History was just made. On November 10, 2024, the FDA removed the Black Box Warning from hormone therapy. After more than 20 years of fear and bad information, women can finally get the truth.

If you’ve ever been told that hormones cause cancer, heart disease, or stroke—or that “you just have to suffer through menopause”—everything just changed.

What Went Wrong with the WHI Study?

In 2003, the FDA put a Black Box Warning on estrogen therapy after a 2002 study called the Women’s Health Initiative (WHI) scared everyone. Doctors stopped prescribing hormones. Women threw away their medications. Millions suffered needlessly.

But the study had major problems:

• Used synthetic hormones (not the bioidentical hormones we use in Functional Medicine)
• Average woman was 63 years old—more than 10 years past menopause
• Gave hormones to women who’d been without estrogen for over a decade
• The women studied were unhealthy women with several risk factors
• Results were misinterpreted and blown out of proportion

An entire generation of women suffered with bone loss, breast disease, heart disease, anxiety, depression, and brain fog, —all because of misinformation.

The REAL Science: Busting 5 Major Myths

MYTH #1: “Estrogen Causes Breast Cancer”

THE TRUTH: Estrogen alone REDUCES breast cancer risk by 23-37% and reduces breast cancer deaths by 40%.

While breast cancer can occur in younger women, there is a sharp increase AFTER menopause when estrogen is LOW, not before when it’s HIGH. When your body is without estrogen, breast cancer risk goes UP.

The small increase in breast cancer risk seen in the WHI came from using estrogen with synthetic progesterone or progestin (MPA). Natural bioidentical progesterone does NOT increase, but helps decrease breast cancer risk by reducing relative estrogen dominance.

For breast cancer survivors: Women who’ve had breast cancer often suffer with severe vaginal dryness, pain, and bladder problems. A recent comprehensive analysis showed that local vaginal estrogen (a vaginal suppository or troche) is safe for these women—with no increased risk of cancer returning or death.

MYTH #2: “Hormone Therapy Causes Heart Disease”

THE TRUTH: When started within 10 years of menopause, hormone therapy PROTECTS your heart.

Women who start hormones in their 50s have:

• Lower heart disease risk
• Fewer heart attacks
• Lower death rates overall

Why timing matters: When you start early, your blood vessels are still healthy. Estrogen keeps them flexible and strong.

MYTH #4: “Hormones Cause Dementia”

THE TRUTH: When started in midlife (during perimenopause or early menopause), estrogen REDUCES dementia and Alzheimer’s risk by 23-32%.

Women who took estrogen in their 40s-50s had dramatically lower dementia risk.

Why it works: Estrogen helps brain cells get energy, supports memory, reduces brain inflammation, and acts as an antioxidant.

MYTH #5: “You Don’t Need Hormones for Bones”

THE TRUTH: Estrogen reduces ALL fractures by 27-40%, including spine fractures by 33%.

After menopause, women lose up to 20% of bone mass in the first 5-7 years. One in three women will have an osteoporosis-related fracture. Estrogen protects bones better than almost any other treatment.

Many women find that adding testosterone completely transforms how they feel. Without testosterone, you’re only getting 2/3 of what your body needs.

Good News for Perimenopause AND Menopause

Whether you’re in perimenopause (still having periods but having symptoms) or menopause (periods stopped), hormone therapy can help.

The key: Start at the right time—within 10 years of menopause—not after you’ve been without hormones for years.

What This Means for YOU

You deserve the full truth:

1. Estrogen PROTECTS your breasts, heart, brain, and bones
2. All three hormones matter (estrogen, progesterone, testosterone)
3. Natural progesterone is safer than synthetic
4. Timing is everything—start within 10 years of menopause
5. Bioidentical hormone therapy is safe and effective when used correctly
6. Your symptoms are real and treatable

Support Your Hormones Naturally

You need more than hormones to create healthy hormones. Whether or not you choose hormone therapy:

• Eat smart: Protein, healthy fats, vegetables. Cut sugar and processed foods.
• Move daily: Strength training, walking, stretching.
• Sleep well: 7-9 hours in a dark, cool room.
• Manage stress: Deep breathing, nature, meditation.
• Test your levels: Ask for hormone testing.

This is About More Than Labels

For decades, women’s health has been ignored. Most medical schools don’t teach menopause care. Millions get antidepressants when they need hormone balance. The average woman spends 30+ years in menopause—that’s 1/3 of her life.

The FDA’s decision marks a turning point from fear to truth, from suffering to solutions

Hormone therapy protects your:

• Breasts (reduces cancer risk!)
• Heart (lowers disease risk)
• Brain (reduces dementia)
• Bones (prevents fractures)
• Energy and quality of life

You are not broken. You are evolving.

And finally—FINALLY—medicine is catching up to what women have known all along: Balanced hormones are the foundation of vitality.

You deserve to feel safe, supported, and empowered—not scared, dismissed, or left to suffer.

References

1. U.S. Food and Drug Administration. “HHS Advances Women’s Health, Removes Misleading FDA Warnings on Hormone Replacement Therapy.” Press Release. November 10, 2024. https://www.fda.gov/news-events/press-announcements/
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4. Menopause. 2024 | AJOG meta-analysis
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7. Hodis HN, Mack WJ, Henderson VW, et al. “Vascular Effects of Early versus Late Postmenopausal Treatment with Estradiol (ELITE).” New England Journal of Medicine. 2016;374(13):1221-1231.
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11. Mosconi L, Berti V, Quinn C, et al. “Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer’s disease and dementia.” Frontiers in Aging Neuroscience. 2023;15:1260427.
12. Saleh RN, Hornberger M, Ritchie CW, Minihane AM. “Hormone replacement therapy is associated with improved cognition and larger brain volumes in at-risk APOE4 women: results from the European Prevention of Alzheimer’s Disease (EPAD) cohort.” Alzheimer’s Research & Therapy. 2023;15:10.
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14. The Writing Group for the PEPI Trial. “Effects of hormone therapy on bone mineral density: results from the postmenopausal estrogen/progestin interventions (PEPI) trial.” JAMA. 1996;276(17):1389-1396.
15. Gambacciani M, Levancini M. “Hormone replacement therapy and the prevention of postmenopausal osteoporosis.” Gynecological Endocrinology. 2015;31(11):866-869.
16. Rossouw JE, Anderson GL, et al. “Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial.” JAMA. 2004;291(14):1701-1712.
17. Davis SR, Baber R, Panay N, et al. “Global Consensus Position Statement on the Use of Testosterone Therapy for Women.” Journal of Clinical Endocrinology & Metabolism. 2019;104(10):4660-4666.

18. Rossouw JE, Anderson GL, Prentice RL, et al. “Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial.” JAMA. 2002;288(3):321-333.
19. Collaborative Group on Hormonal Factors in Breast Cancer. “Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence.” The Lancet. 2019;394(10204):1159-1168.