FDA Commissioner Dr. Makary on lifting HRT warnings: 50M women haven't experienced the benefits

Hormone Replacement Therapy (HRT) Safety and Efficacy - The FDA Commissioner suggests removing black box warnings from HRT products, arguing they have unnecessarily deterred women from using these treatments [1][12] - A 2002 study led to a nearly 50% reduction in HRT use due to concerns about increased risks of heart disease and breast cancer [2] - Subsequent clinical trials have not confirmed that HRT increases breast cancer mortality, and cardiovascular complications are linked to starting HRT more than 10 years after menopause onset [4] - Starting HRT within 10 years of menopause onset can reduce heart disease risk by 30-50% and heart attack deaths by 48% [5] Benefits of HRT - HRT can alleviate menopause symptoms, which 80% of women experience, including hot flashes, night sweats, mood swings, and weight gain [6][7] - Long-term benefits of HRT include reducing cognitive decline by up to 64% and Alzheimer's risk by 35% in some studies, as well as reducing bone fracture rates [7] Considerations for HRT Use - The 2002 study had flaws, including exclusively studying women who were on average 10 years post-menopause with an average age of 63, a demographic already vulnerable to cardiovascular disease [8] - The study only evaluated one delivery method (a daily pill combining estrogen and progesterone), while delivery methods have improved since then [9] - Contraindications for HRT include a predisposing risk to blood clots or active breast cancer, but these are rare [14] - Doctors generally don't prescribe hormone therapy if you're over age 60 or more than 10 years after the onset of menopause [18] - Estrogen reduces cardiovascular risk in post-menopausal women by 30 to 50% [21]