The Brief

Women should not suffer through menopause with hot flashes, night sweats and poor sleep. That's the message from FDA Commissioner Dr. Marty Makary.

The agency announced it will remove "black box" warning labels from estrogen-based hormone therapy, which treat the symptoms of menopause, saying the warnings have made women scared to try the therapy and doctors reluctant to prescribe it.

The warnings stem from the early 2000s when data from the Women's Health Initiative study found hormone therapy increased risks of heart attacks, strokes, blood clots and breast cancer.

But, women in that study were given a type of hormone therapy formulation that is no longer commonly used. And the average age of women in the study was 63, which is now considered too late to start hormone therapy.

Now, experts say there's a lot more known about safe and effective combinations, when therapy is initiated earlier.

"If you're under age 60 or within ten years of menopause onset, when you start hormone therapy, you're going to see improvements in hot flashes, sweats, fewer sleep disruptions, " says Dr. JoAnn Pinkerton, a menopause expert at the University of Virginia Health.

She also points to protection against bone loss and fractures, as well as potential benefits for heart health, brain fog and overall quality of life.

"When it's dosed appropriately, hormone therapy can be given safely and have multiple benefits," she says.

But here's an important reality check: "Not all women can take hormone therapy," Pinkerton says. She says some women have medical conditions or symptoms that can make hormone therapy risky.

"It's really important that women have a discussion with an informed health care provider because you want to know what are the benefits and risks for you," Pinkerton says.

So, here are some things to consider when talking to your healthcare provider about hormone therapy for menopause.

1. When should you start hormone therapy?

Experts recommend starting estrogen therapy before the age of 60 or within ten years of the start of menopause — which begins one year after your last period. Many women remain on birth control through perimenopause, which can help with hot flashes and night sweats as hormones fluctuate.

Once you're through the menopause transition and you don't need pregnancy prevention, then it doesn't make as much sense to use birth control, Pinkerton says, because it's typically stronger than the amount of estrogen used in menopause hormone therapy, so that's a good time to talk to your provider about hormone therapy options.

2. How long should you be on hormone therapy?

In general, women stay on hormone therapy for three to five years, but that's not a hard and fast rule.

"For women who have persistent symptoms or bone loss — which can be treated with hormone therapy — we will continue it," Pinkerton says. But, it's important to keep assessing each year. "It's about working with the patient to come up with what's safest and best," Pinkerton says.

"We don't take someone off [hormone therapy] just because it's been three to five years, " says Lauren Streicher of Northwestern University. She points to differences in how long menopause symptoms persist, noting that Black and Hispanic women tend to experience symptoms for longer  time periods.

3. How has hormone therapy changed?

Science has evolved over the last 20 years, since the results of the Women's Health Initiative came out. And, importantly, there's been a shift in how estrogen is administered, as well as new formulations of hormones. For instance, many women are now prescribed patches instead of pills.

"We know that oral therapy can slightly increase the risk of blood clots and stroke," Pinkerton says, so providers often opt for transdermal therapy for women at risk of these conditions. Transdermal patches, gels or rings deliver estrogen that is absorbed directly through the skin which research shows can lower the risk of blood clots.

Also, women enrolled in the WHI study were given synthetic progestin which was linked to an increased breast cancer risk. But, now doctors can prescribe  micronized progesterone that has fewer side effects. Micronized progesterone is a bioidentical hormone with a molecular structure identical to the estrogen produced in the ovaries.

4. Do all estrogen products carry the same risks?

No. Local estrogen, such as low-dose vaginal creams, target symptoms such as vaginal dryness, painful sex, bladder control and reduced risk of urinary tract infections. This is different from systemic estrogen, delivered through pills, patches or gels. Systemic estrogen is a higher-dose treatment that circulates throughout the body to address symptoms including hot flashes and night sweats, and can carry a higher risk of side effects.

