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

This story first appeared on The LA Local.

Since 1977, Richard Santillan has been to every Opening Day game at Dodger Stadium. 

“The tradition goes from my father, to me, to my children and grandchildren. Some of my best memories are with my father and children here at Dodger Stadium,” Santillan told The LA Local, smiling under the shade of palm trees near the entrance to the ballpark Wednesday morning. He was there to protest the team less than 24 hours before Opening Day.

Santillan, like countless other loyal Dodgers fans, is grappling with his fan identity over the team’s decision to accept an invitation to the White House and owner Mark Walter’s ties to ICE detention facilities.

More than 30 people joined Santillan on Wednesday morning for a press conference held near 1000 Vin Scully Drive to convey a message directly to the team. 

“We are demanding the Dodgers stop participating in funding of inhumane treatment of families and do not go to the White House to celebrate with the criminal in chief,” Evelyn Escatiola told the crowd. “Together, we have the power to make a change.”

Escatiola, a former dean of East Los Angeles College and longtime community organizer, urged fans to flex their economic power by “letting the Dodgers know that we do not support repression.”

Jorge “Coqui” Rodriguez, a lifelong Dodgers fan, spoke to the crowd and called on Dodgers ownership to divest from immigration detention centers owned and operated by GEO Group and CoreCivic.

Jorge Coqui H Rodriguez speaks at a press conference outside Dodger Stadium on March 25, 2026, to demand the Dodgers not to visit the White House following their 2025 World Series win.

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J.W. Hendricks

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The LA Local

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In a phone interview a day before the protest, Rodriguez told The LA Local he did not want the Dodgers using his “cheve” or beer money to fund detention centers. 

“They can’t take our parking money, our cacahuate money, our cheve money, our Dodger Dog money and invest those funds into corporations that are imprisoning people. It’s wrong,” Rodriguez said. 

Rodriguez considers the Dodgers one of the most racially diverse teams and said the players need to support fans at a time when heightened immigration enforcement has become more common across L.A.

The team’s 2025’s visit to the White House drew ire from the largely Latino fan base, citing the Trump administration’s ongoing attacks on immigrants. 

In June, the team came under further scrutiny when rumors swirled online that federal immigration agents were using the stadium’s parking, which immigration authorities later denied in statements posted on social media accounts.

The team again came under fire after not releasing a statement on the impacts of ICE raids on its mostly Latino fan base at the height of immigration enforcement last summer. The team later agreed to invest $1 million to support families affected by immigration enforcement.

When he learned the Dodgers were pledging only $1 million to families in need, Rodriguez called the amount a  “slap in the face.” 

“These guys just bought the Lakers for billions of dollars and they give a million dollars to fight for legal services? That’s a joke,” Rodriguez said. “They need to have a moral backbone and not be investing in those companies.”

According to reporting from the Los Angeles Times, former Dodgers pitcher Clayton Kershawsaid last week that he is looking forward to the trip.

“I went when President [Joe] Biden was in office. I’m going to go when President [Donald] Trump is in office,” Kershaw said. “To me, it’s just about getting to go to the White House. You don’t get that opportunity every day, so I’m excited to go.”

The Dodgers have yet to announce when their planned visit will take place. 

Santillan sometimes laments his decision to give up his season tickets in protest of the team. His connection to the stadium and the memories he has made there with family and friends will last a lifetime, he said. On Thursday, he will uphold his tradition and be there for the first pitch of the season, but with a heavy heart.

“It’s a family tradition, but the Dodgers have a lot of work to do,” he said.

A local favorite mom-and-pop bookshop in Eagle Rock is facing displacement due to a steep rent hike. The owners say theirs is just one of several small businesses along Eagle Rock Boulevard struggling to keep up with lease increases.

Over the past 19 years, many in the neighborhood have come to love READ Books for its eclectic collection of used titles and shop dog Florence.

Co-owner Jeremy Kaplan said it’s been a delight to grow with the community over the years.

“Like seeing kids come back in, who were in grade school and now they’re in college,” Kaplan said.

But the building where Kaplan and wife Debbie rent was recently sold, and the rent increased by more than 130% to $2,805 a month, Kaplan said. He told LAist it was an increase his small business simply could not absorb.

