The FDA has officially removed the black box warning from hormone therapy. For many, this may appear to be a small regulatory update. But for those of us who have spent years watching women suffer in silence because of fear-based misinformation, this moment is nothing short of historic.
After caring for women for more than 24 years — and treating thousands of patients through every hormonal transition imaginable — I can say this plainly:
Withholding hormone therapy has been one of the greatest missteps in modern women’s health.
I’ve cared for women through perimenopause, menopause, surgical menopause, postpartum crashes, PCOS, thyroid dysfunction, adrenal dysregulation, infertility struggles, mood instability, cognitive decline, and metabolic collapse. And the pattern has been heartbreakingly consistent:
Women told their symptoms were “normal.”
Women told to accept brain fog, weight gain, anxiety, insomnia, and pain as part of aging.
Women told hormones are dangerous — when the science never supported those claims.
When hormones are restored correctly, safely, and individually, the transformation is profound. Women regain clarity. Sleep returns. Mood stabilizes. Libido reappears. Energy rises. Weight becomes responsive again. They recognize themselves.
Hormone therapy is the single most groundbreaking, life-changing, and health-preserving treatment available to women.
And for me, this work is personal.
My three sisters are all on hormone therapy — each on completely different regimens, because hormone care should never be one-size-fits-all. Every woman’s genetics, biomarkers, metabolism, and goals are unique, and her treatment must reflect that.
My mother continued HRT when most women her age were scared into stopping. She trusted the data, not the fear — and because of that, she has protected her heart, brain, and bones well into her late 80s.
Even my sister, one of the country’s leading breast cancer surgeons, also takes hormone therapy herself — a powerful reminder that those who understand risk most deeply are often the ones who see the greatest value in properly prescribed care.
One of the most important truths women were never told:
Estrogen, progesterone, and testosterone are foundational regulators for every cell in the human body.
Every organ — the brain, heart, bones, muscles, immune system, metabolism, skin, and emotional centers — has hormone receptors. Hormones are the body’s communication system. When they decline, the entire system struggles.
This is why menopause symptoms touch every domain of health.
Hormone therapy is profoundly protective:
For the brain:
Starting estrogen in the optimal window reduces Alzheimer’s and cognitive decline by around 40%.
For the heart:
When implemented in the first decade of menopause, hormone therapy improves cholesterol, reduces plaque buildup, supports insulin resistance, and can lower heart disease risk by up to 50%.
For bones & muscles:
Hormones preserve bone density, muscle mass, balance, and strength. Without estrogen, women can lose up to 20% of their bone density in the early years of menopause.
For metabolism, mood, and sexual wellness:
Sleep stabilizes. Mood improves. Libido returns. Weight becomes easier to manage. Emotional resilience strengthens.
These are not fringe benefits — they are essential components of long-term health.
For two decades, the black box warning created fear, confusion, and silence. Women were denied life-changing treatment because of misinterpreted data. Many physicians felt constrained or hesitant, while women suffered needlessly.
The removal of the black box warning is an overdue, historic correction — one that finally aligns medical policy with the science many clinicians have practiced for decades. This shift acknowledges that hormone therapy, when prescribed and monitored appropriately, is not just safe — it is profoundly beneficial.
Medicine is finally catching up to what experienced clinicians have seen in their practices for years:
Women do better when their hormones are restored.
In my practice, hormone restoration is approached safely, intelligently, and individually. There is never a one-size-fits-all plan. Every woman receives a regimen tailored to her biomarkers, genetics, symptoms, and long-term goals.
Hormones are not a luxury. They are not experimental. They are not cosmetic. They are essential.
For women who want to protect their healthspan, cognitive vitality, emotional wellbeing, physical strength, and longevity, hormone restoration remains the most powerful tool I can offer.
Women deserve to feel strong, clear, vibrant, connected, and fully themselves — at every age.
And now, finally, the science and the policy are aligned in a way that makes that fully possible.