"I think most would agree that with local, low-dose vaginal estrogen therapy that the risks are negligible," says Dr. Monica Christmas, director of the Menopause Program at the University of Chicago. "For local, vaginal estrogen, it's reasonable to remove the black box warning. I don't think we need to scare people unnecessarily," Christmas says.

However, for higher dose, systemic estrogen therapy — which is absorbed into the blood stream — including estrogen pills, Christmas and other menopause experts are more equivocal about removing the black box warning.

"It provides a pause," Christmas says, and prompts patients to discuss the risks with their providers."

5. Who should avoid hormone therapy? 

Some women have medical conditions that can make hormone therapy more risky. This includes women with estrogen sensitive breast or uterine cancer, and women who are at high risk for or have had a heart attack, stroke, blood clot, or pulmonary embolism.

"It's really important that women have a discussion with an informed health care provider because you want to know what are the benefits and risks for you," Pinkerton says

6. Are there alternatives for women who don't want to take hormone therapy?

The Food and Drug Administration has approved two non-hormonal medications to treat severe hot flashes in menopause. According to the FDA, about 80% of menopausal women experience hot flashes which can include sweating, flushing and chills that last for several minutes.

Lynkuet, which was approved last month, and Veozah, which was approved in 2023, are both oral medications that work by targeting the neural activity that causes hot flashes during menopause. Lynkuet has been shown to reduce the severity and frequencies of hot flashes.

The National Institutes of Health has tips for managing symptoms, including limiting alcohol and caffeine, and maintaining a healthy body weight. And early-stage research shows hypnotherapy and mindfulness meditation may help manage hot flashes.

Some people find herbal remedies helpful.  A study of medicinal plants including sage, lemon balm, red clover and licorice finds they may be effective in the treatment of menopausal symptoms like hot flashes.

Copyright 2025 NPR

In his final year in office, Gov. Gavin Newsom plans to go after large investors buying and owning California housing — in the same week that President Donald Trump also took rhetorical aim at Big Landlord.

It’s an unlikely meeting of the minds of two political foes who, in a race to head off the electorate's concerns about affordability, have landed upon the same populist message: Blame Wall Street.

Newsom plans to say during his State of the State address to lawmakers on Thursday that he wants to work with them to regulate the practice of investors buying up large stocks of housing to rent out, forcing California residents to compete with them to afford buying a home, according to the governor’s office.

Proposals could include “enhanced state oversight and enforcement and potential changes to the state tax code,” according to the governor’s office.

“When housing is treated primarily as a corporate investment strategy, Californians feel the impact,” a source in the office said. “Prices go up, rents rise, and fewer people have a chance to buy a home.”

That sounds similar to a proposal Trump made on his social media platform Truth Social on Wednesday. The two previously closely aligned on policy related to clearing of homeless encampments.

“I am immediately taking steps to ban large institutional investors from buying more single-family homes,” the president wrote, sending stock prices of major publicly traded residential investment firms plummeting. He urged Congress to put the proposal into law and promised to unveil additional housing policy proposals at the World Economic Forum summit in Davos, Switzerland later this month.

Newsom is stopping short of calling for an outright ban on institutional investors’ ownership, though the source said he will seek to “curb” it with the goal of making home ownership more affordable for California residents.

He hasn’t yet proposed anything concrete. Whatever Newsom seeks to do, he’ll need the approval of the state Legislature.

Trump, for his part, did not offer any details about his proposal, such as how institutional investors would be defined under the proposed law or why he targeted single-family homes in particular. The White House’s press office did not respond to an email with those questions.

The twin announcements come after years of long-shot efforts by California progressives to address a surge in companies buying up single-family housing stock in the wake of the Great Recession. The issue has been the subject of renewed anxiety in post-fire Los Angeles, where a recent report by RedFin showed investors (loosely defined as any buyer with a name that includes “LLC,” “Inc” or “Corp”) have purchased 27 of 61 burned vacant lots that sold in Altadena — more than 40%.

