Meningioma and Hormone replacement therapy.

During my consult with the neuro oncologist one of his questions was, "Have you ever been on hormone replacement therapy?" When I asked him why the question, his answer was meningiomas are much more prevalent in women than men and there's speculation that the estrogen hormone might be a factor.

Yes there are also studies about meningioma growth related to progesterone. The data supposedly shows that very high levels (akin to pregnancy) may be related. HRT in menopause is given at much lower doses.

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.

@dollydaydreamer999 Thanks for that background and interesting perspective. All of surgeons I’ve consulted have been men so far. I stopped HRT after seeing the first doctor and will plan to stay off them until I have another MRI and/or surgery so I know more about the pathology of the tumor. I’m dreaming of going back on them post surgery!

I can imagine you are. I know they can be a massive help through a difficult time and now you have this to deal with as well. I hope everything goes well for you!

The studies are inconclusive and one's quality of life is worth something. The only way to know the pathology is a with a biopsy, and I would think that would be done while having a craniotomy to remove the meningioma. At least that was the protocol in my case. I was on ERT for 24 years and did it contribute to my 3 meningiomas? Maybe. First of all, I didn't even know what a "meningioma" was till 2 years ago. Secondly, ever after being told there may be a link between estrogen and these benign brain tumors I wouldn't have changed a thing. As I said, one's quality of life is worth somethng in the big picture of life.

If anyone is interested in the male bias in medicine there is an extra interesting article in the conversation dot com . It won't let me send you the link as I'm a new member. The article is called 'How male anatomy became the default in medicine – and why that’s a problem' the article is written by Michelle Spear who is a professor in anatomy at University of Bristol in the UK.