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The most important stories for you to know today
  • Funds for unfinished project were allegedly stolen
    A diagonal view of a black granite wall with the outline of names vaguely visible on the surface and an internal flame in the center with a map of Vietnam engraved on it.
    The partially completed Vietnam War memorial in Mile Square Park, as seen earlier this week.

    Topline:

    Former Orange County Supervisor Andrew Do gave a nonprofit $1 million in taxpayer funds to build a Vietnam War Memorial in Mile Square Park in Fountain Valley. Now, Do is in prison and the memorial stands unfinished.

    The backstory: Do is serving a five-year sentence in federal prison on a bribery charge. But the county is suing Do and several of his associates in an effort to recoup allegedly stolen taxpayer money, including from the memorial project.

    The memorial's uncertain future: Supervisor Janet Nguyen called the unfinished memorial a “disgrace.” She said the memorial would likely be demolished, given the high cost of repairing or relocating it.

    Read on ... for more about the financial scandal that ensnared the memorial.

    Listen 0:45
    The story behind a cracked, unfinished Vietnam War Memorial in OC

    The memorial to Vietnam veterans in Mile Square Park was supposed to be a smaller version of the revered Vietnam War Memorial in Washington D.C., with an Orange County addition: the memorial would pay special homage to the South Vietnamese army and allies — tens of thousands of whom settled in O.C. as refugees after communist forces took over South Vietnam 50 years ago.

    Former Supervisor Andrew Do awarded $1 million in taxpayer dollars for the memorial in 2023 to a nonprofit where his daughter, Rhiannon Do, was an officer. Now, Andrew Do is in prison on a federal bribery charge; the head of the nonprofit is a fugitive; and the memorial stands unfinished, surrounded by caked dirt and dry grass. The county is suing for damages, alleging that most of the money allocated for the memorial was diverted for personal gain.

    A hairline crack runs down the surface of one of the black granite-looking slabs that make up the memorial (neither the county nor the monument maker has confirmed the type of material used). The eternal flame sculpture at the center of the memorial is covered in bird poop. The names of soldiers were never etched onto its surface.

    “I’m very sad, very, very sad,” said Doàn Trọng upon seeing the unfinished memorial this week. Trong is an Orange County resident and local television host who worked with U.S. troops in Vietnam during the war.

    “Who’s going to take responsibility for this?” he said.

    Trong and other reporters, including from LAist, saw the memorial up close for the first time on a media tour organized by Supervisor Janet Nguyen, who won Do’s former seat in an election last year. It’s in an area of Mile Square Park currently closed to the public for renovations.

    A closeup of a hairline crack running through black granite. The outline of names are visible on the granite and there is leftover masking tape next to the names.
    The granite surface of the monument is starting to crack, only about a year after the walls were erected. The etching of soldiers' names was never completed.
    (
    Jill Replogle
    /
    LAist
    )

    LAist was the first to report on the unfinished memorial and raise questions about its $1 million price tag in August 2024. One architect who visited the site with LAist at the time estimated the work cost around $185,000 or less.

    Pham returned $150,000 of the initial $1 million to the county last year, saying the project came in under budget. (Pham’s lawyer at the time said the memorial was on track to be unveiled in October 2024.) But that still raises questions about the rest of the funds — and why the project remains unfinished.

    On this week’s visit, the tarps and fence had been removed, leaving the memorial exposed to the elements. Vinyl stencils that had previously covered the blocks, printed with the names of Orange County-based Vietnam veterans, had also been removed.

    Nguyen called the unfinished memorial a “disgrace.”

    “This is not how we honor our veterans by any means,” she told LAist.

    Nguyen said the memorial would likely be demolished, given the high cost of repairing or relocating it.

    “Let’s restart and do it right,” she said.

    How the memorial came to be

    In September 2023, the county signed a $1 million agreement with the nonprofit Viet America Society, or VAS, for the "design, construction, and maintenance" of the memorial. Do later posted a video featuring himself and others reviewing plans for it .

    Do did not publicly disclose that his daughter, Rhiannon Do, was an officer of VAS at the time. The failure to do so would be at the heart of an unfolding scandal involving millions in taxpayer dollars that have yet to be fully accounted for.

    A mockup showing two long, black walls with a torch between them. The art on the wall includes the South Vietnamese flag, American flag, a dedication and a block full of names.
    A mockup of the planned Vietnam War memorial in Mile Square Regional Park, provided in 2024 by Pham's previous lawyer. The memorial was never completed.
    (
    Courtesy Mark Rosen
    )

    The former supervisor would ultimately direct at least an additional $12 million in taxpayer funds to VAS, according to an LAist investigation . Those funds were supposed to be used to pay for meals for needy seniors. But federal prosecutors and county attorneys say most of that money was diverted for personal gain by using VAS as a cover.

    The money for the memorial came from federal pandemic relief funds, a portion of which was assigned to each supervisor to dole out in their respective districts to organizations supporting veterans and infrastructure projects, among other work.

    Do is currently serving a five-year prison sentence in Arizona on a federal bribery charge stemming from the misuse of millions of those funds, though not including the $1 million spent on the memorial. Meanwhile, the county is still seeking to recover the money allegedly misspent by Do, including the memorial funds, through a civil lawsuit.

    LAist tried to contact Do’s lawyer, Eliot Krieger, by phone but has not heard back.