Kaplan said he originally was given 30 days notice of the rent increase. After some research, assistance from Councilmember Ysabel Jurado’s office and some pro-bono legal help, Kaplan said he pushed back and got the 90-day notice he’s afforded by state law.

California Senate Bill 1103 requires landlords to give businesses with five or less employees 90 days’ notice for rent increases exceeding 10%, among other protections.

Systems Real Estate, the property management company, did not immediately respond to LAist’s request for comment.

What can small businesses do? 

Nadia Segura, directing attorney of the Small Business Program at pro bono legal aid non-profit Bet Tzedek said California law does not currently allow for rent control for commercial tenancies.

Outside of the protections under SB 1103, Segura said small businesses like READ Books don’t have much other recourse. And even then, commercial landlords are not required to inform their tenants of their protections under the law.

“There’s still a lot of people that don’t know about SB 1103. And then it’s very sad that they tell them they have these rent increases and within a month they have to leave,” Segura said.

She said her group is seeing steep rent hikes like this for commercial tenants across the city.

“We are seeing this even more with the World Cup coming up, the Olympics coming up. And I will say it was very sad to see that also after the wildfires,” Segura said.

Part of Bet Tzedek’s ongoing work is to advocate for small businesses, working with landlords who are increasing rents to see if they are willing to give business owners longer leases that lock in rents.

What’s next 

After READ Books posted about their situation on social media, commenters chimed in to express their outrage and love for the little shop.

While he looks for a new spot, Kaplan says he’s forming a coalition of local businesses and activist groups to see what can be done to help other small businesses facing similar displacement. He wants to address the displacement issue for businesses like his, which have made Eagle Rock the distinctive neighborhood that it is today.

Owl Talk, a longtime Eagle Rock staple selling clothing and accessories in a unit in the same building as READ Books, is facing a “more than double” rent increase, according to a post on their Instagram account.

Kaplan said he’s been in touch with the office of state Assemblywoman Jessica Caloza and wants to explore the possibility of introducing legislation to set up protections for small businesses like his, including rent-control measures or a vacancy tax for landlords. Kaplan said he also reached out to the office of state Sen. Maria Durazo.

By his count, Kaplan said there are about a dozen businesses within surrounding blocks that are at risk of closing their doors or have shuttered due to rent increases or other struggles.

When READ Books was founded during the Great Recession, Kaplan said he knew it was a longshot to open a bookstore at the same time so many were struggling to stay in business.

“It was kind of interesting to be doing something that neighborhoods needed. That was important to me growing up, that was important to my children, that was important to my wife growing up,” Kaplan said.

“And then somebody comes in and says, ‘We’re gonna over double your rent.”

Topline:

Frozen budget: Most of the city’s Bureau of Street Lighting budget comes from an assessment that people who own property illuminated by lights pay on their county property tax bill. The amount people pay depends on the kind of property they own and how much they benefit from lighting. A typical single-family home currently pays $53 annually, and in total, the assessments bring in about $45 million annually for the city to repair and maintain streetlights. Changing the amount the Bureau of Street Lighting gets from the assessment requires a vote among property owners who benefit from the lights.

Ballots: L.A. City Council’s vote gives city staff the green light to prepare and send out those ballots. Miguel Sangalang, who oversees the bureau, said at a committee meeting earlier this month that he expects to send out ballots by April 17. Notices about the ballots will be sent out prior to the ballots themselves.

Near unanimous vote: L.A. City Councilmember Monica Rodriguez was the only “No” vote Tuesday, saying she wanted to see a more current strategic plan for the bureau. Sangalang said the bureau developed a plan in 2022 that lays out how money will be spent. Councilmember Imelda Padilla was absent for the vote.

Vote count: Votes will be weighted according to the assessment amount. Basically, the more you’re asked to pay yearly to maintain streetlights, the more your vote will count. Ballots received before June 2 will be tabulated by the L.A. City Clerk.

How much more money: According to a report, the amount needed in assessments from property owners to meet the repair and maintenance needs of the city’s streetlighting in the next fiscal year is nearly $112 million.

Use of the money: Sangalang said at a March 11 committee meeting that the extra funds would be used to double the number of staff to handle repairs and procure solar streetlights, which don’t face the threat of copper wire theft. That would all potentially reduce the time it takes to repair simple fixes down to a week. Currently, city residents wait for months to see broken streetlights repaired. The assessment would come with a three-year auditing mechanism.