Two major medical organizations are reinforcing what menopause specialists have advocated for years. Here's why that's worth celebrating.
By Desirae Bloomquist, MSN, FNP-C, MSCP
New 2026 menopause guidelines are putting hormone therapy front and center. And for women navigating perimenopause and menopause, this is news worth celebrating!
Finally, some really good news for women’s health!
For far too long, women experiencing perimenopause and menopause have been told that their symptoms are simply part of getting older—that hot flashes, night sweats, poor sleep, and changes in how they feel are just something they have to live with.
Some women have been offered antidepressants without ever having a conversation about hormone therapy. Others have been told that estrogen is dangerous or that they aren't candidates for treatment, without a thorough evaluation of their individual health.
And many women have simply stopped asking for help.
But things are changing. And I'm excited to share why.
Two Major Medical Organizations Just Made Important Announcements
In October 2026, the American College of Physicians (ACP), one of the nation's leading medical organizations, released new clinical guidelines recommending menopausal hormone therapy (MHT) as the first-line medication treatment for hot flashes and night sweats in women who are appropriate candidates (Qaseem et al., 2026).
This is a big deal!
And later that month, the American College of Obstetricians and Gynecologists (ACOG) released updated menopause treatment guidelines of its own.
ACOG's recommendations support systemic hormone therapy for menopausal hot flashes and night sweats, as well as sleep disturbances caused by these symptoms, in women without contraindications (American College of Obstetricians & Gynecologists’ Committee on Clinical Practice Guidelines–Gynecology [ACOG Committee], 2026).
Think about that for a moment.
Two major medical organizations, whose recommendations influence the care women receive across the country, are reinforcing the importance of hormone therapy in menopause treatment.
And here's what makes this particularly exciting to me:
The science supporting hormone therapy isn't new. What's changing is that mainstream medicine is finally catching up.
We've Known Hormone Therapy Works for Years
If you've been following menopause research, you may be wondering why these announcements are such big news.
After all, haven't menopause specialists been recommending hormone therapy for years?
Yes! Absolutely.
The Menopause Society, an internationally recognized organization dedicated to menopause research and education, has long identified hormone therapy as the most effective treatment for menopausal hot flashes and night sweats.
In fact, its 2022 position statement concluded that for most healthy women younger than 60 or within 10 years of menopause onset, the benefits of hormone therapy for bothersome hot flashes and night sweats generally outweigh the risks when there are no contraindications (“The 2022 Hormone Therapy Position Statement of The North American Menopause Society” Advisory Panel [NAMS Advisory Panel], 2022).
And this isn't just happening in the United States.
The United Kingdom's National Institute for Health and Care Excellence (NICE) recommends offering hormone replacement therapy for menopause-related hot flashes and night sweats (National Institute for Health and Care Excellence [NICE], 2026).
So what does all of this mean?
We aren't witnessing the discovery of a new treatment. We're witnessing broader recognition of a treatment that has been supported by scientific evidence for years.
And hopefully, that recognition will translate into better care for women everywhere.
How Did We Get So Far Behind?
To understand why these new guidelines matter, we need to go back a little.
In 2002, findings from the Women's Health Initiative (WHI), a large study investigating hormone therapy and women's health, made headlines around the world.
The public message was frightening. The combined estrogen–progestin trial found increased risks of breast cancer, coronary heart disease, and stroke with the regimen studied (Writing Group for the Women’s Health Initiative Investigators, 2002).
Almost overnight, women stopped taking their hormones, prescriptions declined dramatically, and an entire generation of healthcare providers became hesitant to prescribe estrogen.
But the story was much more complicated than those headlines suggested.
The WHI studied specific hormone formulations, oral conjugated equine estrogens, with or without medroxyprogesterone acetate. Many participants were older than the women who typically seek treatment when menopausal symptoms first begin.
Over the following decades, researchers continued examining the results, including how age, timing of treatment, hormone formulation, and individual health factors influence benefits and risks.
We now have a much more nuanced understanding of hormone therapy.
For example, starting treatment closer to menopause is generally associated with a more favorable benefit-risk profile than beginning many years later. Different formulations and routes of administration also have different risk profiles (NAMS Advisory Panel, 2022).
Does that mean hormone therapy is risk-free? Of course not. But it does mean that the blanket message that estrogen is dangerous for all women is simply not supported by the evidence.
Unfortunately, the fear surrounding hormone therapy has been much harder to undo than it was to create.
And women have been living with the consequences.
Menopause Symptoms Are Not Something You Just Have to Endure
I want to talk about something that often gets overlooked when we discuss menopause treatment.
It's not just about hot flashes.
It's about the woman who wakes up at 2 a.m., drenched in sweat, and can't fall back asleep.
It's about the woman who has always been sharp, organized, and confident but suddenly feels exhausted and unlike herself.
It's about trying to manage a career, relationships, children, aging parents, and everything else life demands, while your body seems to be changing in ways you don't fully understand.
And it's about being told that what you're experiencing is normal.
Here's the thing: Something can be common without being something you should have to suffer through.
Hot flashes and night sweats can significantly disrupt sleep, daily functioning, and quality of life. Vasomotor symptoms and sleep disturbances are also associated with a greater risk of depressive symptoms during the menopause transition. Hormone therapy can effectively treat hot flashes and night sweats, including related sleep disturbances, but it is not an established treatment for depression (ACOG Committee, 2026).
Systemic hormone therapy also helps prevent bone loss and reduces fracture risk (NAMS Advisory Panel, 2022).
But I want to be clear about something. Not every symptom that develops during midlife is caused by declining estrogen, and hormone therapy isn't a cure for everything.
Sleep disturbances, mood changes, fatigue, and cognitive concerns deserve thoughtful evaluation. Sometimes hormones are part of the answer. Sometimes other medical conditions, life circumstances, or treatments need to be considered.
Good menopause care isn't about prescribing hormones to every woman. It's about understanding what's happening and finding the right treatment for her.
References & Further Reading
American College of Obstetricians & Gynecologists’ Committee on Clinical Practice Guidelines–Gynecology. (2026). ACOG clinical practice guideline: Management of menopause-related vasomotor, sleep, and mood symptoms. Obstetrics & Gynecology, 148(5), e345–e369. https://doi.org/10.1097/AOG.0000000000006428
National Institute for Health and Care Excellence. (2026). Menopause: Identification and management (NICE Guideline No. NG23). https://www.nice.org.uk/guidance/ng23
Qaseem, A., Mackey, K., Yost, J., Shekelle, P. G., Shamliyan, T. A., Cross, J. T., Jr., & Clinical Guidelines Committee of the American College of Physicians. (2026). Pharmacologic treatments for females with menopausal vasomotor symptoms: A clinical guideline from the American College of Physicians. Annals of Internal Medicine. Advance online publication. https://doi.org/10.7326/ANNALS-26-01205
“The 2022 Hormone Therapy Position Statement of The North American Menopause Society” Advisory Panel. (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794. https://doi.org/10.1097/GME.0000000000002028
Writing Group for the Women’s Health Initiative Investigators. (2002). Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women’s Health Initiative randomized controlled trial. JAMA, 288(3), 321–333. https://doi.org/10.1001/jama.288.3.321
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