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Surgical Menopause and Hormone Therapy: Golda Arthur’s Story of Genetic Risk and Recovery

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What happens when your body forces you into menopause before you're ready?

In this episode of the Women’s Digital Health Podcast, journalist and podcast creator Golda Arthur shares her deeply personal story of navigating genetic cancer risk, surgical menopause, and the emotional fallout that followed. When her mother was diagnosed with ovarian cancer, Golda discovered she carried a rare gene mutation—RAD51C—that increased her own risk. After years of fear and hesitation, she made the decision to undergo a preventive surgery to remove her ovaries and fallopian tubes.

Golda describes perimenopause as chaotic and fiery—but surgical menopause? That was something else entirely. Abrupt. Flat. Emotionally deadening. Her symptoms included debilitating joint pain, insomnia, and emotional numbness—symptoms that left her questioning whether she was experiencing depression for the first time.

We also talk about the decision to start hormone therapy—a path Golda didn’t take lightly, given her genetic risks. Her story offers a nuanced look at how personalized, science-informed care can be both life-changing and life-restoring. With the support of cancer researchers at the University of British Columbia, she discovered Duavee, a form of estrogen therapy that doesn’t require progesterone—an option that helped her reclaim her vitality and movement.

This episode isn’t just about hormones—it’s about health equity. Host Dr. Brandi exposes the systemic failures that leave women scrambling for answers: the underfunding of menopause research, the near-defunding of the Women’s Health Initiative, and the shockingly low venture capital investment in women’s health beyond fertility and breast cancer. We dive into why symptom trackers and apps aren’t enough—and why women, as both patients and taxpayers, deserve connected data, evidence-based options, and funding that reflects our value.

Whether you’re in perimenopause, navigating surgical menopause, or simply trying to understand your body better—this conversation is for you.

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Disclaimer
The information in this podcast is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition or treatment.

The personal views expressed by guests on Women's Digital Health are their own. Their inclusion here does not constitute an endorsement from Dr. Brandi, Women's Digital Health, or associated organizations.

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Golda Arthur: So when my mom told me this, I just put the brakes on everything. I didn't get myself tested. A year passed, and then the second year, and she was like, are you going to get tested? And I was like, well, I don't know. And what I was doing was dealing with fear. I didn't want to know. I didn't want to know the results.

Dr. Brandi Sinkfield: This is Golda Arthur, a journalist, a daughter, and a woman sitting on a genetic time bomb. 

Dr. Brandi Sinkfield [intro]: Welcome to the Women's Digital Health Podcast, a podcast dedicated to learning more about new digital technologies in women's health. We discuss convenient and accessible solutions that support women with common health conditions. Join us as we explore innovations like mobile health applications, sensors, telehealth, and artificial intelligence, plus more. Learn from a board-certified anesthesiologist the best tips to fill in some of your health experience gaps throughout life's journey. 

Dr. Brandi Sinkfield: Welcome back to Women's Digital Health Podcast. I'm Dr. Brandi, your host, and this season we're talking all things perimenopause. But what happens when that hormonal transition of perimenopause gets fast-tracked? Today's guest, Golda Arthur, made one of the most difficult health decisions anyone can face, removing her ovaries, not because she has cancer, but because she has the genetic risk for cancer. Her story is personal, is powerful, and deeply relevant to so many women who are navigating hormonal shifts and asking, what now? We'll also explore the role of hormone therapy, the confusion around surgical menopause, and where digital tools might finally catch up to the realities of women. Let's dive in.

Golda Arthur: I am a journalist and I've been a journalist for about 25 years. I'm also the host and creator of Overlooked, which is a podcast about women's health. I am a mother of two boys and a New Yorker and someone who lives in Queens. So those are all the things that I am.

Dr. Brandi Sinkfield: You can hear it right away. Golda's not just a journalist. She's someone who understands the power of personal storytelling. And for her, the story that brought her into this conversation began at home with her mom.

