Hot flashes at noon, wide awake at 2 a.m. — menopause can turn life upside down. Hormone replacement therapy (HRT) is one of the most effective options to ease the changes. But for years, a warning label on estrogen treatments scared doctors and patients away.
“I’ve sat across from women who were exhausted, frustrated and searching for relief, only to leave my office hesitant because of a warning that didn’t reflect the latest science,” says Manisha Purohit, MD, an OB/GYN at HonorHealth.
In November 2025, the FDA officially removed the “black box” warning from most estrogen-based hormone therapies, opening new possibilities for women seeking relief.
Why HRT came with a warning
In 2002, early findings from a Women’s Health Initiative study raised concerns about breast cancer, stroke and heart disease. “The women in that study were well beyond the typical age when hormone therapy is started and they were using formulations we rarely prescribe today,” Dr. Purohit explains.
Over time, those details got lost and fear filled the gap. Many women refused to take hormones even when their symptoms were significantly affecting their quality of life. With the FDA’s update, that’s all set to change.
New science, new hope
Research shows that when hormone therapy is started within 10 years of menopause onset or before age 60, the benefits often outweigh the risks.
“I’ve seen firsthand how transformative HRT can be,” Dr. Purohit says. “Women who were exhausted from sleepless nights, struggling with mood swings or sidelined by hot flashes often return to vibrant, engaged lives after starting therapy.”
Patients may experience:
- Fewer hot flashes and night sweats
- Better sleep and mood
- Protection against bone loss and fractures
- Less vaginal dryness and discomfort
Some studies even suggest potential benefits for heart and brain health when therapy begins early.
A new age in women's health
For years, many women were left navigating menopause with more questions than answers. Today, clearer science and updated guidance are helping change that.
At HonorHealth, menopause care has never been one-size-fits-all. Dr. Purohit takes a personalized approach that includes thoughtful discussion about treatment benefits, risks and alternatives including non-hormonal options. “Removing the black box warning doesn’t mean ignoring risks,” she adds. “It means replacing fear with facts and empowering women with choices.”