The Future of Women's Healthcare Looks Brighter Inside the FDA's Historic Menopause Panel

Coaching Team
Jul 22
4 min read

On July 17, 2025, something happened that could change the future of women’s health care — and most people didn’t even hear about it.

A group of expert clinicians, researchers, and advocates gathered in Washington, D.C., for a historic FDA advisory panel meeting focused entirely on menopause and hormone therapy (HT). For those of us who have felt ignored, dismissed, or poorly served by our healthcare system during perimenopause and menopause, this felt huge.

And I was up way too late watching it all unfold.

Here’s why this matters — and what was shared during this important step forward.

Why Has Hormone Therapy Been So Controversial?

To understand why this moment is so significant, we need to rewind to 2002, when the Women’s Health Initiative (WHI) — the largest study ever conducted on postmenopausal women — released data that sent shockwaves through the medical world.

Their findings suggested that hormone therapy increased the risk of breast cancer, stroke, and heart disease. Almost overnight:

Doctors stopped prescribing hormone therapy (HT)
Estrogen and progesterone were slapped with black box warnings
Millions of women were told to just “ride out” menopause

But here’s the real problem — the original WHI study had major flaws:

Most participants were over age 63 — long past the typical onset of menopause
The study used high-dose, synthetic hormones, not the safer bioidentical versions widely used today
Follow-up research shows that starting bioidentical HT within 10 years of menopause can actually offer benefits, not risks, for many women

Despite these updates, the fear and stigma around hormone therapy have lingered for over two decades — affecting doctors, media coverage, and women’s access to treatment.

So What Was This FDA Panel All About?

The FDA Advisory Committee for Reproductive and Urologic Drugs convened the panel in response to growing pressure from researchers, clinicians, and women's health advocates who have been calling out outdated medical standards for years.

Each expert was given 10 minutes and one slide to present their findings to FDA advisors. While no official policy decisions were made (this was a scientific advisory meeting, not a vote), the discussion laid a foundation for future federal changes.

5 Big Takeaways from the Expert Panel

These moments stood out not just for their clinical significance — but for what they mean for the everyday woman navigating menopause today.

1. It’s Time to Remove the Black Box Warning on Estrogen Therapy

Dr. Heather Hirsch opened the panel by spotlighting the stark differences between modern bioidentical hormone therapy and the outdated synthetic drugs studied in 2002.

She advocated for removing the black box warning from transdermal estradiol and micronized progesterone, arguing that the safety profile of these bioidentical hormones does not justify the current level of fear and restriction.

2. Hormone Therapy May Reduce Bone Fractures and Protect Heart Health

Dr. Vonda Wright, an orthopedic surgeon, presented data showing that women lose up to 15–20% of their bone density in the first years of perimenopause — and this drop is directly tied to declining estrogen.

While HT is already FDA-approved for treating osteoporosis, Dr. Wright argued it should also be approved for prevention. Studies show that starting HT early can reduce fracture risk by as much as 30–50% — especially when used within 10 years of menopause.

👉 She also spoke on one of my favorite podcast episodes. Highly recommend listening to her work!

3. Vaginal Estrogen Is Safe, Effective & Misunderstood

Dr. Joanne Pinkerton and Dr. Rachel Rubin both made the case that vaginal estrogen has no meaningful systemic absorption — meaning it doesn’t enter the bloodstream or raise hormone levels. It’s safe, effective, and incredibly underused.

Despite this, vaginal estrogen products still carry black box warnings, which Dr. Pinkerton called “unethical” and “misleading.”

This type of local estrogen can dramatically reduce:

UTIs
Vaginal dryness
Painful intercourse
Urinary urgency and frequency

Yet many women are still being prescribed antibiotics repeatedly when a $13 tube of estrogen cream could solve the issue.

4. Estrogen Supports Brain Health and May Reduce Alzheimer’s Risk

Dr. Philip Sarrel and Dr. Roberta Diaz Brinton presented compelling research showing that estradiol plays a critical role in cognitive health.

During menopause, a woman's brain undergoes dramatic shifts, including reduced glucose metabolism. Estradiol — when started early — has been shown to improve brain function, reduce hospital visits, and even reduce risk of Alzheimer’s disease.

This aligns with the groundbreaking work of Dr. Lisa Mosconi, whose book The Menopausal Brain and TED Talk are both worth exploring.

5. Women Still Don’t Have Access to FDA-Approved Testosterone

Dr. Kelly Casperson, urologist and sexual medicine expert, pointed out that men have more than a dozen FDA-approved testosterone products — and women have none.

Testosterone plays a critical role in libido, mood, energy, and brain function. And while women do make testosterone naturally, there is still no standardized dose or delivery method approved for them.

Until this changes, women are left to self-advocate — or pay out of pocket — for a hormone that could drastically improve their quality of life.

So What Happens Now?

This FDA panel won’t solve everything overnight — but it’s the loudest and most hopeful moment we’ve seen in decades.

It reflects a powerful shift in momentum: clinicians are speaking up, outdated science is being challenged, and women’s voices are finally being heard at the highest levels.

If you’ve ever felt dismissed, confused, or unsupported during perimenopause or menopause, know this — change is coming. And this panel may be the spark that finally moves the needle toward better, evidence-based care for all of us.

Want to Go Deeper?

You can watch the full 2-hour panel replay on the FDA’s YouTube Channel. And if you’re interested in following the experts mentioned above, I’ve linked them in my original notes — they’re doing the work for us, and it’s worth staying informed.