The evidence

Research & Updates

Plain-language summaries of published studies and official updates on menopause, plant-based and natural approaches, and skin. Each entry links to the original source. Evidence is reported as it is, including mixed or negative results.

These summaries are for education only and are not medical advice or a recommendation for any treatment. Talk with your doctor about what's right for you. Herbal and dietary supplements can interact with medicines.

Menopause updates

FDA approves the first labeling changes to menopausal hormone therapy products

U.S. Food and Drug Administration · February 12, 2026

FDA approved updated labels for the first six hormone therapy products under the November 2025 request, covering combination, estrogen-alone, progestogen and vaginal estrogen products. FDA said 29 companies had submitted proposed changes. Whether hormone therapy is right for a person is still an individual decision made with a clinician.

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FDA asks makers to remove broad boxed warnings from menopausal hormone therapy labels

U.S. Food and Drug Administration · November 10, 2025

FDA asked companies to remove language about cardiovascular disease, breast cancer and probable dementia from the boxed warning on hormone therapy products, while keeping the endometrial cancer boxed warning for systemic estrogen-alone products. Labels will add that starting systemic therapy can be considered for moderate to severe hot flashes in women under 60 or within 10 years of menopause. Risk information still appears elsewhere in the labeling.

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FDA approves elinzanetant (Lynkuet) for menopausal hot flashes

U.S. Food and Drug Administration (Drug Trials Snapshot) · October 24, 2025

Elinzanetant, a second nonhormonal option that acts on neurokinin 1 and 3 receptors, was approved for moderate to severe hot flashes due to menopause. FDA's snapshot summarizes who was in the trials and the side effects seen. It is prescription-only.

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FDA adds a boxed warning about rare liver injury with Veozah (fezolinetant)

U.S. Food and Drug Administration · December 16, 2024

After a post-marketing report of liver injury, FDA first added a warning in September 2024 and then a boxed warning in December 2024. Liver blood tests are recommended before starting and at set points during treatment, and patients should stop the drug and call their prescriber if signs of liver problems appear.

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Elinzanetant in the OASIS 1 and 2 randomized trials

JAMA, via PubMed · August 22, 2024

Two 26-week placebo-controlled trials found elinzanetant reduced hot flash frequency and severity and improved sleep disturbance and menopause-related quality of life. The trials were funded by the manufacturer.

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The Women's Health Initiative randomized trials and clinical practice: a review

JAMA, via PubMed · May 28, 2024

WHI investigators reviewed about 20 years of follow-up from the large hormone therapy trials. They support hormone therapy for managing bothersome symptoms in early menopause but not for preventing chronic disease, and they note risks differ by age, time since menopause and type of therapy.

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The 2023 nonhormone therapy position statement of The North American Menopause Society

Menopause (journal), via PubMed · June 1, 2023

This statement rates nonhormonal options for hot flashes. It recommends cognitive behavioral therapy, clinical hypnosis, certain prescription drugs and some procedures, and it does not recommend many supplements and herbal remedies, including soy foods and extracts and black cohosh, because the evidence was not strong enough.

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FDA approves fezolinetant (Veozah), a nonhormonal drug for hot flashes

U.S. Food and Drug Administration · May 12, 2023

FDA approved fezolinetant, a neurokinin 3 receptor antagonist that works on the brain's temperature-control pathway, for moderate to severe hot flashes from menopause. It was the first drug of its kind. It is a prescription medicine and requires liver blood tests.

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Fezolinetant for hot flashes: the SKYLIGHT 1 phase 3 trial

The Lancet, via PubMed · April 1, 2023

In this randomized, placebo-controlled trial, fezolinetant reduced the frequency and severity of moderate to severe hot flashes over 12 weeks compared with placebo, with a 40-week extension. The authors called for more research on quality of life, mood and sexual wellbeing.

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The 2022 hormone therapy position statement of The North American Menopause Society

Menopause (journal), via PubMed · July 1, 2022

The society (now The Menopause Society) reviewed the evidence and concluded that for healthy women under 60 or within 10 years of menopause without contraindications, the benefits of hormone therapy for bothersome hot flashes and bone loss generally outweigh the risks. It stresses individualized decisions about type, dose, route and duration.

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Natural & plant-based approaches

Soy: usefulness and safety

National Center for Complementary and Integrative Health (NIH) · Reviewed periodically

NCCIH summarizes research on soy for menopausal symptoms and bone health and notes results are mixed. Soy foods are considered safe as part of a normal diet. The page also covers what is known about longer-term isoflavone supplement use.

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Black cohosh: usefulness and safety

National Center for Complementary and Integrative Health (NIH) · Reviewed periodically

NCCIH reports that studies of black cohosh for hot flashes have mixed results. It notes rare reports of liver problems in people taking it and advises talking with a health care provider before use, especially with liver disease.

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Menopausal symptoms: in depth

National Center for Complementary and Integrative Health (NIH) · Reviewed periodically

This overview covers mind and body practices, dietary supplements and other complementary approaches for menopausal symptoms, and what the research does and does not show for each. It reminds readers that 'natural' does not always mean safe and that supplements can interact with medicines.

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A low-fat vegan diet with whole soybeans and hot flashes (WAVS trial)

Menopause (journal), via PubMed · July 12, 2021

In a small 12-week randomized trial of postmenopausal women, a low-fat vegan diet plus half a cup of cooked soybeans daily was associated with fewer and less severe hot flashes than the control group. The study was small and not blinded, so larger trials are needed.

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Black cohosh for menopausal symptoms (Cochrane review)

Cochrane Database of Systematic Reviews, via PubMed · September 12, 2012

This review of 16 trials found insufficient evidence that black cohosh relieves menopausal symptoms, and many trials were poorly reported. The authors said more good-quality research was justified.

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Soy isoflavone supplements and hot flashes: systematic review and meta-analysis

Menopause (journal), via PubMed · July 1, 2012

Pooling randomized trials, the authors found soy isoflavone supplements reduced hot flash frequency and severity more than placebo, with higher-genistein products appearing stronger. Results varied a lot between studies. The Menopause Society's 2023 statement still did not recommend soy for hot flashes.

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Skin in menopause

Perimenopause and menopause: estrogen-deficient skin and quality of life

Dermatology and Therapy, via PubMed · November 3, 2026

This new review looks at how estrogen loss during perimenopause and menopause shows up in the skin and how those changes can affect quality of life. It is a review of existing literature, not a new clinical trial.

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Overview of aging, skin health, estrogen, menopause and HRT

Life (Basel), via PubMed · March 2, 2026

This narrative review describes how falling estrogen affects collagen, skin thickness, hydration and wound healing. It discusses hormone therapy as a possible option while stressing that risks and benefits must be reviewed individually with a medical professional.

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Menopausal hormone therapy and skin: systematic review and meta-analysis

Journal of Menopausal Medicine, via PubMed · December 1, 2023

Pooling available trials, the authors found hormone therapy was linked with higher skin elasticity, thickness and collagen content, with no significant effect on dryness. They said more well-conducted trials are needed. Hormone therapy is not approved specifically for skin.

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Last updated November 4, 2026.

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