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

Public officials across California are contemplating what to do with dozens of streets, parks and libraries named in honor of civil rights icon César Chávez in the wake of allegations he sexually assaulted two girls and a woman decades ago.

The allegations surfaced in an investigation by the New York Times published earlier this week that sent shock waves across the country.

Chávez, who was head of the United Farm Workers union, is widely recognized as one of the most influential labor leaders in U.S. history, known for founding the union and for leading national boycotts of grapes to improve working conditions for farmworkers.

Chávez died in 1993.

Many state and local leaders, including L.A.’s mayor and county supervisors, suggested changing the César Chávez holiday on March 31 to Farm Workers Day. March 31 was Chávez’s birthday.

In Sacramento on Thursday, Democratic leaders of the state Legislature said they would push for such a change.

“The farmworker movement was never ever about one man,” Assembly Speaker Robert Rivas said at a news conference. “It was built by tens of thousands of workers. People who labored in the fields, people who organized, people who sacrificed and who stood up when it was hard.

“We have a responsibility to remember the movement and to move it forward with integrity.”

Also on Thursday, Los Angeles Mayor Karen Bass signed a proclamation renaming the city's César Chávez Day holiday as “Farm Workers Day.” The city recognizes the holiday on the last Monday of March.

“I grew up as a child admiring the farmworker movement,'' Bass said. “I didn't think I was ever going to eat grapes again because my family boycotted grapes.”

The grape strike, organized in part by Chávez, lasted five years from 1965 to 1970.

Multiple allegations of sexual assault

The New York Times investigation uncovered multiple allegations that Chávez had sexually assaulted girls and women in the 1960s and ‘70s, when he was head of United Farm Workers, including union co-founder Dolores Huerta.

Huerta, now 95, told the Times the rape and sexual assault resulted in pregnancies that she kept secret. Huerta said she gave the children up for adoption after birth.

In a statement, Huerta said in part: “... for the last 60 years [I] have kept a secret because I believed that exposing the truth would hurt the farmworker movement I have spent my entire life fighting for.”

Bass said Thursday she met Chávez once and “thought it was an opportunity of a lifetime.” She said her heart “broke” this week when she heard the allegation that Chávez had raped Huerta.

The mayor said renaming the holiday would allow people “to reflect on how the struggle of farmworkers has elevated working people everywhere.”

She added that the city would need to consider changing the names of buildings, streets and other things named in honor of Chávez.

For example, César Chávez Avenue runs through the heart of the Boyle Heights neighborhood. Several murals of Chávez dot the city.

Bass said she had been in contact with Chávez's family, and they supported her action.

The mayor was joined at the proclamation signing by Councilwoman Eunisses Hernandez, who said in a statement that the farmworker movement has always been about the power of the people, “especially the women whose labor built it and too often went unseen."

“As we honor that legacy, we also have a responsibility to tell the truth about harm and stand with survivors,” Hernandez said.

Councilwoman Ysabel Jurado also attended the news conference. She said the movement doesn’t belong to one person.

“Farm Workers Day honors the workers, families and organizers still in the fields and still fighting for fair wages, safe conditions and dignity,” the statement from Jurado read. “And it recognizes that this movement is carried forward every single day by people whose names we may never know but whose impact continues to define the spirit of Los Angeles.”

Other cities and counties 

Many other cities and counties are considering wiping Chávez's name from public spaces.

L.A. County Supervisor Hilda Solis said she would introduce a motion looking at renaming the county’s César Chávez holiday.

Supervisor Janice Hahn suggested the county consider renaming Chávez day “Farm Worker Day.”

“For those of us who grew up admiring the farmworker movement, today's news is heartbreaking,'' Hahn said in a statement Wednesday. "But as in any other civil rights movement, men were only half the story. The abuses of one man will never diminish the extraordinary sacrifices, accomplishments, and legacy of the women of the farmworker movement.

“It's time we put them first.”

