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Hormones for menopause are safe, study finds. Here's what changed
Low-dose estrogen can be taken orally, but it’s also now available in patches, gels and creams.
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Low-dose estrogen can be taken orally, but it’s also now available in patches, gels and creams.
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The benefits of hormone therapy for the treatment of menopause symptoms outweigh the risks. That’s the conclusion of a new study published in the medical journal JAMA.
“Among women below the age of 60, we found hormone therapy has low risk of adverse events and [is] safe for treating bothersome hot flashes, night sweats and other menopausal symptoms, ” says study author Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital. This is a departure from the advice many women have been given in the past.
The new analysis is based on two decades of follow-up data from the Women’s Health Initiative study, which followed thousands of women taking hormone replacement therapy. The study was halted after it was found that women taking Prempro, which is a combination of estrogen and progestin, had higher risks of breast cancer and stroke.
“The findings were surprising,” Manson says, pointing out that the reason the randomized trial was conducted was because scientists were trying to determine if hormone therapy decreased the risk of heart disease and other conditions.
After the initial findings came out, many women abruptly stopped the therapy. Prescriptions plummeted, and many healthcare providers still hesitate to recommend hormone therapy. But menopause experts say it’s time to reconsider hormone therapy, because there’s a lot known now that wasn’t known two decades ago.
Most significantly, there are now different types of hormones — delivered at lower doses — that are shown to be safer.
“Women should know that hormone therapy is safe and beneficial,” says Dr. Lauren Streicher, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine.
Looking back, Dr. Streicher says, it’s clear the Women’s Health Initiative study was flawed and that some of the risks that were identified were linked to the type of hormones that women were given.
“We learned what not to do,” Streicher says. The type of progestin used, known as medroxyprogesterone acetate, was “highly problematic,” she says. This was likely responsible for the increase in breast cancer seen among women in the study. “So we don’t prescribe that anymore,” Streicher says.
Increasingly, other types of hormones are used, such as micronized progesterone which does not increase the risk of breast cancer, ” Streicher says. Micronized progesterone is a bioidentical hormone that has a molecular structure identical to the progesterone produced by womens’ ovaries, and tends to have fewer side effects.
Another problem with the study was the age of the women enrolled. Most of the women were over the age of 60, Streicher says .” And we know that there is a window of opportunity when it is the safest to start hormone therapy and that you get the most benefit.” That window is typically between ages 50 and 60, she says.
Another risk identified in the Women’s Health Initiative study, was an increased incidence of pulmonary embolism among women taking hormones. A pulmonary embolism is a blood clot that blocks blood flow to the lungs.
Since women in the study were taking estrogen orally, by pill, this may have increased their risk, Streicher says. A better option for people at risk of clots is to take estrogen through the skin, via a patch, a cream or gel.
“The advantage of a transdermal estrogen is that it is not metabolized by the liver,” Streicher says. “And because it’s not metabolized by the liver, we don’t see that increase in blood clots.”
With a range of hormone therapies available now, Dr Streicher says there’s not a one-size fits all approach. “Hormone therapy is beneficial way beyond the benefits to just helping with hot flashes,” she says. Ongoing research points to protection against bone loss and heart disease, too.
Streicher says women should talk to their healthcare providers about what options may best suit their needs.
This story was edited by Jane Greenhalgh
new video loaded: What Trump Told Us About the ICE Shooting
By Zolan Kanno-Youngs, Alexandra Ostasiewicz, Nikolay Nikolov and Coleman Lowndes
January 8, 2026
Good morning. You’re reading the Up First newsletter. Subscribe here to get it delivered to your inbox, and listen to the Up First podcast for all the news you need to start your day.
Today’s top stories
An Immigration and Customs Enforcement officer shot and killed 37-year-old Renee Nicole Good, a Minneapolis woman, yesterday. Multiple observers captured the shooting on video, and community members demanded accountability. Minnesota law enforcement officials and the FBI are investigating the fatal shooting, which the Trump administration says was an act of self-defense. Meanwhile, the mayor has accused the officer of reckless use of power and demanded that ICE get out of Minneapolis.
People demonstrate during a vigil at the site where a woman was shot and killed by an immigration officer earlier in the day in Minneapolis, Minnesota, on Jan. 7, 2026. An immigration officer in Minneapolis shot dead a woman on Wednesday, triggering outrage from local leaders even as President Trump claimed the officer acted in self-defense. Minneapolis Mayor Jacob Frey deemed the government’s allegation that the woman was attacking federal agents “bullshit,” and called on Immigration and Customs Enforcement (ICE) officers conducting a second day of mass raids to leave Minneapolis.
Kerem Yucel/AFP via Getty Images
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- 🎧 Caitlin Callenson recorded the shooting and says officers gave Good multiple conflicting instructions while she was in her vehicle. Callenson says Good was already unresponsive when officers pulled her from the car. Homeland Security Secretary Kristi Noem claims the officer was struck by the vehicle and acted in self-defense. In the video NPR reviewed, the officer doesn’t seem to be hit and was seen walking after he fired the shots, NPR’s Meg Anderson tells Up First. Anderson says it has been mostly peaceful in Minneapolis, but there is a lot of anger and tension because protesters want ICE out of the city.
U.S. forces yesterday seized a Russian-flagged oil tanker in the north Atlantic between Iceland and Britain after a two-week chase. The tanker was originally headed to Venezuela, but it changed course to avoid the U.S. ships. This action comes as the Trump administration begins releasing new information about its plans for Venezuela’s oil industry.
