I work in admin at a neurosurgery dept. From what I've seen the female neurosurgeons say that although there is some evidence it is not conclusive yet and that if you are suffering with significant menopause symptoms then it is justified to use HRT especially if you have a meningioma that is stable or very small. The men are much more cautious about it and seem to warn against it. I'm not sure if that matches your experience @arb29
There are loads of conditions that seem to affect women much more than men though. Some scientists think microchimerism is another reason for this because of the different DNA we are exposed to as mothers hosting our children who have different DNA to us. Google it, it's quite interesting. They think it could be why women seem to get more autoimmune diseases than men.
Women are so biologically different to men but historically most drugs and treatments have been tested on white men. There are loads of treatments that don't work as well on women or non-white people but they didn't realize until much later because they did most of the research on white men. I try not to think about stuff like this too much though as it makes me super angry. The patriarchy has a lot to answer for.
To answer your question more succinctly you won't get a definitive answer because there isn't one. We already know that different neurosurgeons have different opinions so you have to make your own decision on it. Weigh up how bad your symptoms are against the risks of your meningioma growing. I hope that helps a bit? I appreciate it's not an easy decision and it's one I'll have to make too in the not too distant future so I may come back to ask you what you decided 🙂 Sending you positive energy.