I recall sitting in my office after a full day seeing patients, catching up on test results. This was back in the day, long before the advent of electronic medical records. Lab results came back on paper, and chart notes were written by hand or dictated via a hand-held recorder.
My desk had a large stack of medical journals off to the side, awaiting my review. I’d page through each one when time allowed, but the pile never got smaller as the daily mail would bring an endless supply of the next editions.
I’d spend an hour or so each day calling patients with their test results. We’d often chat about other things, such as a change in their health, family updates, upcoming holiday plans, and so on.
I’ll never forget making calls to patients in 2002 just after the Women’s Health Initiative data had been released. These were women ages 50 to 85 who were taking Premarin (estrogen) or Prempro (estrogen + progesterone).
I had to share the bad news that they needed to stop taking these hormones immediately.
These were NOT fun conversations to have.
Even worse were the frantic calls from these same women in the ensuing weeks, as they were now struggling with hot flashes and night sweats—and this was before brain fog was a thing. I recall many times my patients pleading, “put me back on hormones, I don’t care if I die early!”
These vivid conversations have stayed with me all these years.
Fast forward…
We have safe choices when it comes to taking hormones: estradiol (oral, transdermal patch, vaginal, gel), micronized progesterone, and testosterone.
And, at long last, the FDA has just removed the black box warnings for menopause hormone therapy (MHT).
It’s about time!
Conversations about MHT still need to be individualized when it comes to discussing pros and cons. It’s not for everyone.
But, at least we have a much better starting point for these discussions, as MHT is no longer something to be feared.
Since the FDA announcement, MHT information has been splashed all over social media to the point where it is getting rather confusing.
The link below is to a good summary from someone who has no skin in the game (translate: is unbiased).
Katelyn Jetelina, MPH PhD, typically writes about viruses, disease outbreaks, vaccines, and other epidemiologically-important public health issues. She co-wrote this article on MHT with Nikki Sapiro Vinckier, OBGYN PA-C, published on November 19, 2025.
Read the full article on her Substack (free):
Now if I only had a solution to the many journals waiting to be read…
Decades later they are no longer stacked in piles, but they occupy a big chunk of real estate in my email inbox!
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Susan J. Baumgaertel, MD is an internal medicine physician who provides telemedicine medical consultation and advocacy for patients in WA state, and professional career pivot navigation support for physicians in the US. Find her at myMDadvocate.
Her book, The Menopause Menu, is an all-in-one giftbook, medical guide and recipe book for navigating menopause.
Join her talk show, Voices With Vigor, which is free, live & virtual. Topics are health-adjacent, and three fantastic guests are profiled each month.