Well, here we are — the FDA finally caught up.

After more than 20 years of fear, confusion, and women being told “no” when the evidence clearly said “yes,” the FDA has officially removed the boxed warning on estrogen therapy. And while the headlines are calling this “new science,” those of us inside the Bioidentical Hormone Revolution — BHRT clinicians, functional medicine practitioners, and every provider who has studied the actual physiology — know the truth.

This isn’t new science.
This is science finally being acknowledged.

I wish this moment had come sooner — because millions of women suffered needlessly while a flawed warning stayed in place for two decades.

Let me walk you through what this means, why it matters, and why the real work begins now — with us.

I. How We Got Here: A Warning Built on Misinterpreted Data

Everything changed in 2002 when the Women’s Health Initiative (WHI) released its first major findings. Fear spread like wildfire. Overnight, providers told women to stop hormones, pharmacies fielded panicked calls, and estrogen was suddenly painted as a villain.

But here’s the truth most people don’t realize:

The WHI did not study bioidentical hormones.

Not estradiol — the hormone your ovaries make.
Not progesterone — the hormone that protects breast and uterine tissue.

Instead, the WHI tested:

  • Conjugated equine estrogens (CEE) — from pregnant mare urine
  • Medroxyprogesterone acetate (MPA) — a synthetic progestin

And yet the entire medical community treated these synthetic molecules as if they represented all hormone therapy.

It was a scientific leap that caused a clinical disaster.

Millions of women were told to accept:

  • Weight gain
  • Brain fog
  • Anxiety
  • Night sweats
  • Insomnia
  • Vaginal atrophy
  • Bone loss
  • Cardiovascular decline

All because a warning — based on the wrong hormones — lived on labels for more than 20 years.

What’s wrong with that picture?
Everything.

II. The Evidence Was Always Clear — The FDA Is Just Catching Up

Let me be very direct:
The fear around estrogen was never supported by the evidence.

When you actually examine the research — not the headlines — the truth becomes undeniable.

1. Estrogen Reduces Breast Cancer Risk

The WHI estrogen-only arm (women with hysterectomy) showed:

  • 30–40% lower breast cancer incidence
  • Lower breast cancer mortality

(Anderson et al., 2004; LaCroix et al., 2011)

Imagine that.
The very hormone women were told causes breast cancer actually reduced it.

2. Synthetic Progestins Raise Risk — Bioidentical Progesterone Does Not

This distinction is critical.

The French E3N Cohort (Fournier et al., 2008) showed:

  • Synthetic progestins increased breast cancer risk
  • Bioidentical progesterone did not

Different molecules, different outcomes.

This is why BHRT protocols — using estradiol and progesterone — look nothing like the therapy used in the WHI.

3. Transdermal Estradiol Does Not Increase Clot Risk

The ESTHER Study (Scarabin et al., 2003) demonstrated:

  • Oral estrogen increased clot risk
  • Transdermal estrogen did not

The 2022 NAMS Position Statement confirmed this safety profile.

Route matters — something conventional training still fails to emphasize.

4. Hormone Therapy Beyond Age 65 Is Protective

A 2024 study in Menopause (Baik et al.) found that women who continued hormone therapy beyond age 65 had:

  • Reduced all-cause mortality
  • Reduced breast cancer
  • Reduced lung cancer
  • Reduced colorectal cancer

Healthspan. Longevity. Quality of life.

This is exactly what we’ve been teaching inside the Bioidentical Hormone Revolution for decades.

 

III. The Real Crisis Isn’t the Warning — It’s the Lack of Training

Now let me be clear about something critically important:

Removing the boxed warning does NOT mean providers know how to prescribe hormones safely.

 

Why?
Because most medical programs never taught it.

Most clinicians graduate having received:

  • Less than two hours of menopause education
  • No training in bioidentical hormone replacement therapy
  • No instruction in estriol
  • No guidance on transdermal estradiol
  • No protocols for testosterone therapy in women
  • No framework for interpreting functional labs
  • No instruction on adrenal–thyroid–insulin interplay

It’s not neglect.
It’s a system failure.

When clinicians are under-trained:

  • They’re hesitant
  • They’re fearful
  • They under-dose
  • They misapply
  • They default to outdated myths

And women suffer for it.

Removing the warning gives providers permission to prescribe.
But it does not give them competence.

 

IV. The FDA’s Decision Validates the Bioidentical Hormone Revolution

For decades, BHRT providers were dismissed as “alternative,” “unorthodox,” or “outside the mainstream.”