Asked about that report in an interview on MS Now this week, Newsom said he had signed an executive order last year seeking to protect homeowners who find it too expensive to rebuild from falling for “predatory” lowball offers for their properties. But he acknowledged “the broader market conditions are challenging.”

The proposals mark new territory for Newsom’s housing affordability platform. The governor, now in his final year in office, has spent most of the past seven years focused on boosting construction. It’s a pivot toward populism for the governor, who is widely expected to run for president in 2028.

Blaming deep-pocketed investors for the nation’s housing woes has become an increasingly ideological-spanning exercise in recent years, with politicians as diverse as New York Rep. Alexandria Ocasio-Cortez and Vice President J.D. Vance championing the cause.

Shortly after Trump’s post, Republican Sen. Bernie Moreno of Ohio, an enthusiastic supporter of the president, promised to introduce legislation in his own post on X.

Is this actually a problem in California?

Many housing industry professionals, economists and policy researchers are skeptical.

“It’s really hard to buy a house right now so people are looking for someone to blame for that, but I think (institutional investors) are more of a symptom of the affordability crisis than they are a perpetuator of it,” said Caitlin Gorback, a University of Texas at Austin economist who has studied investors’ effect on local real estate markets.

Research on the topic is mixed, though most analyses have found that by taking owner-occupied homes and converting them into rentals, these companies tend to increase the supply of rentals. That puts downward pressure on rents, while taking away purchasable homes, leading to higher prices.

Fewer than 3% of all single-family homes in the state are owned by companies that own at least 10 properties.That also takes away opportunities for would-be homeowners to buy a coveted single-family home. But even that comes with an under-appreciated upside, said Gorback: They provide more priced-out renters the opportunity to live in single-family homes — typically in wealthier, whiter and higher-resourced neighborhoods — something historically reserved for those who can afford to buy.

While apartment buildings are commonly owned and managed by large financial companies, single-family rentals weren’t seen as Wall Street-worthy money-making opportunities until the aftermath of the Great Recession. Since then, companies like Invitation Homes, Blackstone, Progress Residential and AMH Homes have typically focused on markets with relatively low prices and rapidly growing populations.

That doesn’t describe California. As a result, larger investors — however defined — make up a relatively small share of single-family landlords in the state. Fewer than 3% of all single-family homes in the state are owned by companies that own at least 10 properties, according to an analysis by the California Research Bureau, which conducts research for state lawmakers. A mere 20,066 are owned by firms with portfolios of 1,000 units or more. The largest of those owners is Invitation Homes, which owns over 11,000 homes in the state and reached a settlement with Attorney General Rob Bonta’s office last year over allegations it price-gouged tenants and illegally raised rents on more than 1,900 properties.

There are more than 16 million rental units across the state, according to Census data.

Though attacking big monied investors for the high cost of housing is a “huge distraction,” it has obvious political appeal, said Stan Oklobdzija, a UC Riverside public policy professor. “Attacking institutional investors is the latest iteration of appearing to do something without actually doing anything. …It's just kind of archetypical cheap talk.”

For nearly a decade, Democrats in the state Legislature have proposed bills to track or ban the practice. Former Gov. Jerry Brown in 2018 vetoed a bill to create a registry of institutional investors that own 100 or more single-family homes, noting that “collecting the data would not stop the purchase of these homes by private investors.”

In 2024, lawmakers proposed banning investors that own at least 1,000 single-family homes from buying more houses and renting them out, prohibiting institutional investors from buying single-family homes for any reason and banning developers from selling entire new single-family subdivisions to investors to rent. All three bills died in committees.

Assemblymember Alex Lee, author of the first proposal, revived the bill last year. It passed the Assembly and awaits a hearing in a Senate committee.

Lee, a Democratic Socialist who has long critiqued the role of big money in the state's real estate market, said he was "flabbergasted" to find himself on the same page with Trump, whom he described as a "far-right fascist." Though he expressed doubts that the Trump administration would follow through with the promises the president made in his social media post, he said that "Democrats need to wake up to this populist, but righteous, position."

