Episode # 87 • 01 Jul 2025
Evaluating Hormone Therapy in Menopause Management
Vaginal estrogen is not the enemy. Outdated data is. In this crossover episode of the BackTable Urology and OBGYN podcasts, Dr. Suzette Sutherland and Dr. Yahir Santiago-Lastra delve into the persistent challenges and ongoing advocacy efforts surrounding the FDA's black box warning on vaginal estrogen.
Timestamps
00:00 - Introduction
02:01 - Menopause Series Overview
03:55 - History of the Black Box Warning on Estrogen
07:26 - Understanding the Black Box Warning
12:11 - The Citizen's Petition and FDA Process
18:11 - Gender Inequity in Medical Treatment
22:45 - Factors Resulting in Gender Inequity
29:02 - Genital Urinary Syndrome of Menopause (GSM)
29:32 - Benefits of Vaginal Estrogen
33:33 - Legislative Advocacy and Medicare
34:43 - Professional and Patient Advocacy
36:35 - Challenges and Progress in Label Change
43:35 - Historical Context and Gender Equity
45:07 - Recap and Future Directions
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More about this episode
They explore the historical context and far-reaching influence of the 1990s Women’s Health Initiative (WHI) study, asserting that its misinterpretation continues to shape misconceptions and hinder effective menopause care. The discussion highlights recent data refuting the risks associated with vaginal estrogen therapies and underscores the urgent need for updated, evidence-based guidelines to support women throughout menopause. Dr. Santiago-Lastra also draws attention to gender-based inequities in hormone treatment, the robust evidence contradicting the current black box warning, and the multi-faceted advocacy required to bring about change. This episode is part of a broader series focused on various aspects of menopause.
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