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FDA Drops Broad Black-Box Warnings on Menopause Hormone Therapy

Labels will keep a boxed warning for endometrial cancer on estrogen‑alone products, with new guidance to start systemic therapy before age 60 or within 10 years of menopause.

Overview

  • Federal officials said the prior warnings were based on outdated interpretations of early‑2000s research and had discouraged many eligible patients from using HRT.
  • The FDA will remove blanket label references to cardiovascular disease, breast cancer and probable dementia risks, while detailed safety information remains in package inserts.
  • Clinician groups welcomed the shift as enabling shared decision‑making, noting that risks vary by age, timing since menopause, formulation and route of administration.
  • Experts cautioned that hormone therapy has not been proven to prevent heart disease or dementia, urging individualized counseling and consideration of nonhormonal options.
  • HRT use fell to roughly 5% of postmenopausal women after the WHI era, and systemic therapy remains inappropriate for breast cancer survivors and many with prior clots, heart attack or stroke.