Hormone Replacement News – FDA update

Recent news from the U.S. Food and Drug Administration is shaking up decades of thinking about menopause hormone therapy. For years, women were warned about the risks of hormone replacement therapy (HRT) following the 2002 Women’s Health Initiative study. Now, the FDA has moved to remove long-standing “black box” warnings from many menopause hormone therapies, signaling that the risk profile is far lower than previously believed. It no longer includes a warning about increased risks of breast cancer, heart disease, or dementia.

This change is significant. It reflects more current research showing that when we use the right form of hormone replacement therapy in the right women, it can be done safely both short and long term. As a naturopathic physician who has worked extensively with perimenopausal and menopausal women for almost thirty years, I regularly review the research to make sure that women receive sensible, science-based advice. I also help women navigate their healthcare at this sometimes tumultuous time with a personalized approach that often combines lifestyle, natural medicine, and, when appropriate, bioidentical hormones. My goal is not just to relieve hot flashes or night sweats, but to support overall health including sleep, mood, heart, bone, brain, sexual and metabolic health.

For women who choose not to use hormones, non-hormonal options are more effective than ever. Several new pharmaceutical medications target hot flashes and night sweats without hormones, and many women also benefit from herbal medicine, nutritional supplements, and lifestyle strategies that improve symptoms with minimal side effects. Lifestyle interventions including regular exercise, stress reduction techniques, and mindful nutrition can significantly reduce vasomotor symptoms and improve energy and mood. The science behind herbal medicine for a variety of menopausal symptoms is quite impressive and, in my experience, herbs can help create much needed balance at this time.

Beyond symptom relief, menopause is a time to prioritize prevention and long-term wellness. Strategies to reduce inflammation and blood sugar while increasing anti-oxidants and improving mitochondrial function are critical for helping to prevent disease and promote health as we age. Specifically, menopause is a turning point for cardiovascular and bone health. Weight-bearing exercise, a Mediterranean-style diet rich in vegetables and healthy fats, and targeted supplements can help reduce the risk of osteoporosis and heart disease. Mind-body practices like yoga, meditation, and breathing techniques help manage stress, improve sleep, and support mental clarity.

What this FDA update highlights is a larger truth: menopause care is highly individual. Some women may benefit from bioidentical hormone replacement, while others thrive with a non-hormonal, natural medicine and lifestyle-focused approach. The key is guidance from a knowledgeable physician who can evaluate your health history, monitor labs, and create a comprehensive plan.

For women navigating this transition, the message is empowering. Menopause does not have to mean enduring discomfort or compromising long-term health. With personalized care combining safe medical options, lifestyle strategies, and natural supports, women can maintain vitality, balance, and wellbeing well into their later years. To learn more about bioidentical hormones check out www.getwellhere.com/bioidentical-hormones-research-update/. To contact the office of Courtenay naturopathic physician, Dr. Deidre Macdonald: 250 897-0235 or www.getwellhere.com

Longevity Supplements

Every generation gets its own set of anti-aging supplements. Some fade quickly. Others earn a closer look because they are grounded in real human biology rather than marketing hype. In recent years, supplements aimed at longevity have gained attention, particularly among adults over 50 who want to preserve energy, strength, and cognitive function. The challenge is knowing which ones deserve thoughtful consideration.

One compound attracting legitimate scientific interest is NAD, or nicotinamide adenine dinucleotide. NAD is not a trendy invention. It is a molecule found in every living cell. It plays a central role in converting food into energy inside mitochondria and is required for DNA repair and cellular stress responses. Research shows that NAD levels decline with age, which may help explain why stamina, recovery, and resilience to disease often diminish over time.

Because NAD itself is poorly absorbed when taken orally, supplements such as NMN, nicotinamide mononucleotide, and NR, nicotinamide riboside, are used as precursors. Animal studies have consistently shown benefits related to metabolic health and mitochondrial function. Human research is still evolving, but clinical trials demonstrate that NMN and NR can safely raise NAD levels and may improve markers of insulin sensitivity, muscle metabolism, and fatigue. Claims of dramatic life extension, however, remain unproven.

Another supplement with strong evidence, though often overlooked, is creatine. Commonly associated with athletics, creatine has been shown in adults over 50 to support muscle strength, reduce age-related muscle loss, and even improve cognitive performance during periods of stress. Unlike many longevity supplements, creatine has decades of human data supporting both its effectiveness and safety.

Omega-3 fatty acids also deserve mention. While not marketed as longevity supplements, omega-3s reduce inflammation, support cardiovascular health, and may help slow cognitive decline. Large population studies consistently associate higher omega-3 intake with reduced cardiovascular risk, still the leading cause of death in older adults.

Not all popular longevity supplements hold up equally well. High-dose antioxidant vitamins (vitamin E, beta-carotene) were once promoted to prevent aging and chronic disease by “neutralizing free radicals.” Large human trials later showed that high-dose supplementation did not reduce mortality and in some cases increased risk, particularly in smokers. The emerging understanding is that some oxidative stress is necessary for cellular adaptation and repair, especially in response to exercise. This gap between theory and real-world benefit is common and highlights why evidence matters.

As a naturopathic physician, my role in healthy aging is not to chase supplement trends, but to help patients understand how these tools fit into the bigger picture. In clinical practice, this includes using detailed blood work to assess and monitor factors that strongly influence aging, such as thyroid function, insulin sensitivity, inflammation, lipid patterns, and nutrient status, alongside standard medical testing. Supplements are chosen thoughtfully and adjusted based on symptoms, objective markers, personal and family medical history.

For adults over 50, the most sensible approach is informed curiosity paired with individualized guidance. Supplements, including NAD precursors, creatine, and omega-3s, may support the biology of healthy aging when used appropriately and alongside strong lifestyle habits.

Aging well is less about finding a miracle pill and more about supporting the body’s capacity to repair, adapt, and function over time. When supplements are used thoughtfully, they can play a useful role, but they work best when grounded in science and personalized care.

Dr. Deidre Macdonald is a naturopathic physician practicing in downtown Courtenay. www.getwellhere.com 250 897-0235