"We can’t let the far-right capture the housing positions that the people care about," Lee said.

Newsom evidently agrees.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

Once upon a time, we lived in a world where the “cool” kids were the ones up drinking until 5 a.m., weekend warriors who relished the pursuit of pleasure no matter the unsavory cost.

In today’s post-COVID world, however, things have gotten a little topsy-turvy. Nowadays, the cool kids are in bed by 9 p.m. so they can be up at 5 a.m., in time to slam down a shot of matcha and head to a day rave where all the attendees are — believe it or not — shockingly, sober.

The thing is, to the undiscerning eye, the crowd at a Daybreaker rave looks exactly the same as its typically drug-fueled nighttime counterpart: buoyant, animated and so very alive with its sea of thrashing bodies, quivering booties and smiling faces.

It’s a testament to a new paradigm shift, one in which adults are increasingly turning away from the hard stuff in favor of celebrating without alcohol. Nurtured by the desire for vitality, the small flame of “Dry January” has taken shape into something much greater — a whole new world of non-alcoholic gatherings.

From coffee raves to tea speakeasies and beyond, the world of adult beverages as we know it is rapidly changing. Whether you’re a social butterfly looking for a new scene or a homebody hoping to finally venture off the couch, we’ve featured three of our favorite non-alcoholic gatherings in L.A. Check ‘em out below in all their glory.

Bar Nuda (pop up locations)

Founded by Morris Ellis, a creative director and branding expert, and Pablo Murillo, a storyteller and entrepreneur, Bar Nuda is a pop up “bar” experience designed for those in mind who want to indulge in the social aspects of the barfly life without any of the lingering regrets the next morning.

“We've been on a mission to redefine a night out,” says Murillo, smiling as he places a drink in front of me. “Our slogan is ‘Drinks to Remember’, because we want you to go out and celebrate life.”

Bar Nuda helps you indulge in the social aspects of the barfly life without any of the lingering regrets

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It’s a mission that’s more personal than professional — Murillo’s experience of losing his father to alcohol-related illness inspired him to redefine the narrative of what a night out could look like. His goal was a surprisingly simple concept: to create a warm, welcoming community where people could mingle without the standard social lubricant of booze.

“We wanted to really hold space for people like myself, you know?” Murillo continues. “When we started Bar Nuda, I was not sober, but I am now. Bar Nuda got me sober. We wanted to change the narrative for my family, but also be there for others to do the same and to say, hey, look, you can go out and have a really good time without drinking booze.”

Bar Nuda's slogan is “Drinks to Remember"

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Bar Nuda partners up with local bars, neighborhood coffee shops and other venues around Los Angeles to create unique non-alcoholic based events for patrons; check out their Instagram for the details. Trivia Night, for instance, is a regular staple in their event roster, with most events starting at 7 or 8 p.m. Other events include benefit concerts (to raise money for CHIRLA, The Coalition for Humane Immigrant Rights), Alcohol Free Game Night and even courses dedicated to making your own non-alcoholic based drinks.

“We do a ton of work with hospitality groups, venues and music festivals who are looking to build out their non-alcoholic programs,” says Brianda Gonzalez, founder of the non-alcoholic shop The New Bar, who partners with Bar Nuda. “Consumers are increasingly looking for other options when they go out and don't want to drink quite as much.”

Ellis and Murillo are certainly doing something right: to walk into one of their events is to feel like you’re, well, inside of a bar, filled with the sounds of warm laughter, buzzing conversations and the inevitable chaotic din of the trivia crowd. Drinks are prepared with a level of craftsmanship that might have you second guessing as to whether or not you’re drinking alcohol. The menu rotates seasonally, with many of the drink ingredients sourced directly from Mexico. The house favorite is the “Rosa Nuda”, made with tantalizingly tangy, fresh bougainvillea sourced by Bar Nuda’s Beverage Director Bryant J. Orozco.

