The weekend roundup
HRT + cancer risk (relax!), MASLD news, a new frozen shoulder intervention, Lisa Rhinna’s doctor, a hormone-detecting wearable (?), Big T and more
I’m going to go deeper on this next week, but a major new narrative review conducted by a team including ob-gyn (and Hotflash inc expert panel member) Dr Vikram Talaulikar takes on one of the most emotionally charged topics in menopause care: cancer risk.
This line was, for me, the hardest to understand: “Despite decades of research, there remains controversy over the cancer risks associated with HRT due to conflicting evidence and limited randomised trial data.”
The review repeatedly emphasizes that we need better data on modern formulations — especially involving micronised progesterone, transdermal regimens and testosterone. (Probably because testosterone can convert to estrogen in tissues, through a process called aromatization. And post-menopause, this process becomes our primary source of estrogen.)
Risk of Cancer With Hormone Replacement Therapy: A Narrative Review, published in BJOG: An International Journal of Obstetrics & Gynaecology.
A big thank you to Phosis for being a gold sponsor of the first-ever Hotflash inc Summit. Phosis is obsessed with repairing, restoring and replenishing your dry and sensitive, hormonal skin. Exceptionally clean and clinically-proven. HOTFLASHINC to get 15% off at PhosisSkincare.com
Quick hits
Early menopause and liver health: Natural menopause before age 50 raises risk of metabolic dysfunction-associated steatotic liver disease (MASLD), suggesting it as a female-specific risk factor, according to an observational study published in Diabetes Metabolism Research and Reviews.
A global Mayo Clinic/Flo app study (17,494 women from 158 countries) showed classic symptoms like hot flashes (71%) are less dominant than fatigue/exhaustion (83%) irritability, depressive mood, sleep problems, and anxiety. The study, published in published in the journal Menopause, suggests many women are unprepared for the mental and physical toll.
The updates are in: On Feb. 12, the US Food and Drug Administration updated labels for six HRT products (systemic estrogen, combination, and progestogen therapies). It removed boxed warnings on cardiovascular disease, breast cancer and probable dementia risks.
Thawing a frozen shoulder: Medscape reports that radiologists are using something called “adhesive capsulitis embolization” – injecting tiny particles into the source of inflammation – as one of the new ways to treat this scourge of the menopausal woman. Time to update my two-part deep dive, which is still well worth a look. (Meanwhile my Sri Lankan physio says he can fix it with massage)
“Perimenopausal fasting insulin and BMI show complementary but distinct associations with menopausal changes.” Elevated insulin is associated with earlier and prolonged hot flashes and night seats, and higher testosterone levels, according to a study in The Journal of Clinical Endocrinology & Metabolism
Wearables | Tech | AI
Wellworthy reports: “@clair_health just unveiled what it calls the world’s first continuous hormone tracker for women. The noninvasive wearable interprets hormonal patterns using multiple physiological signals in real-time.” Clair claims to use sensors and AI to provide reliable continuous monitoring of estrogen, progesterone, LH and FSH – without blood or urine tests. There is a waiting list; it’s entering beta testing early 2026.
Wearable maker Oura Ring has teamed up with hormonal testing company Mira. From the press release: “With this integration, we’re connecting hormone data with daily health signals, giving women insights they can act on. Understanding these patterns can change how women manage fertility, navigate perimenopause, or address hormonal imbalances.” – Mira founder and CEO Sylvia Kang. Here is an example of one of their paid partnerships:
“Everybody was discouraging me. Doctors were discouraging me from going on hormones because my mom had breast cancer. So I went to a new doctor, and I thought for sure he’d be like, ‘no, no, no, no hormones.’ Instead, he said, ‘No, you have to be on bioidentical hormones, or by the time you’re 60, you will be on two different antidepressants, your hair will be falling out, your skin will be brittle and it’ll be too late to start them.’ I was like, ‘Give them to me now.’ It was life-changing.”
American reality start Lisa Rhinna to Women’s World
“face soojh jaata hai”
Aka facial swelling, part of what Shark Tank India judge and entrepreneur Namita Thapar has bee experiencing in perimenopause
Man who gets it
The Quiet Transition, a new Substack that is part of the new wave of “men who support women in menopause”, nails it in his response to our post about menopause, anger and marriage: “If women have to explain themselves it only adds to the emotional labor. Men need to have an active role in this transition. Education can stop them from relying on old skills, like ‘fixing things’. Their partner isn’t broken. No fixing required. It’s a big lesson the men I talk to say they had to learn.”
Quick hits
Amy B Killen writes about testosterone hormone therapy in 10 Testosterone Tricks You Probably Didn’t Know; no mention that primary source of estrogen post-menopause is aromatized testosterone. Also this section was kind of terrifying: Side Effects Take Months to Show Up - and Months to Go Away
Dr. Mary Claire Haver is joining Midi Health as Chief AgeWell Officer, heading up the integration of menopause care with advanced screening and prevention across metabolic, bone, brain and cardiovascular health.
Government-run menopause clinics are happening in Maharashtra, India
“If you feel well, you are probably well. If you don’t feel well, see a doctor – not your wrist.” Dr Ellie Cannon wants you to know your body is smarter than a wearable on LinkedIn
Kiran Singh from Midlife by Design nails what it’s like to come out of decades of living in survival mode in I’m regulated enough, to be honest
The Big M, an anthology of essays, pulls some big writers, including Cheryl Strayed and Lidia Yuknavitch
“What’s inaccurate about my experience?” Kim Anami, vaginal weightlifter and founder of an academy of sex-positive education, claps back at all the people who got offended by her “Why I don’t take HRT” IG post.
PS….
Is anyone as horrified as I am by Lisa Rhinna’s doctor?
Interested in cannabis medicine for women? There’s a free seminar Wednesday, February 18, 7pm ET. Featuring: CEO and co-founder of Goldstein Wellness, Dr. Bonni Goldstein, filmmakers Ricki Lake and Abby Epstein, and Lisa Williams, owner of women focused hemp brand Hello Again. Register here. And If you are in the US, use code hotflash15 to get 15% off Hello Again products.
I’m not sure this “I’m not hot” breathable clothing campaign really lands for me.
AMx
For a more nuanced look at the current landscape, what about an All Access Passto the Hotflash inc Summit? You get lifetime access to all 40 videos, as well as Hotflash inc Summit Book of Knowledge (top takeaways from all the interviews) and for just one more week, my guide to navigating all the gaps in hormone therapy information. What you don’t get? Fear. I made sure of it.
» If you order any of products listed in this email, Hotflash inc may receive a commission.
» Hotflash inc is for educational purposes only and not to be used or considered for medical advice.
I’m going to be very interested in your deep dive on the cancer risk and Dr Vikram Talaulikar’s position. Given the horrific impact the WHI paper caused (the reduction from ~ 40% of menopausal women being on HRT before WHI to ~ 5% today). It’s always good to have counterpoints to current thinking.