The Menopause Misinformation Boom: How to Tell Evidence From Hype

Menopause has gone viral, and it's about time. But with that interest comes misinformation and companies looking to profit by capitalizing on this unheard need. Social media feeds are packed with “hormone balance” supplements, celebrity-endorsed clinics, and personalized “menopause optimization” programs. It’s excellent that menopause is finally being talked about, but not everything you hear online is grounded in evidence and focused on whole-body wellness.

What’s Behind the Boom

Few medicines have captured the imagination, and provoked fear and anxiety, as menopause hormone therapy (MHT). From the 1970's to 1990's, MHT was treated as an elixir that could cure anything, and prevent aging, heart disease and dementia. Much of this was not based on any real studies, but rather based on observation. Then a complex and somewhat flawed trial showed a concerning rise in cardiovascular issues, and so a complete reversal occurred, and physicians discontinued and stopped prescribing MHT in record numbers.

For years, those going through menopause felt unheard or unsupported when they went to their doctors. Now the pendulum has swung back, with a major resurgence of interest, and that swing has created a market for anyone offering answers. 

Like everything, the reality of this much debated medication lies somewhere in the middle. Hormone therapy for menopause can have powerful benefits, but there's so much more to this complex stage of life than just hormones, and it deserves a well-rounded treatment.

What the Evidence Actually Supports

Hormone Therapy (HT):

Estrogen (sometimes with progesterone) remains the most effective treatment for hot flashes, night sweats, and vaginal dryness. It can also improve sleep and mood in the right context. Modern evidence shows HT is very safe for most healthy people within 10 years of their last period, when prescribed appropriately and monitored.

Topical Testosterone:

There’s growing evidence that low-dose transdermal testosterone can improve sexual desire, arousal, and satisfaction in postmenopausal people with low libido not explained by other causes. Current research supports its careful use at doses that restore testosterone to the normal female range, not beyond it. Because there’s no FDA-approved product for women in the U.S., we typically use compounded or carefully titrated male formulations under close supervision.

Oral Progesterone:

Progesterone taken by mouth at bedtime can reduce the risk of uterine cancer when used with estrogen, but also has additional benefits. Many patients experience improved sleep quality and decreased nighttime anxiety. Its mild sedative effect can be helpful even in those not using estrogen therapy.

Non-Hormonal Options:

SSRIs (selective serotonin re-uptake inhibitors) , SNRIs (serotonin norepinephrine re-uptake inhibitors), gabapentin, and other medications can help with vasomotor symptoms 9aka "hot flushes") if MHT isn’t the right choice. Cognitive behavioral therapy (CBT) and paced breathing can also reduce symptoms.

Lifestyle Foundations:

Regular resistance training, good sleep hygiene, and balanced nutrition matter more than any supplement. These reduce cardiovascular risk, maintain bone density, and support mood stability—areas that often worsen during menopause.

Primary care physicians excel at administering all of these treatments. Our training emphasizes a holistic, comprehensive approach that makes us competent to manage multiple body systems at once. We focus on symptoms and quality of life, while also using the context of your health and body to choose the safest and most effective treatments to meet your goals. 

Red Flags Online:

• “Customized” hormone pellets or creams sold without lab testing or medical follow-up.

• Fear-based claims like “synthetic hormones cause cancer.”

• Promises of “detoxing estrogen” or “resetting metabolism.”

• Testimonials as evidence instead of data.

• Focusing only on hormones as the treatment, rather than whole health.

  
  

If it sounds like marketing, it probably is.

The Role of Primary Care

Menopause affects every system in the body, so it belongs within whole-person primary care—not just hormone clinics. We approach menopause care with the same principles as any other life stage: evidence, shared decision-making, and context. We listen to you and your story, assess your symptoms, learn about your goals and priorities, and then thoughtfully weigh the benefits and the risks. And then you make the decision that is right for you.

If you’re sorting through mixed messages or wondering what’s right for you, bring your questions to a visit. We’ll review your symptoms, your medical history, and your goals—and build a plan that’s grounded in evidence, not hype.