As the guests at the bar form a small crowd, giggling about events to come, I take a sip of the Rosa Nuda before a huge smile spreads across my face.

The bartender laughs at me, pleased.

“Not bad, eh?”

Grab tickets here.

Daybreaker (rotating locations)

A recent Daybreaker event in Venice giving good vibes

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The first time I attended a Daybreaker event was in Portland several years ago. I attended because friends of mine had told me there was a new, sober day rave spreading across town, and I simply didn’t believe them.

How very wrong I was. It may have been 9 a.m., but this crowd seemed just as rowdy, if not rowdier, than its nighttime counterpart. The only difference between the two was this crowd seemed decked out in yoga pants rather than rave gear.

Bubbling with energy at Daybreaker Venice

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Bailey Templeton

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“I wanted to have fun while still being able to function,” said Nemo, a DJ I met there. “At some point my body was not able to handle the disrupted sleep cycles and booze anymore, but I still wanted to be able to go to events and enjoy myself.”

To my great surprise, I discovered raving sober had its own unique appeal. The lack of alcohol kept me light and energetic rather than clouded in a drunken haze. I was able to dance for much longer than usual, and felt a familiar euphoric high similar to a runner’s high the longer I danced.

Daybreaker throws day raves in a number of different cities: Los Angeles, Seattle, Atlanta, New York. The next event in L.A. is Saturday Jan. 24 from 9 a.m. - 12 noon, to be held in a secret venue. Given it’s described as “dry January, wet with endorphins”, there’s a good chance it’s in a sauna, where Daybreaker is known to throw dance parties.

Celebrating life at 9am in Venice

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“We’re living in a cultural moment where people are craving clarity, connection, and control over their wellbeing — and ultimately belonging,” says Daybreaker founder Radha Agrawal.

“Post-pandemic, there’s been a mass re-evaluation of what we put into our bodies and how we spend our time. Gen Z in particular is leading the charge — they’re drinking nearly 30% less than millennials did at their age — and they’re looking for ways to connect without sacrificing health or mental clarity," he says.

"People want to wake up feeling good, not hungover, and they’re realizing that social connection can actually feel better without alcohol.”

Snag tickets here.

Bu Tea Den (DTLA)

In true speakeasy style, I reached Bu Tea Den through an inconspicuous metal door in a back alley downtown. Once inside, however, the vibe quickly shifted. A curious video was projected onto a wall by the entrance, lit up by colorful, digital Paisley shapes swimming about. Each Paisley had a customer’s name plastered above it, giving the surreal sensation that I was watching some sort of digital city like a god from up above on high. ‘PAISLEY ID’ read across the top of the screen.

Nearby, what I initially thought was an ATM was actually marked "AFTM: automated fortune telling machine". Patrons can take a quiz and receive a spiritual fortune of sorts, printed out neatly onto a slip of paper like an ATM receipt, along with a corresponding Paisley.

(According to the machine, my life path number is seven, my soul age is baby, and my chakral focus is sacral. "Trust what steadies you, even if it changes tomorrow.")

Writer Janelle Lassalle experiencing Bu Tu Den's AFTM — an automated fortune telling machine

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Inspired by time spent in the Burning Man community, co-founders Severin Sauliere and Natalie Tran created the art installation to help inspire a sense of community at Bu Tea Den.

Sauliere and Tran are husband and wife: Sauliere is an artist/Creative Director, and Tran is Chief Steeping Officer in charge of tea operations. Their goal is to redefine happy hour by giving guests the opportunity to slow down and get social without the thundering din of techno music and flashy cocktails.

"It's not an upsell kind of thing," said Sauliere. "It's based on you chilling with your friends, having some tea together and talking. I'm not against alcohol, but it's everywhere. Having a space that doesn't have it challenges the dynamic a little bit."

Co-founder Natalie Tran, at Bu Tea Den “part tea lounge, part interactive art installation, and part intimate gathering space.”

