ACOG Now Recommends Hormone Therapy for Many Women With Hot Flashes

The American College of Obstetricians and Gynecologists (ACOG) now recommends hormone therapy for many women with these symptoms, according to CBS News. Dr. Kameelah Phillips, an OB-GYN and menopause specialist, said hormone replacement therapy "is now the first line" for hot flashes, night sweats and sleep problems. "We're using hormones mainstream now," she said.

Most menopause symptoms come from steep drops in the hormones estrogen and progesterone, typically in a woman's late 40s or early 50s, according to CBS News. Low levels can also reduce bone density, which raises the risk of osteoporosis and fractures. Phillips said hormone therapy can help "eliminate these symptoms."

Phillips described what women were often told before: take an antidepressant, exercise, or try a glass of wine. "All of those were not helpful," she said. ACOG put it this way in a statement: "Menopause is a normal and natural stage of life, but that doesn't mean that women must suffer through the symptoms without help."

Timing matters. The ACOG recommendations say women should begin hormone therapy before age 60 or within 10 years of starting menopause. For women weighing the decision, that makes the start date part of the question, not just whether to try it.

The timing advice connects to older worries. A 2002 long-term study of women's health raised concerns that hormones could be linked to more breast cancer. Dr. Céline Gounder, a CBS News medical contributor, explained that the study focused on older patients who may not have started treatment until about a decade after menopause. CBS News reports that newer research shows age and dosing can make treatment safe for many patients. It also cites a 2024 study of more than 10,000 women suggesting hormone therapy may help slow biological aging. That is one study, and the report gives no further detail on it.

Not everyone is eligible. According to ACOG, women with a history of blood clots, stroke or liver disease should not use hormone therapy. Neither should women with a personal history of breast cancer.

Treatment comes in several forms: pills, patches, sprays, gels, or a vaginal ring that delivers hormones into the bloodstream. Some women also benefit from low-dose vaginal estrogen. Women who cannot take hormones have non-hormonal options, Phillips said, and she recommends seeing a menopause-trained specialist. "That's why this requires conversation with your healthcare provider," she said.

This guidance adds to what The Arising reported on October 6. The American College of Physicians, a separate organization, issued its own guidance naming hormone therapy as the first treatment to try for hot flashes and night sweats. The two pieces of guidance come from different groups, and they point in the same direction.

What to watch next

How doctors apply the "before 60 or within 10 years" window in practice, and whether more detailed ACOG guidance clarifies dosing and who should be offered treatment first.

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