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FDA Orders Removal of Black Box Warnings From Many Menopause Hormone Therapies

The agency cites newer evidence favoring earlier initiation, with detailed risk information moving from the box to prescribing inserts.

Overview

  • The move covers more than 20 estrogen- and progestin-containing pills, patches and creams, with manufacturers asked to update labels in the coming months.
  • A boxed warning will remain for endometrial cancer risk on systemic estrogen‑only products for women with a uterus, and labels will add guidance to start therapy before age 60 or within 10 years of menopause.
  • Regulators say newer analyses show lower risks for appropriately timed use, refining conclusions from the 2002 Women’s Health Initiative trial that involved older participants.
  • Supporters expect increased access and prescribing after a two‑decade decline, while critics question the review process and note the FDA did not convene a formal independent advisory committee.
  • The FDA also approved a generic version of Premarin and a non‑hormonal treatment for hot flashes as part of Monday’s actions.