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FDA Begins Removing Broad Black Box Warnings From Menopause Estrogen Therapies

Regulators aim to refocus care on individualized decisions grounded in timing.

Overview

  • The FDA and HHS have initiated label changes to lift broad boxed warnings from many estrogen-containing treatments for menopausal symptoms.
  • Updated labels will drop references to cardiovascular disease, breast cancer and probable dementia risks, with the FDA directing manufacturers on revised language.
  • A boxed warning for endometrial cancer will remain for systemic estrogen‑only products.
  • ACOG leaders and practicing OB-GYNs welcomed the move as enabling shared decision-making, with some clinicians preferring transdermal patches due to lower clot risk than oral estrogen.
  • HHS points to a long decline in use to roughly 5% after the Women’s Health Initiative and underscores benefits when therapy begins within about 10 years of menopause.