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FDA Drops Black-Box Warning From Menopausal Hormone Therapies After Evidence Review

The agency cites newer evidence showing lower risks with timely initiation, prompting label updates across more than 20 products.

Overview

  • The removal applies to more than 20 pills, patches and creams containing estrogen or progestin that are approved to treat menopausal symptoms.
  • Updated FDA guidance advises initiating systemic therapy before age 60 or within ten years of menopause onset to reduce risk.
  • Regulators will work with manufacturers to delete label references to cardiovascular disease, breast cancer and probable dementia while retaining an endometrial cancer warning for estrogen-only use.
  • FDA Commissioner Marty Makary and some clinicians backed the change as evidence-based, while experts including Harvard’s JoAnn Manson cautioned that claims of broad long-term benefits remain unsettled.
  • The FDA also approved the first U.S. generic version of Premarin to broaden access at lower cost, according to the reporting.