But let’s tell the truth:

We were simply ahead of the science — not outside it.

What the FDA is doing now is not announcing new evidence…
It’s admitting that the original fear was misplaced.

This is a turning point in the Bioidentical Hormone Revolution:

  • Institutions are reconsidering outdated dogma
  • Patients are demanding real answers
  • Providers are seeking advanced education
  • The medical community is finally questioning old narratives

This is the moment we’ve been preparing for.

 

V. We Cannot Allow the Next Generation of Providers to Repeat the Same Mistakes

If the medical system does not fix the hormone-education gap, the same harms will continue — just without the black box warning.

We will see:

  • Under-treatment
  • Over-treatment
  • Wrong-route treatment
  • Synthetic-vs-bioidentical confusion
  • Persistent fear
  • Continued misdiagnosis

Hormone therapy requires training.
Precision.
Evidence-based protocols.
And an understanding of the entire endocrine symphony.

And this is exactly what medical school still does not teach.

 

Which is why…

 

VI. This Is Why I Built the BHRT Training Academy

To fix the pipeline.

Inside the BHRT Training Academy, we teach what medical school didn’t — and still doesn’t:

  • How estradiol, estriol, and progesterone work at the receptor level
  • How to dose transdermal estrogen safely and effectively
  • How to use progesterone for endometrial protection
  • Optimal vs. normal hormone targets
  • Functional lab interpretation
  • Thyroid-adrenal-insulin crosstalk
  • Testosterone therapy for women
  • Case-based clinical reasoning
  • Comprehensive endocrine evaluation
  • Evidence-based safety frameworks

This isn’t a weekend course.
This isn’t a “certificate.”
This is a rigorous, academically structured training system designed to create:

Provider excellence → Better patient outcomes → A global standard of hormone care

This is how we train 100,000 providers to help 100 million women.
This is the future of women’s health.
This is the Bioidentical Hormone Revolution.

 

VII. The Next Chapter Starts Now — And It Starts With Us

The FDA made a correction.
Now medicine must make one too.

Women are ready.
The science is clear.
The warning is gone.

Now we need trained clinicians — providers who understand optimal, not just normal. Providers who understand comprehensive, not conventional. Providers who are ready to lead.

And that’s you.

 

Bottom Line

 

The removal of the boxed warning on estrogen is not the end of the story — it is the beginning of a new era in women’s health.

The evidence was always there.
BHRT clinicians have always known it.
And now the world is finally catching up to the truth.

What this means for you:
If you want to practice medicine that is rooted in physiology, not fear — evidence, not outdated dogma — then you must get the training that bridges the gap.

Join the Bioidentical Hormone Revolution inside the BHRT Training Academy.

Women are waiting.
Let’s not make them wait another 20 years.

 

 

 

References

Anderson, G. L., Limacher, M., Assaf, A. R., Bassford, T., Beresford, S. A., Black, H., … & Prentice, R. L. (2004). Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: The Women’s Health Initiative randomized controlled trial. JAMA, 291(14), 1701–1712.

Baik, S. H., Baye, F., & McDonald, C. J. (2024). Use of menopausal hormone therapy beyond age 65 years and its effects on women’s health outcomes by types, routes, and doses. Menopause, 31(3), 244–254.

Fournier, A., Berrino, F., & Clavel-Chapelon, F. (2008). Unequal risks for breast cancer associated with different hormone replacement therapies: Results from the E3N cohort study. Breast Cancer Research and Treatment, 107(1), 103–111.

LaCroix, A. Z., Chlebowski, R. T., Manson, J. E., Aragaki, A., Johnson, K. C., Martin, L., … & Anderson, G. L. (2011). Health outcomes after stopping conjugated equine estrogens among postmenopausal women with prior hysterectomy: The Women’s Health Initiative randomized trial. JAMA, 305(13), 1305–1314.

Rossouw, J. E., Anderson, G. L., Prentice, R. L., LaCroix, A. Z., Kooperberg, C., Stefanick, M. L., … & Writing Group for the Women’s Health Initiative Investigators. (2002). Risks and benefits of estrogen plus progestin in healthy postmenopausal women. JAMA, 288(3), 321–333.

Scarabin, P.-Y., Oger, E., & Plu-Bureau, G. (2003). Differential association of oral and transdermal oestrogen-replacement therapy with venous thromboembolism risk. The Lancet, 362(9382), 428–432.

The North American Menopause Society. (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794.

White, D. (2024). The Bioidentical Hormone Revolution. BHRT Training Academy Publishing.