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World Menopause Day: What ACOG's New Guidance Says About Hormones and Herbal Supplements
- 18 October, 2026
- Dr. Eric Dohner
October 18 is World Menopause Day, and October is Menopause Awareness Month. This year the date lines up with real news, so I'll skip the greeting-card version.
Twenty years of mixed messages
In 2002, early results from the Women's Health Initiative study led a great many women, and their doctors, to stop hormone therapy almost overnight. Over the next two decades the advice went back and forth. Hormones were dangerous. Then they were fine for some women. Then it depended on your age, your timing, and who you asked.
If you also waited six weeks for an appointment and got eight minutes and a pamphlet, none of that back-and-forth helped.
What ACOG said this week
On October 15, the American College of Obstetricians and Gynecologists (ACOG) released expanded guidance on managing menopause symptoms. According to NPR, it's the first update to these guidelines since 2014.
The guidance covers hot flashes, night sweats, sleep trouble, and mood changes. For women without a medical reason to avoid it, ACOG says prescription hormone therapy "can be a great option, and in many cases the best option," ideally started before age 60 or within 10 years of menopause. They frame it as a decision a woman and her clinician make together.
That is a long way from 2002. Hormones aren't the villain they were made out to be.
What ACOG said about herbal supplements
ACOG also reviewed herbal supplements and phytoestrogens (plant estrogens) for hot flashes and found the evidence doesn't support them.
That covers a lot of shelf space: black cohosh, soy isoflavones, and the many "menopause support" blends built around them. If you tried products like these and noticed little difference, that is consistent with the research.
Where Midlife Cream fits
To be plain about it: ACOG's guidance is about prescription hormone therapy. It doesn't address Midlife Cream, and nothing here should be read as ACOG endorsing it.
Midlife Cream is a separate option. I formulated it as a physician for women who would rather not start a prescription, and would rather not book an appointment just to talk about one. It's a bioidentical cream.
Some women will want the prescription route, and that's a sensible choice backed by this week's guidance. Others want something different. Midlife Cream is for them.
One safety note
Bleeding after menopause isn't normal and should be checked by a doctor, as should any new or worrying symptom. If you're on a treatment your doctor prescribed, don't stop it without talking with them first.
If you're curious about Midlife Cream, start with the FAQ (how to use it, the full ingredient list, and who should not use it), read about Dr. Dohner, or see the Midlife Cream product page.
Dr. Dohner, Midlife Cream
This article is for general information only.
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