Golda Arthur: So Overlooked was launched in the fall of 2023 and the first season of Overlooked told one story and that story was my mom. So my mom was diagnosed seven years ago with ovarian cancer, which was all the way back in 2018. Statistically speaking, she is an outlier. Most. women who are diagnosed with ovarian cancer don't make it to seven years. And she has, and it has been not an easy seven years. But at the time when Overlooked was launched, I had asked her to collect audio diaries of her experience when she was first diagnosed. And in 23, she said to me, Oh, by the way, I've got all these audio diaries. What do you want me to do with them? And I was like, Oh, I guess I'm going to make a podcast this year.

Dr. Brandi Sinkfield: In 10 episodes, she chronicled the diagnosis, treatment, and recurrence, and the emotional toll on their whole family. But the line between journalist and daughter blurred quickly.

Golda Arthur: That distance disappeared when I told my mom's story, and that distance completely vanished when I became part of that story as well.

Dr. Brandi Sinkfield: Overlooked began as one season, but the questions Golda uncovered, the silences in women's health, kept coming.

Golda Arthur: When I made it and when it got done, people would say to me, it got a bit of an audience and people would say to me, so when's the next episode coming out? And I was like, no, there's not gonna be another episode about my mom, because that was just, it's too hard. And I also felt like, you know, I've told a story, I've got people talking about ovarian cancer. But what I decided to do was keep Overlooked going, and try and answer some of the other questions that I had, like, wait, why, why don't we know more than we do about the ovaries, relatively speaking? And what do you mean you can't really tell if you have endometriosis until you, you know, like these, some of the things that I learned I was truly astonished that we did not know the answers to what felt like really basic questions. So I kept the show going for another season and then another season, and now we're on season four. And every episode is a new topic and a new guest and a new story.

Dr. Brandi Sinkfield: As Golda continued documenting her mother's experience, something shifted. This wasn't just a story about her mom anymore. It became her story, one shaped by a surprising and deeply personal genetic discovery.

Golda Arthur: they found that she had a genetic mutation called RAD51C, R-A-D 51C. Most people sort of know the BRCA1 and 2 genes. This was a rarer gene mutation. And so she said to me, my sister and my brother, you guys have to get tested. My sister got tested before I did. She lives in London. She got involved as part of a study as well, and she had a self-injectomy, which is a removal of her fallopian tubes. At that point, she had two children. She decided she didn't want any more. Around this time, in science time, we discovered that the ovarian cancer can start in the fallopian tubes. So having your fallopian tubes removed is one way to prevent ovarian cancer. However, I am eight years older than my sister and I was, I'm 50 now, I was 47 at the time, and it was presented to me that it would be a different picture for me, that I would need to have my ovaries as well as my fallopian tubes removed.

Dr. Brandi Sinkfield: At age 45, the probability of developing ovarian cancer for RAD5-1c carriers is still relatively low. Most cancers don't occur until after age 60, but the risk builds steadily with time. And by the time a woman turns 50, she's already facing the steepest part of that curve. And that's exactly where Golda found herself, standing at the intersection of probability and inevitability. Let's rewind, Golda had been living in the storm of perimenopause for years. Raging hormones, weight gain, sleep loss, her body wasn't hers anymore. And then on top of all of that, came a decision no one wants to make. Remove the ovaries or wait it out.

Golda Arthur: I was in perimenopause for quite a few years, and it was awful. I would go into these rages. And the thing about rages is like, they're not over nothing, you know? But I didn't feel like I had control over my emotions. I had zero control over my weight. Didn't feel good in my body. I was just unhappy, not in a good headspace, not as mobile as I used to be.

Dr. Brandi Sinkfield: So, when her genetic results came back and the recommendation was surgery, Golda wasn't starting from zero. She was already worn thin, navigating a body that didn't feel like hers, and now she had to decide whether to push it even further.

