Hormone Replacement Therapy

There are multiple HRT options to treat menopause and perimenopause symptoms

This lengthy video features a board-certified OB/GYN based in Texas who provides a thorough overview of the different formulations for HRT, used to treat symptoms including hot flashes, vaginal dryness, and mood swings, and the pros and cons of each. She also discusses modern synthetic options versus the older formulation extracted from the urine of confined pregnant horses.

Menopause hormone therapy infuses the body with estrogen after the body's natural levels drop

The treatments can treat symptoms like hot flashes and vaginal dryness at varying doses. Progestogen, another hormone, is also typically prescribed with estrogen because estrogen alone can thicken the uterus lining, which elevates the risk of developing endometrial cancer.

FDA has removed black box warnings from HRT for menopause

The agency removed the label in 2025, reversing its 2003 decision to warn women about HRT's links to stroke risk, developing cancer, and heart disease. Years of accumulating research have found that the risks had been overstated and unnecessarily deterred hormone therapy use. The agency still warns against using certain estrogen-alone products, however, due to elevated endometrial cancer risk.

Within months of a landmark 2002 study that indicated HRT harms, sales dropped by about half

In the early 2000s, Women's Health Initiative studies indicated HRT increased risk of breast cancer, heart disease, and stroke in some women—so many physicians stopped prescribing it to help with menopause symptoms. But further research has concluded that much of the elevated risk was overblown and that it was also disproportionately seen in women in their 70s who had been taking an older HRT formulation.

HRT for menopause may not help with mental health or sleep says a large 2026 analysis

A recent analysis investigating the effects of menopause and HRT use on mental health, cognition, and brain health suggested HRT did little or nothing to aid with mental health and sleep. But the researchers caution that, among other data gaps, they didn't have information on which HRT formulations were used among their nearly 125,000 participants, so results may have varied by drug treatment.

Health problems are being misdiagnosed as perimenopause symptoms

Symptoms of menopause and perimenopause (the premenopause period) can be varied enough that clinicians dismiss them in patients in their mid-30s and onward as just a symptom of hormone level change. In this story, a woman's itching was dismissed as a hormonal change, but after two years and 11 separate doctor consultations, was diagnosed as cancer. (Some users may experience a paywall.)

The term 'low T' was coined in 2002, recasting testosterone therapy and elevating demand

The marketing shift and accompanying awareness campaigns, both by the company behind the first testosterone product approved by the FDA, changed the landscape for testosterone product demand. Testosterone is often considered low when it's below 300 nanograms per deciliter of blood. (Some users may experience a paywall.)

Men are flocking to hundreds of new online testosterone clinics for low T prescriptions

Many primary care clinicians may not be familiar with testosterone testing protocols and treatments, but online testosterone clinics are proliferating, with names like DudeMeds. COVID-era restrictions loosened remote prescribing rules, allowing them to expand online widely, though those more lenient prescribing policies are slated to expire in December 2026 unless they're renewed. (Some users may experience a paywall.)

Testosterone prescriptions remain very low overall

Though demand for an injectable formulation of testosterone roughly doubled between 2019 and 2025, testosterone prescriptions still remain very uncommon—adding up to less than 2 per 100,000 prescriptions in 2025.

FDA removed its cardiovascular risk warning on testosterone products in 2025

The change came a decade after the FDA added the label. Recent work, including a gold-standard randomized trial, found that men receiving the products had similar cardiovascular risk levels as men taking placebo products. Testosterone, however, may hold other health risks, including infertility.