflammation ? if this keeps up can it cause cancer in the future?

@drsusan 2 ай бұрын

That's definitely something to talk to your physician about. Sounds like you have some hormonal fluctuations of your own going on in the background Would be happy to see you here in Houston and discuss!

@Dan-e2n Ай бұрын

Is there more of a risk for women with dense breasts?

@s.m.painter8808 3 ай бұрын

Where are you located?

@stef3565 3 ай бұрын

I think she's in Dallas

@Pachangko 3 ай бұрын

Houston

@sesame7551 3 ай бұрын

She is in Houston, TX

@drsusan 3 ай бұрын

Houston

@mariapalos6101 3 ай бұрын

Is it too late for an 89 year old woman with osteoporosis to start taking estrogen?

@drsusan 3 ай бұрын

Unfortunately it will be unlikely to be beneficial at this point . Starting hormones early is the goal for all of us who have that opportunity.

@Alexa4Grace 3 ай бұрын

How do you find a doctor that will prescribe bio-identical hormones. I live in Oregon which is chock full of ND's but they will not give them to us. Even a world renowned ND who is purported to be a "women's health" expert.

@KC-kh5dv 3 ай бұрын

Estrogen: Estradiol and Progesterone are bio identical no different name or brand name.The plant based ones are compounded. Maybe a neuropath can prescribe this for you.

@susanvanputten492 3 ай бұрын

I would never live in Oregon then! Good luck I hope you can find the help you need

@drsusan 2 ай бұрын

Menopause.org