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The space is cultivated in the style of a tea lounge, with a number of booths scattered about facing the Paisley display. Guests can enjoy a unique tea experience at the bar in which they’re served several rounds of tea blends, along with snacks like Ube popcorn, Fridays - Sundays 5 - 9 p.m.

Billed as “part tea lounge, part interactive art installation, and part intimate gathering space,” Bu Tea Den isn’t just a place where you can come to enjoy a strong cup of jasmine tea: it’s also gearing up to become a community-oriented event space. Guests can come by for regular events like Mahjong at the Den, a Hong Kong style version of the popular game, or an upcoming "Tea and Tease" burlesque and comedy night on Saturday Jan. 17.

Get in on the fun here.

Homeownership has become increasingly out of reach for many young families, especially in pricey California. On Wednesday, President Donald Trump said he plans to make housing affordable again by cutting deep-pocketed investors out of the single-family home market.

“I am immediately taking steps to ban large, institutional investors from buying more single-family homes, and I will be calling on Congress to codify it,” Trump said on the social media platform Truth Social. “People live in homes, not corporations.”

But in California, housing policy experts say Trump’s strategy might not move the needle on affordability much. That’s because institutional investors aren’t buying many single-family homes in the Golden State to begin with.

“It's kind of a red herring,” said Richard Green, director of the USC Lusk Center for Real Estate. “Institutional ownership of single-family rentals is a very small share of all single-family rentals, let alone all of the housing stock in the United States.”

Less than 3% of CA homes 

Trump’s idea is not new. Democratic California lawmakers have also proposed limits on investor home-buying. To inform the legislative process, state researchers have looked into the question of how California homes are getting scooped up by institutional buyers.

The answer: Not many.

Statewide, 2.8% of single-family homes are owned by investors who own 10 properties or more. That’s according to the California Research Bureau, which produces nonpartisan policy research for the Governor’s Office and the state Legislature.

According to the Urban Institute, large investors own a much greater stock of single-family homes in cities including Jacksonville, Charlotte and Atlanta, where institutional investors own nearly 29% of single-family rentals.

Corporate ownership rates are much lower in California. In Los Angeles County, home to more than 10 million people, only about 72,474 homes are owned by large investors, according to the California Research Bureau. That number includes single-family homes as well as condos, townhomes and duplexes.

Would banning corporate owners reduce competition?

Invitation Homes is the largest owner of single-family homes in California, with more than 11,000 properties to its name statewide, including about 3,100 in Los Angeles County. Its business model involves buying single-family homes, updating them and then renting them out to tenants who may not otherwise be able to afford home-ownership.

LAist reached out to Invitation Homes for comment on Trump’s announcement. We were sent a statement from the National Rental Home Council.

“Housing affordability is a critical issue, and we appreciate the administration’s focus on ensuring Americans have access to a diverse mix of housing options,” the statement read.

The statement continued: “Professional single-family housing providers represent a small segment of the overall housing market, and the single-family rental industry remains focused on supporting renters while also supporting pathways to homeownership.”

David Garcia, deputy director of policy at UC Berkeley’s Terner Center for Housing Innovation, said getting rid of institutional investors probably wouldn’t do much to bring down home prices for young Californians.

“The vast, vast majority of homes that are purchased are by people who are generally going to live in them,” Garcia said. “So you're not really reducing the main competition for home buyers, which is other home buyers.”

Lack of supply, lots of demand fuel CA’s high prices

Garcia and USC’s Green both said California’s home prices are high because of lack of supply. Steady demand for California homes coupled with low building rates since the Great Recession have produced a market where the wealthiest buyers out-bid everyone else for the few homes coming up for sale.

Trump’s proposal echoes similar policy explorations from the L.A. City Council, which voted in 2021 to consider banning companies like Zillow and Redfin from buying homes within the city.

Details were scant in Trump’s post, but he said more information about his plans would be forthcoming.

In his Truth Social post, he said: “I will discuss this topic, including further Housing and Affordability proposals, and more, at my speech in Davos in two weeks.”