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Hormones for menopause are safe, study finds. Here's what changed

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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.

svetikd/Getty Images

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.

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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.

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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.

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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

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What the Supreme Court did on the final day of its term

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What the Supreme Court did on the final day of its term

The U.S. Supreme Court

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The Supreme Court Tuesday upheld the long-established right of children born on U.S. soil to automatic American citizenship, regardless of their parents’ immigration status. In so doing, the court rejected President Trump’s most aggressive attempt to limit immigration in the United States.

Writing for the court majority, Chief Justice John Roberts traced birthright citizenship back to the founding of the nation. Just as the colonists demanded “the rights of Englishmen” more than 250 years ago, he said, Congress, after the Civil War, amended the Constitution to specify automatic citizenship for any child born on U.S. soil.

“Citizenship then and now was the right to have rights”—and the framers of the 14th amendment extended that promise to every free born person in this land. He concluded: “We keep that promise today.”

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The vote was 6-to-3, depending on how you count it. Altogether, five justices signed on to the Roberts’ majority opinion. A sixth, Justice Brett Kavanaugh, agreed only that federal legislation enacted in the 1950s grants automatic citizenship for children born in the U.S.

Justice Clarence Thomas wrote the lead dissent, a 91-page opus that agreed with Trump’s assertion that the 14th amendment only applied to former slaves and their descendants. The Thomas dissent added ominously that he “was not sure that “today’s opinion will stand the test of time.” The dissent was joined by Justice Neil Gorsuch, with Justice Samuel Alito writing a separate dissent.

Justice Ketanji Brown Jackson, who, like Thomas is African American, responded to some of the themes in the Thomas dissent.

“Despite his longstanding endorsement of a colorblind society,” she wrote, “Justice Thomas now surprisingly suggests that the citizenship clause was a race-conscious remedial measure relating only to freed slaves.”

Cecillia Wang, legal director of the ACLU, who successfully argued the case at the Supreme Court, said President’s Trump failed attempt to limit birthright citizenship was transparent.

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Rep. Tom Kean returns to Congress, says depression is why he went missing for months

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Rep. Tom Kean returns to Congress, says depression is why he went missing for months

Rep. Thomas Kean Jr., R-N.J., arrives at the U.S. Capitol with his wife Rhonda Kean on June 30.

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New Jersey Republican Thomas Kean Jr. said it was struggles with depression that kept him away from Congress for nearly four months with no explanation to his constituents.

Kean last voted on March 5th, missing numerous votes and other appearances on Capitol Hill since. In April, House Speaker Mike Johnson told reporters he had spoken to Kean and that he was dealing with an undisclosed medical issue. Kean was not spotted until recently at his New Jersey home.

Speaking from the House floor on Tuesday, the second term lawmaker said he had checked into a hospital for testing several months ago after health concerns, and was subsequently diagnosed with depression.

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“Talking about myself has never come naturally,” Kean said. “But I believe that I owe an explanation to the people of New Jersey’s seventh district, to my colleagues in this chamber and to the American people for my absence.”

Kean said he originally did not think his diagnosis would result in a long-term absence. Doctors recommended he remain in the hospital to address the illness, and it was his fastest route to recovery, he said.

“It is physical. It is emotional,” he said. “And until you experience it yourself, it is difficult to fully understand how powerful this illness could be.”

Kean said he miscalculated how long he would be away, estimating it would be a matter of weeks. However, he said like the roughly 48 million Americans who have battled the illness, he learned there is no timeline for recovery.

“I am grateful that I accepted help,” Kean said. “Today I stand before you healthier, stronger and excited to return to the work that I love.”

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Kean’s absence proved a struggle for House Republicans, who contend with a razor thin majority to pass party priorities. For weeks, Kean and his office declined to share additional details on why he was away, feeding rumors and speculation and raising interest in a member known for his privacy.

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Michigan governor threatens to pull troops from D.C. if used for Trump task force

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Michigan governor threatens to pull troops from D.C. if used for Trump task force

Members of the National Guard stand in front of a large image of U.S. President Donald Trump that hangs from the the Robert F. Kennedy Department of Justice Building on May 18, 2026 in Washington, D.C.

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WASHINGTON, D.C. — In a strongly worded letter to the head of Michigan’s National Guard, Gov. Gretchen Whitmer reiterated troops from her state are only to be used for operations surrounding America 250 celebrations in Washington, D.C., and not for President Trump’s long-running — and controversial — joint task force to fight crime. She said that she would pull her troops from the city if that is not the case, in the letter obtained by NPR.

“Please take all necessary measures to ensure the Michigan National Guard is only supporting the narrow and limited America 250 Mission and is in no way supporting the D.C. Safe and Beautiful Mission,” wrote Gov. Whitmer, referencing the official name for the federal task force.

Trump deployed hundreds of troops to Washington, D.C., in August of 2025, in what experts said was a stunning departure from governing norms. He said he did so to address rampant crime, despite declining crime rates at the time. The number of troops in the city has increased over time to more than 4,800 from Washington, D.C. and almost two dozen states, which until recently were exclusively Republican-led.

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Michigan — which has 161 guard members currently in the city — is one of four Democratic-led states that sent members of their National Guard to D.C. in recent weeks, ahead of an influx of tourists for America 250 celebrations. North Carolina and Kentucky each sent one member of their guard, while Minnesota sent more than a hundred last week.

Kentucky confirmed to NPR Monday that it had recalled its one guard member over the weekend, after that member was “diverted to the task force by the federal government without the knowledge or consent of Gov. Beshear of the Kentucky Guard,” Scottie Ellis, a spokesperson for Gov. Beshear, wrote to NPR in an email.

When contacted by NPR, spokespeople for each respective Democratic governor’s office made it clear that their guard members were sent to help specifically with America 250, not for law enforcement purposes as part of the larger ongoing federal joint task force operation. All four states have been clear about their opposition to the Trump administration’s ongoing deployment of National Guard troops to D.C., filing an amicus brief in support of litigation challenging it as recently as May.

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