Golda Arthur: My gynecologic oncologist, Dr. Kevin Holcomb, he was fantastic. And I think that if he was anything less than fantastic, I would have bailed. The first time I saw him, I had written all my questions on my hand, because I ran out of paper on the subway. And he said, what's on your hand there? And I was like, oh, these are my questions. He was like, OK, let's hear them all. He was incredibly compassionate. And he took what is a really complex topic and helped me understand it. But I was in the zone where I was recording audio diaries all over the place. And I remember leaving his office the first time and recording myself. And you can hear the nerves in my voice as I came out of it, you know, because I still didn't feel like I knew truly kind of what would happen next or what to expect, even though he did a great job of explaining it to me. And then I was like, well, and then what?

Dr. Brandi Sinkfield: The decision was made, but certainty still miles away. What came next wasn't just surgery. It was a physiological reboot. A body without hormones, a mind without a road map. Golda underwent a bilateral salpingo-oophorectomy, the removal of both ovaries and fallopian tubes. It's a preventative surgery often recommended for women with genetic mutations like RAD5-1c, which raises the risk of ovarian cancer. But removing the ovaries means more than removing organs. It shuts down estrogen production overnight, triggering surgical menopause.

Golda Arthur: That was a year where I think I came as close as I've ever come to being actually depressed, which scared me. And the symptoms that I experienced during that year were quite different than perimenopause.

Dr. Brandi Sinkfield: In Hormone Harmony, I wrote, hormonal changes in your late 30s to 50s don't arrive gently. They crash into your life like a to-do list you didn't sign up for. And suddenly, your brain, your sleep, your skin, your libido, and your memory are all playing musical chairs. And while I didn't write this in the book, I often explain perimenopause versus surgical menopause like this. Perimenopause, slow flicker of a light bulb. There's some dimming, there's some sputtering, kind of sneaks up on you. Surgical menopause, that's the circuit breaker. Lights off, no warning, no taper.

Golda Arthur: Perimenopause for me was very fiery and very up and down maybe. That year after surgical menopause was very flat. It was like almost a deadening of everything.

Dr. Brandi Sinkfield: She faced joint pain, insomnia, emotional numbness. She couldn't walk for 15 minutes without pain. The quiet after the hormonal storm, it was not peace. It was shutdown. Golda didn't leap into hormone therapy. There was a gap, a long one, between surgery and decision to get relief. In that time, her body felt foreign. Her body was fogged and her spirit was dulled.

Golda Arthur: I think there was this one day where, you know, I hadn't slept and every joint in my body was in pain. I thought to myself, am I actually depressed? I'm not terribly sad and I'm not terribly happy. And I don't think I could stretch myself to be either of these emotions ever again. And I thought to myself, like, is this depression? And I was like, okay, well, why am I doing this? Why am I not taking estrogen? Why don't I just figure out a way to do this?

Dr. Brandi Sinkfield: And I want to pause here, not just as a host, but as a physician, because this is what I see all the time, women waiting. Not because they're passive, but because the risks feel bigger than the options. The guidelines are unclear, and that's because of fallout from a decades-old research that still clouds every decision.

Golda Arthur: I said, no, not because I was worried about HRT because, you know, yes, the Women's Health Institute had the study, it's been debunked, blah, blah, blah. I would go to menopause conferences. I heard the authors of Estrogen Matters, for example, who were really great at talking about why estrogen is safe to take and that kind of thing. But with my particular genetic predisposition, I thought to myself, nobody knows what'll happen with that.

Dr. Brandi Sinkfield: Let's talk about what she's referencing. The Women's Health Initiative, or the WHI, launched in the 1990s, was meant to study the long-term effects of hormone therapy in postmenopausal women. But when early results in 2002 linked combined estrogen and progestin therapy to an increased risk of breast cancer, it caused a wave of panic. millions of women just stopped hormone therapy. Doctors pulled back, and the media painted hormone replacement therapy as a dangerous scamble. What got burned in the headlines was that later data would show the increased risk was overstated, especially for younger women in early menopause. But by then, the damage was done. And even now, decades later, women like Golda are still navigating fear, stigma, and silence.