- 🎧 It has been a dramatic week for U.S. operations in Venezuela, NPR’s Greg Myre says, prompting critics to ask if a real plan for the road ahead exists. Secretary of State Marco Rubio responded that the U.S. does have a strategy to stabilize Venezuela, and much of it seems to involve oil. Rubio said the U.S. would take control of up to 50 million barrels of oil from the country. Myre says the Trump administration appears to have a multipronged strategy that involves taking over the country’s oil, selling it on the world market and pressuring U.S. oil companies to enter Venezuela.
Health Secretary Robert F. Kennedy Jr. released new dietary guidelines for Americans yesterday that focus on promoting whole foods, proteins and healthy fats. The guidance, which he says aims to “revolutionize our food culture,” comes with a new food pyramid, which replaces the current MyPlate symbol.
- 🎧 “I’m very disappointed in the new pyramid,” Christopher Gardner, a nutrition expert who was on the Dietary Guidelines Advisory Committee, tells NPR’s Allison Aubrey. Gardner says the new food structure, which features red meat and saturated fats at the top, contradicts decades of evidence and research. Poor eating habits and the standard American diet are widely considered to cause chronic disease. Aubrey says the new guidelines alone won’t change people’s eating habits, but they will be highly influential. This guidance will shape the offerings in school meals and on military bases, and determine what’s allowed in federal nutrition programs.
Special series
Trump has tried to bury the truth of what happened on Jan. 6, 2021. NPR built a visual archive of the attack on the Capitol, showing exactly what happened through the lenses of the people who were there. “Chapter 4: The investigation” shows how federal investigators found the rioters and built the largest criminal case in U.S. history.
Political leaders, including Trump, called for rioters to face justice for their actions on Jan. 6. This request came because so few people were arrested during the attack. The extremists who led the riot remained free, and some threatened further violence. The government launched the largest federal investigation in American history, resulting in the arrest of over 1,500 individuals from all 50 states. The most serious cases were made by prosecutors against leaders of the Proud Boys and Oath Keepers. For their roles in planning the attack against the U.S., some extremists were found guilty of seditious conspiracy. Take a look at the Jan. 6 prosecutions by the numbers, including the highest sentence received.
To learn more, explore NPR’s database of federal criminal cases from Jan. 6. You can also see more of NPR’s reporting on the topic.
Deep dive
U.S. President Donald Trump speaks during a news conference in the Roosevelt Room of the White House in Washington, DC.
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U.S. President Donald Trump speaks during a news conference in the Roosevelt Room of the White House in Washington, DC.
Andrew Harnik/Getty Images
Trump takes 325 milligrams of daily aspirin, which is four times the recommended 81 milligrams of low-dose aspirin used for cardiovascular disease prevention. The president revealed this detail in an interview with The Wall Street Journal published last week. The U.S. Preventive Services Task Force recommends that anyone over 60 not start a daily dose of aspirin to prevent cardiovascular disease if they don’t already have an underlying problem. The group said it’s reasonable to stop preventive aspirin in people already taking it around age 75 years. Trump is 79. This is what you should know about aspirin and cardiac health:
- 💊 Doctors often prescribe the low dose of aspirin because there’s no benefit to taking a higher dose, according to a large study published in 2021.
- 💊 Some people, including adults who have undergone heart bypass surgery and those who have had a heart attack, should take the advised dose of the drug for their entire life.
- 💊 While safer than other blood thinners, the drug — even at low doses — raises the risk of bleeding in the stomach and brain. But these adverse events are unlikely to cause death.
3 things to know before you go
When an ant pupa has a deadly, incurable infection, it sends out a signal that tells worker ants to unpack it from its cocoon and disinfect it, a process that results in its death.
Christopher D. Pull/ISTA
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Christopher D. Pull/ISTA
- Young, terminally ill ants will send out an altruistic “kill me” signal to worker ants, according to a study in the journal Nature Communications. With this strategy, the sick ants sacrifice themselves for the good of their colony.
- In this week’s Far-Flung Postcards series, you can spot a real, lone California sequoia tree in the Parc des Buttes Chaumont in Paris. Napoleon III transformed the park from a former landfill into one of the French capital’s greenest escapes.
- The ACLU and several authors have sued Utah over its “sensitive materials” book law, which has now banned 22 books in K-12 schools. Among the books on the ban list are The Perks of Being a Wallflower and Wicked: The Life and Times of the Wicked Witch of the West. (via KUER)
This newsletter was edited by Suzanne Nuyen.
new video loaded: Minnesota Governor Condemns ICE Shooting
transcript
transcript
Minnesota Governor Condemns ICE Shooting
Governor Tim Walz of Minnesota slammed the fatal shooting of a woman by an immigration agent. President Trump said that the agents had acted in self-defense.
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This morning, we learned that an ICE officer shot and killed someone in Minneapolis. We have been warning for weeks that the Trump administration’s dangerous, sensationalized operations are a threat to our public safety, that someone was going to get hurt. Just yesterday, I said exactly that. What we’re seeing is the consequences of governance designed to generate fear, headlines and conflict. It’s governing by reality TV. And today, that recklessness cost someone their life.
By Jiawei Wang
January 8, 2026
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Video: Minnesota Governor Condemns ICE Shooting
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