Rethinking Menopause Hormone Therapy
A JAMA Perspective outlines how updated FDA labeling may reshape menopause care.
By
Kerri Miller
April 23, 2026
Clinical Scorecard: Rethinking Menopause Hormone Therapy
At a Glance
Category Detail
Condition Menopause Key Mechanisms Menopausal hormone therapy (MHT) benefits when initiated prior to age 60 or within 10 years of menopause. Target Population Middle-aged women experiencing menopausal symptoms. Care Setting Primary care and women's health clinics.
Key Highlights
MHT use declined from over 20% to under 5% post-Women's Health Initiative. FDA removed black box warnings related to cardiovascular disease, stroke, dementia, and breast cancer. Updated labeling emphasizes individualized risk-benefit discussions and treatment options. Symptoms of menopause can begin years before menopause itself. Need for improved education and screening practices among clinicians. Guideline-Based Recommendations
Diagnosis
Routine symptom assessment for menopausal symptoms. Management
Individualized discussions on the risks and benefits of MHT. Monitoring & Follow-up
Regular follow-up to assess treatment efficacy and side effects. Risks
Consideration of prior cardiovascular and cancer risks in treatment decisions. Patient & Prescribing Data
Women in midlife experiencing menopausal symptoms.
MHT is favorable when started early in the menopausal transition.
Clinical Best Practices
Incorporate menopause symptom screening into routine care. Engage in shared decision-making with patients regarding treatment options. Stay updated with continuing education on menopause management. References