Golda Arthur: And my OBGYN was like, you can take estrogen. There is a small risk. And, you know, she was saying it because she has to say it, right? There's a small risk and I wouldn't let that risk stop you. Risk of breast cancer. Because my RAD51C is a genetic mutation that predisposes you to ovarian cancer as well as breast cancer.

Dr. Brandi Sinkfield: This wasn't a casual conversation. It was layered with decisions. Golda understood the science, but she also understood her story. And that's what led her to the Gynecologic Cancer Institute at the University of British Columbia.

Golda Arthur: I worked with the Gynecological Cancer Institute at the University of British Columbia. And I knew the folks there from my reporting on ovarian cancer. They have done some really marvelous needle moving work in helping us to understand where ovarian cancer comes from, They are very interested in this concept of survivorship. It's a tough concept because it means like, hooray, innovation in science has saved your life. So you're not dying of cancer, but you are living with cancer, as my mom is. My mom is in chemo nine months of the year, every year. You know, it's like you have survived. Hooray, this is your prize. You get to be in chemo for more than half the year. And survivorship questions, well, what kind of life are you living?

Dr. Brandi Sinkfield: And survivorship isn't just about being alive. It's about living well. That's when Golda learned about an option that might work for her unique risk profile.

Golda Arthur: but they consider me also part of that survivorship narrative because I've taken certain actions to prevent myself from getting ovarian cancer. And in talking to them about how my life was going, crap, we talked about one particular type of estrogen called DUAVI, and this uses conjugated estrogens, which is Premarin, and something else called basal doxephine, if I'm saying that correctly. The way that helps someone like me is that it doesn't have progesterone in it. And the basal doxephine protects my bones in the way that progesterone would, but doesn't have the additional risks of progesterone. And after that conversation, which was so science-based, I felt a lot more reassured. And I went to my OB-GYN and I said, I would like to try taking this drug, Duabi. And she hadn't heard of it. So she went and did her homework on it. And she said, yes, okay, this seems like it's a good one for you to take. And I started that four months ago. And Brandi, it's like somebody switched the lights back on. I can get up, sit down, go back to yoga. I'm walking an hour a day. Joint pain's gone. Joint pain is gone. I can't quite believe it. It's been restorative. And I look back and I think, why did I wait so long?

Dr. Brandi Sinkfield: Stories like Golda are why the rules around hormone therapy need to evolve. It can't just be about risk on paper. It has to be about listening to women in real life and helping them live better in the bodies they're already in. All right, listeners, fair warning. 