The process for renaming streets and other public structures varies from city to city and school district to school district. It could take months before many cities move to erase Chávez's name from public spaces.

You can follow your city council agenda to keep up with what’s going on, or better yet, reach out to your representatives on the council and county Board of Supervisors to make your voice heard on the issue.

California, along with a coalition of 23 other states and a dozen cities and counties, sued the U.S. Environmental Protection Agency on Thursday for rolling back the scientific finding requiring it to regulate greenhouse gas pollution.

“This isn’t a small technical change,” California Attorney General Rob Bonta said at a press conference in Sacramento. “It’s a sweeping decision that would increase pollution, worsen climate change and put the health of millions of Americans at risk. And it’s not based on any credible science.”

The lawsuit, filed in the U.S. District Court of Appeals for the District of Columbia, seeks to reinstate a 2009 conclusion known as the endangerment finding — that carbon dioxide and other planet-warming gases threaten public health and welfare.

The climate rule served as the scientific basis for the agency’s ability to limit emissions under the Clean Air Act.

The Trump administration finalized the repeal of the endangerment finding Feb. 12. A post on the EPA’s website stated the change would also dissolve restrictions on vehicle emissions and save Americans $1.3 trillion.

“As a result of these changes, engine and vehicle manufacturers no longer have any future obligations for the measurement, control and reporting of GHG emissions for any highway engine and vehicle, including model years manufactured prior to this final rule.”

Sanchez said California’s authority to regulate greenhouse gas emissions under the landmark 2006 Global Warming Solutions Act, AB 32, signed into law by then-Republican Gov. Arnold Schwarzenegger, “remains unchanged.”

Los Angeles, San Francisco and Santa Clara counties also were parties to the suit.

KQED’s Laura Klivans contributed to this report.

California voters are split along party lines on two controversial proposed ballot measures — a billionaire tax and an initiative requiring voters to show government ID when they cast a ballot — according to a new poll.

The survey from UC Berkeley’s Institute of Governmental Studies found 52% of voters backing a proposed one-time, 5% tax on the net worth of billionaires. The money would be used to fund health care programs, which are being cut by the Trump administration; 33% of registered voters said they were opposed and 15% said they are still undecided.

Whether voters back the measure, which is being pushed by a health care labor union, is highly correlated to their partisan leanings: 72% of Democrats said they’d support the billionaire tax if it qualifies for the November ballot, while the same percentage of Republican voters are opposed. Voters with no party preference were more split, with 51% backing the wealth tax.

The voter ID ballot measure is more evenly divided, with 44% of voters in support and 45% opposed. Republican voters said they would overwhelmingly vote “Yes.” Democrats are unified in opposition, with only 19% in support.

IGS co-director Eric Schickler said that while neither measure has qualified yet for the ballot, most voters surveyed said they are aware of the proposals.

“The Billionaire Tax Initiative starts out in a relatively strong position, but with it polling just above 50%, that still leaves room for what will be an intense, expensive campaign,” he said. “The Voter ID Initiative looks like it faces an uphill climb: given the strong Democratic opposition, it needs very strong support among nonpartisan voters, and it currently seems to be falling short. But it is still very early.”

If they move forward, the campaigns around both measures are expected to be expensive and bruising. Democrats are split on the billionaires tax: Gov. Gavin Newsom is opposed, Silicon Valley Rep. Ro Khanna said he’s in support, and many other Democrats — including legislative leaders and candidates for governor — have offered support for the concept but expressed concerns with the details of this proposal.

Some billionaires have already left California, and others, like Google co-founder Sergey Brin, are lining up huge campaign war chests to fight the measure.

And Democrats are gearing up to fight the voter ID measure, which several Southern California Republican lawmakers are pushing. The proposed ballot measure comes as the U.S. Senate debates what’s known as the SAVE Act, a far more draconian voter ID measure.

