For more than 20 years, menopausal hormone therapy carried an FDA black box warning that reshaped the way women — and their doctors — thought about estrogen. With the warning now removed from most forms of MHT, many women are asking what this change truly means for their breast cancer risk, cardiovascular health, and long-term brain function. In this article, I break down the science behind the original warning, what the updated evidence actually shows, and how to approach hormone therapy safely and thoughtfully in midlife.

If you’re wondering whether MHT is safer now, riskier, or simply better understood — this guide explains what every woman needs to know.

The Faces of Dementia

When I think back on the thousands of patients I’ve cared for with dementia, I see the faces of women. Most were in their 70s and 80s, but just as vivid are the memories of the daughters, nieces, and sisters who stood beside them, offering care and support. Dementia affects men too — but the numbers are clear: dementia disproportionately affects women…For decades, the higher rates of Alzheimer’s in women were explained by longevity: women live longer, so dementia follows. But emerging science points to gender-specific risks that go far beyond lifespan. In fact, more than 30 risk factors for AD have been shown to affect women greater than men. Some are beyond our control. But many of these gender preferential risk factors are modifiable, such as…