This next part, I'm about to go in, but that's because I care. I've just seen the gaps firsthand as a doctor and as a patient, and so this next part, it just needs to be said loudly and clearly. Let's talk about technology, but let's talk about the systemic failure that's holding it back. Number one, there are apps for menopause and perimenopause. Midday, Health and Her, Balance. There are also artificial intelligence platforms like the Paws and wearables like Perry that we featured in our last episode. They are all trying to bring structure to this chaos. And yet, we are still operating in a vacuum. Each company builds its own tools, its own trackers, its own data. And it's like trying to treat a forest fire with 12 different garden hoses aimed in different directions. Meanwhile, federal research funding for women's health is laughable. The NIH allocates less than 10% of its budget to conditions that exclusively or disproportionately affect women. And while women make up over half the population, research that centers on women from perimenopause to autoimmune disorders lags far behind. Let's talk about the Women's Health Initiative, a landmark study launched in 1991 that reshaped our understanding of menopause and postmenopausal health for women. Earlier this year, the Department of Health and Human Services quietly pulled funding for the Women's Health Initiative, effectively shuttering one of the largest and most influential women's health studies in history. public backlash led to a reversal and the study's continuation. But let's be real. Even the threat of defunding one of the few robust public health efforts for post-menopausal women, that is not austerity. That's financial coercion. It's like when a controlling parent or a partner threatens to cut you off, not because they will, but because they can. Then they say, just kidding. But the damage is done. The message is clear. Your stability is conditional. Your health is negotiable. Your data, your body is only as valuable as the budget mood of the moment. That alone tells you everything. And then there's venture capital. In 2023, just 2% of venture capital funding in the U.S. went to women-led startups. Only 1.4% of all healthcare venture dollars were allocated to women's health, and most of that went towards fertility and breast cancer. Menopause? Practically a rounding error. And if you're a woman-led company, focused on menopause? Oh, you are too niche, too risky, and somehow not innovative enough, even though you're literally trying to reinvent care for 50% of the population. What this means is we're patching together care with consumer-facing apps and telehealth startups, while the institutions meant to support public health continue to treat menopause like a side quest. Women should most certainly have and need symptom trackers, but we also deserve clinical trials, personalized algorithms, shared data sets, and real funding that reflects the scale of this transition to the millions of women who enter perimenopause and menopause every day. Golden Story shouldn't just live in a podcast. It should live in research, in health workers, in algorithms that learn. Because we don't need more data. We need connected data that actually works for women. Oh, and here's the deeper injustice. Women aren't just patients. We're taxpayers. Women make up a significant portion of the workforce, and many sit in the highest tax brackets. We are funding public health systems that systemically under-invest in our bodies. We're paying into a system that won't pay us back in health equity. So when federal initiatives like the Women's Health Initiative lose funding, and when venture capitalists gatekeep write-off menopause innovation as too niche, what we're seeing isn't just oversight. Oh, that's theft. A siphoning of public and private investment away from people keeping the entire system afloat. We deserve better, not because it's charity, because it's ours. We've already paid for it.

Golda Arthur: I think that I want to tell people who are just starting on this perimenopause journey, I want to tell them two things. The first is, now is a good time to put yourself first. We don't do that as women. We don't put ourselves first. And now's a good time to do that. And the second thing is, it's going to be okay.

Dr. Brandi Sinkfield: Golda's story is about more than surgical menopause. It's about reclaiming a sense of self, even when your body feels unfamiliar. It's about making the best choice you can with the information you have and honoring your story in the process.

Golda Arthur: I think I'm also someone who just needs to sit with things for a minute before I make a decision. And then when I make that decision, I'm incredibly decisive. There's no room for regrets because I've like pre-regretted it, you know.

Dr. Brandi Sinkfield: Now that, that is the brilliance of women's health stories. They aren't just data points, they are maps. And every time someone like Golda shares her story, it helps another woman find her way. Before we go, if you're looking for a community to keep this conversation going, join our private WhatsApp group. You'll find the link in our show notes. And for a deeper dive, grab my ebook on hormone transitions, hormone harmony, because the algorithm doesn't teach you what your body is going through, but we can. If you want to hear the raw interview, join my newsletter to get access to the full conversation with Golda. The link's in the show notes or head to womenstigialhealth.com. And the last thing I'll leave you with is, I've been in the operating room for so many of these surgeries, removing ovaries and fallopian tubes. And for a long time, I thought my job ended there. But hearing Golda's story has reminded me that the real healing starts after the OR lights go dim. You have to ask better questions. We have to offer better answers and show up for the long road of recovery, not just the incision. Thanks for joining me on the Women's Digital Health Podcast. I'm Dr. Brandi, and if Golda's story resonated with you, share this episode, rate this show on your favorite place to listen to podcasts, and stay with us this season as we continue to explore the intersections of hormones, technology, and the care women actually deserve. Until next time, keep owning your story. The world needs to hear it. And remember, you are enough, even more than that. Bye for now. 

Dr. Brandi Sinkfield [outro]: Although I'm a board-certified physician, I am not your physician. All content and information on this podcast is for informational and educational purposes only. It does not constitute medical advice and it does not establish a doctor-patient relationship by listening to this podcast. Never disregard professional medical advice or delay in seeking it because of something you heard on this podcast. The personal views of our podcast guests on women's digital health are their own and do not replace medical professional advice.