Backed by President Donald Trump, that legislation would require a passport or birth certificate to register to vote, essentially eliminate mail-in ballots and require states to hand over their voter rolls to the federal government. It already passed the House but is facing a steep climb in the Republican-led Senate.

The poll was conducted between March 9 and 15 among more than 5,000 registered California voters. It has a sampling error of plus or minus 2 points.

The Los Angeles Unified board members who represent schools named for César Chávez are calling for their renaming.

A New York Times investigation published Wednesday found the famed labor leader Chávez sexually abused girls and women including United Farmer Workers co-founder Dolores Huerta.

“In light of this information, we believe it is necessary to move away from traditional César Chávez-centered celebrations and lessons tied to the state holiday and instead prioritize student safety, dignity and truth,” read a statement from board member Kelly Gonez and Vice President Rocío Rivas.

The renaming process would likely take months and include meetings with school staff, students and parents. In the meantime, district leaders and educators are grappling with how the allegations of abuse change lessons about a figure who helped galvanize generations of activists.

“ I think we are all deeply, deeply troubled by the allegations that have come forward over the last couple of days,” said Andres Chait, the acting Los Angeles Unified superintendent.

Chait said that March 27 will continue to be a school holiday (the currently named César Chávez Day, on March 31, falls during LAUSD’s spring break).

A district spokesperson provided a statement Wednesday that said a review of curriculum and resources related to Chávez is underway “to ensure the emphasis remains on the important work of the farmworker movement, not on any one individual.”

How are community members and educators reacting?

Last semester, students at STEM Academy of Hollywood learned about Chávez and the movement to unionize farmworkers in Irene Atilano’s ethnic studies class.

Atilano said students walked into her classroom Wednesday with questions after seeing the allegations of Chávez’s abuse on social media.

“ They were just like, ‘What do you think?’” Atilano said. “And I'm like, 'It doesn't matter what I think. What do you guys think? Let's learn together.'”

Their reactions ranged from “this really sucks,” to a sense of loss.

“This is why we don't try to idolize people,” Atilano said. “We want to make sure that we focus on the community, we focus on the movement.”

Atilano said she plans to teach ethnic studies again and is thinking about how misogyny and patriarchy intersect with political and social justice movements.

“It can be found everywhere,” Atilano said. “I’m trying to see how I can make those connections in the future, but it's a work in progress.”

On March 10, the LAUSD board unanimously approved a resolution recognizing Chávez — one of many such resolutions over the years — and pledging to provide curriculum and resources aligned with the foundation that promotes his legacy, education and economic development. The board last year also passed a resolution honoring Huerta.

In response to LAist’s questions about curriculum related to Chávez, an LAUSD spokesperson provided a statement that said the district is providing additional instructional materials “to support classroom learning, ensuring students continue to engage with themes of leadership, service and social justice in age-appropriate and meaningful ways.”

LAUSD board member Tanya Ortiz Franklin issued a statement Wednesday morning with links to resources related to sexual and domestic violence.

“Just my own team, we’re seven women … and our own triggers, our own stories are coming out,” Ortiz Franklin said. “You can imagine that happening everywhere in homes, in classrooms, the adults having to manage this, and then also, helping students process.”

César Chávez Elementary in El Sereno is one of several schools in Southern California named after the labor leader.

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How would renaming work?

Blanca Juarez was at César Chávez Elementary in El Sereno on Wednesday to pick up her daughter. With a father and grandmother who were both farmworkers, she said she was troubled by the news.

“He was like the only hope in those days — the only one speaking for all of the — and now, well, I don’t know. I don’t know what to say,” Juarez said.

She said it was too soon to be talking about renaming the school.

Gonez and Rivas said they would work with the communities surrounding the elementary school and the César Chávez Learning Academies in San Fernando to identify new names.

In recent years, the school renaming process has included meetings with staff, students, parents and community members and a public vote. The LAUSD board must vote to finalize any name changes.

LAist Deputy Managing Editor Fiona Ng contributed to this story.