The U.S. Food and Drug Administration (FDA) has approved drug labeling changes to six menopausal hormone therapy products, also known as hormone replacement therapy (HRT), to clarify risk considerations for these drugs. Specifically, risk statements related to cardiovascular disease, breast cancer, and probable dementia were removed from the “boxed warning,” the agency’s most prominent safety-related warning.
The FDA initiated the removal of these warnings in November 2025, following a comprehensive review of the scientific literature. At the FDA’s request, 29 drug companies have submitted proposed labeling changes. This first batch of six products with approved labeling changes includes products from each of the four categories of HRT for menopausal women:
- Systemic combination therapy (estrogen and progestogen)
- Systemic estrogen-alone therapy
- Systemic progestogen-alone therapy for women with a uterus using systemic estrogen
- Topical vaginal estrogen therapy.
Menopause is a normal life stage, but its symptoms can significantly reduce quality of life. Common symptoms include hot flashes and night sweats (called vasomotor symptoms); vaginal, vulvar, and urinary tract changes caused by lower estrogen levels; and osteoporosis, which increases fracture risk.
The FDA has approved multiple hormone therapies for moderate-to-severe hot flashes, vaginal dryness and discomfort, and bone loss prevention. In addition, randomized studies show that women who initiate HRT within 10 years of the onset of menopause (generally before age 60) have a reduction in all-cause mortality and fractures. Just a small fraction of women who could benefit from these treatments, however, are using them. In 2020, about 41 million U.S. women were aged 45 to 64 years—yet only about 2 million women aged 46 to 65 received a hormone therapy prescription.
This action will allow women, working with their health-care professionals, to make better-informed decisions about their treatment plan for menopause symptoms. Women are encouraged to consult the drug label for more detailed information about the benefits and risks of these products.
