HRT is the new cholesterol. And I owe my mother an apology.

Yesterday was World Menopause Day. I shared stories, interviews, research and the voices of doctors working to change the way we care for women.

But the most important thing I have to say starts with something I got wrong.

One of the biggest mistakes of my professional life was telling my mother and her friends not to take hormone replacement therapy, 20 years ago.

I was newly graduated from naturopathic college. The findings from the Women’s Health Initiative were dominating the conversation. The message reaching women—and the people advising them—was frightening: hormones could cause breast cancer, heart disease and stroke.

I thought I was protecting them.

More than twenty years later, I wish I had understood what I understand now.

When a finding becomes a verdict

In 2002, the combined hormone therapy arm of the Women’s Health Initiative was stopped early. It studied oral conjugated equine (horse) estrogens with medroxyprogesterone acetate, a synthetic progestin, in women aged 50 to 79. Their average age was 63.

Those details matter. Which hormones? Given how? Started at what age, and how long after menopause?

What many of us heard was much simpler.

HRT is dangerous. Don’t take it.

A finding about a particular treatment in a particular population became a much broader verdict on hormones.

The trial identified real risks. We needed to understand them. But we also needed to understand what those findings could—and could not—tell us about a woman seeking treatment during her menopause transition.

A 52-year-old considering treatment for debilitating symptoms deserves a discussion about her own circumstances.

Why I call HRT “the new cholesterol”

In a recent reel, I compared the HRT story with the changing public conversation about cholesterol, eggs, butter and dietary fat.

Think about how confidently food advice has been delivered through magazine covers and headlines. Think about how difficult it can be to revisit a message once people have absorbed it as fact.

That is the parallel I am drawing.

I am not suggesting that cholesterol does not matter, or that every concern about dietary fat was imaginary. I am asking us to recognise what happens when a complicated scientific story becomes a slogan.

Fear travels quickly. A correction can take decades.

Women are still living with the consequences of the message they heard about hormones twenty years ago.

The FDA has changed the warning. We need to change the conversation.

In November 2025, the US Food and Drug Administration initiated the removal of broad boxed warnings from menopausal hormone therapy products. In February 2026, it approved the first six revised labels, removing statements about cardiovascular disease, breast cancer and probable dementia from their boxed warnings.

That is a significant change, and I am grateful to see it.

It means women deserve risk information that reflects the treatment being offered and the woman receiving it.

TIME covered the FDA announcement, bringing this conversation to a much wider audience. But a headline cannot finish the work. Updated information has to reach consulting rooms, medical education and the women who were frightened away from asking.

Why are we so comfortable treating everything around menopause?

In another interview clip, I explained why I am comfortable supporting appropriate HRT today.

I see women taking medication for pain, anxiety, depression and sleep. Sometimes those treatments are essential. I use medication myself, and I have no interest in shaming anyone for needing it.

But I want us to ask a question:

Have we considered the role of the menopause transition in what this woman is experiencing?

We can investigate her pain, support her mental health, assess her sleep and discuss her hormones. Those conversations belong together.

Antidepressants are not a failure. Neither is HRT. Neither is needing both.

What concerns me is a woman accumulating treatments while nobody asks whether changing ovarian hormones might be contributing to her symptoms.

My own menopause experience has made this deeply personal. Anxiety, disrupted sleep, PAIN and changes in how I felt in my own body were never abstract topics to me.

Women deserve to be heard before they reach breaking point.

Following the science means being willing to change your mind

Hormone therapy remains the most effective treatment for menopausal hot flashes and night sweats. It can treat genitourinary symptoms like recurrent UTIs and prevent bone loss and fractures.

Formulation, dose, route, medical history and timing matter.

Supporting HRT means supporting informed choice, good assessment and ongoing care.

I can acknowledge that I gave advice I would give differently today. I believe that is part of being a responsible clinician.

The science should be allowed to change our minds.

Why we are writing The Menopause Plan Book

This is part of what drives the book I am writing with Dr. Melissa Hague, an obstetrician-gynaecologist.

Melissa brings her expertise in gynaecology and medical care. I bring more than twenty years of work in women’s hormonal and metabolic health, my experience with insulin resistance and nutrition, and my determination to make physiology understandable.

I also bring my experience as a woman who has lived with PCOS and gone through menopause.

Together, we want to help women understand what is happening, make sense of treatment options and build practical support for their health.

My work has long focused on how we eat, when we eat, what we eat, sleep and stress, and movement and strength. Those foundations remain important in menopause. They belong alongside appropriate medical care.

Women should have access to the tools that can help them.

Awareness has to become care

I am proud to be part of a growing community advocating for better women’s health now.

I have been sharing voices such as Dr. Rachel Rubin and Dr. Mary Claire Haver because women need access to knowledgeable clinicians and clear conversations. No single person has every answer. We need research, education and professionals willing to listen.

World Menopause Day matters. What happens after it matters too.

My mother and her friends deserved a more informed conversation. So did a generation of women who heard that hormones were dangerous and quietly carried on suffering.

We cannot undo those conversations.

We can change the ones we are having now.

Listen to women. Update the teaching. Make appropriate care accessible.

Follow the science—and be willing to follow it somewhere different from where you started.