What You Need to Know
New evidence is changing our view on the safety and benefits of hormone replacement therapy. After over twenty years of doubt, it’s time to rethink what we know.
The Great Hormone Debate
For decades, hormone therapy was a mainstay of menopause care. Then came 2002, when the Women’s Health Initiative study sent shockwaves through medicine. Headlines warned about higher risks of breast cancer and heart disease. As a result, hormone therapy use dropped sharply. Millions of women suffered through debilitating symptoms rather than face what seemed like unacceptable risks.
But there was a problem with how that study was interpreted. The average participant was 63 years old. This is over ten years past the typical menopause age. Further, they received hormone treatments that are no longer in use.
In November 2025, the FDA made a big announcement. They will remove the broad “black box” warnings from hormone replacement therapy for menopause. This decision came after a thorough review of studies and expert opinions. Evidence shows that the fears about hormone therapy are mostly unfounded, especially for women who begin treatment at the right time.
The core question is no longer whether hormone therapy is inherently dangerous. It’s about knowing who benefits, when to begin, and how to reduce risks with personalized treatment.
A Key Discovery: “Timing Hypothesis”
Women who start hormone therapy within 10 years of menopause had lower cardiovascular risk. Some studies suggest heart disease risk dropped by up to 50%. The higher risk showed in women who began therapy long after menopause. Women experiencing perimenopause or who are in menopause are great candidates for hormone therapy.
Hormone therapy helps prevent osteoporosis and bone fractures. It can cut fracture risk by 50 to 60%.
Quality of Life
Hormone therapy is the best treatment for hot flashes and night sweats. These can happen many times a day, disrupting sleep, work, and daily activities. New studies show that starting hormone therapy early may help prevent cognitive decline. It could lower the risk of Alzheimer’s disease by as much as 35% if begun during menopause.
Personalization: The New Gold Standard
Modern hormone therapy is all about customization. For women, FDA-approved bioidentical hormones have been well-studied and are generally preferred.
Current practice follows the “lowest effective dose” philosophy. For women, the goal is to use just enough hormone therapy to relieve symptoms and protect bone health.
Hormone therapy isn’t a “set it and forget it” treatment. Regular check-ups help your healthcare provider see how you’re doing. They watch for side effects and change your treatment as needed.
A New Era of Informed Consent
Hormone therapy—whether for women or men—is not inherently safe or dangerous. It’s a tool that requires a personalized risk-benefit analysis based on your age, health history, symptoms, and values.
For women, the removal of blanket FDA warnings signals a return to nuanced, individualized medicine.
What’s clear is that fear and misinformation have dominated the hormone therapy conversation for far too long. Modern evidence shows a more hopeful story. This is especially true for those who begin treatment on time, use the right formulations, and have proper medical supervision.
If you notice symptoms that could be from hormonal changes, consider talking to your naturopathic doctor sooner rather than later. Together you can determine when to start treatment, delivery methods, and what’s important for your quality of life.
How to Get Started
The first step to improved hormone health begins with a consultation and a blood exam to test your current hormone levels as well as other important markers. If you have questions to be answered before getting started, simply call our care team at (206) 729-6211. You may also learn more and schedule your initial consultation online at our information page for hormone replacement therapy.
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, 2025. https://www.fda.gov/news-events/press-announcements/hhs-advances-womens-health-removes-misleading-fda-warnings-hormone-replacement-therapy
Dr. Jamie Doughty, ND is a licensed Naturopathic Physician and Medical Director at Temple Natural Health. She supports individuals and families with hormone balance, digestion, detox, and overall wellness. A graduate of the National College of Natural Medicine, she is certified in IV therapy, classical homeopathy, and natural childbirth. Dr. Jamie also leads Temple Natural Health’s Virtual Clinic, offering remote naturopathic care to help clients achieve vibrant, balanced health.
