The women whose data built menopause hormone therapy's scariest warning averaged 63. Menopause hits at 51. That 12-year gap is the whole story.
In February the FDA stripped its black-box warning from six products, admitting the 2002 trial behind it studied the wrong women. The risks it found were real but modest: over one year, per 10,000 women, about 7 more heart events, 8 more strokes, 8 more breast cancers. Use collapsed from 4.4 percent to 1.7 percent and never recovered. Now prescribing is surging, hard enough to land the estrogen patch on the national shortage list.
The fix for one blanket message is not the opposite one. It is a prescription drug, dosed and timed for the woman taking it, not for the trial that happened to run first.