    Pham’s lawyer responds

    Peter Pham, the founder of VAS, was indicted earlier this year for allegedly bribing Do to keep the money flowing to VAS. Pham left the U.S. on a one-way ticket to Taiwan in December 2024 and is still a fugitive.

    Pham, through his O.C.-based lawyer, Hoa Truong, has denied wrongdoing, alleging he was tricked by Do into creating VAS as a shell organization through which to funnel county funds back to Do. Truong also told LAist that Pham left the country on bad advice from his previous lawyer.

    Earlier this year, Truong filed a cross-complaint on behalf of Pham in the county’s civil lawsuit against Do, Pham, VAS and others. In that complaint, Truong alleged that Do took advantage of his friendship with Pham to involve Pham in the scheme to steal taxpayer money.

    Truong told LAist that even though Pham is credited on the Vietnam War Memorial as the designer and builder, Pham merely signed the contract, relegating the rest of the work to his longtime business partner, Le Dan Hua.

    Hua, who also served as an officer of VAS, is also a defendant in the county’s civil lawsuit over the memorial and other allegedly misused taxpayer funds. LAist left a voicemail for Hua’s lawyer.

    “His English is very limited,” Truong said of Pham. ”Do asked him to sign, he just signed because he saw so much money coming in.”

    Hua and Pham also did renovations on the North Tustin home that Andrew Do shared with his wife, Orange County Superior Court Judge Cheri Pham , in 2021, according to records obtained by LAist.

    A woman in a red jacket and black pants stands in front of an unfinished, black granite monument surrounded by caked dirt and dry grass.
    Orange County Supervisor Janet Nguyen called the abandoned memorial a "disgrace" and vowed to replace it, perhaps at the future veterans cemetery planned for Gypsum Canyon.
    (
    Jill Replogle
    /
    LAist
    )

    The memorial’s uncertain future

    The new section of Mile Square Park where the memorial is located is scheduled to open by the end of 2026. It’s unclear whether the memorial will still be there by then. Nguyen, the county supervisor, estimated it would cost $25,000 to $30,000 to demolish, and much more to try to move it elsewhere.

    If the memorial were to remain in place, the county would likely have to come up with even more money to repair it and put in pathways and other infrastructure to make it compliant with accessibility laws. Nguyen thinks a better option is to build a new memorial, perhaps at the new O.C. veterans cemetery planned for Gypsum Canyon in Anaheim.

    Nguyen is among the some 130,000 Vietnamese refugees who settled in Orange County after the Fall of Saigon. She said she’s determined to come up with a new plan for a memorial, though she’s not yet sure where the funds would come from.

    “The 58,000 American soldiers who sacrificed for the land I was born in, that’s why I’m here,” she said. “This is not how we honor them, by any means.”

    How to watchdog your local government

    One of the best things you can do to hold officials accountable is pay attention. Your city council, board of supervisors, school board and more all hold public meetings that anybody can attend. These are times you can talk to your elected officials directly and hear about the policies they’re voting on that affect your community.

  • Mammoth opens Saturday with fresh snow expected
    Chairlifts, lightly dusted in snow, hang on a wire over a white ski slope. Obscured by falling snow in the distance is a line of pine trees.
    A view of an empty ski chair lift at Squaw Valley Resort on March 14, 2020, in Olympic Valley.

    Topline:

    Mammoth Mountain postponed its opening day to Saturday in anticipation of a winter storm this week that could dump as much as a foot of fresh powder.

    Background: Resort officials initially planned to welcome the 72nd winter season Friday but announced Tuesday that the season season is postponed .

    How much snow is expected? The peaks in the Eastern Sierra and Mono are likely to see at least a foot of snow above the 9,000-foot level. “There's a pretty decent shot at Mammoth seeing upwards of maybe a foot of snowfall between probably early Thursday morning into Thursday night,” Tyler Salas, meteorologist with the National Weather Service, told LAist.

    Where can you get tickets? Mount Baldy , Big Bear Mountain and Mountain High are expected to announce their winter season dates in the coming weeks. The resorts already are offering ski lift tickets.

    Will SoCal see snow? No, we’ll mostly see heavy rain dropping between 1 to 2 inches across much of L.A., Ventura and Santa Barbara counties. Some mountain communities could see as much as 4 inches of rain. Here’s a closer look at the upcoming storm .

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  • Long Beach breaks ground along LA River
    Trees, surrounded by orange mesh, are lined up close to a metal fence with sandbags holding it up. Trees in the foreground are out of focus.
    The 51st Street Greenbelt project is under construction in Long Beach on Monday, Nov. 10, 2025.

    Topline:

    Long Beach leaders broke ground Monday on a $6 million project to give new life to an undeveloped acre in North Long Beach.

    More details: The 51st Street Greenbelt Project will turn a stretch of land on De Forest Avenue between 51st and 52nd Streets into a park featuring pedestrian and cycling paths, fitness equipment, play structures, native plants and green infrastructure.

    Why it matters: The greenbelt, which is part of Long Beach’s infrastructure investment plan , is scheduled to be completed by fall 2026, the project manager said. In recent years, the city has expanded recreational space in the lower Los Angeles River region by dozens of acres. This project represents the latest effort to create more green space in the area.

    Read on... how this greenbelt came to be.

    Long Beach leaders broke ground Monday on a $6 million project to give new life to an undeveloped acre in North Long Beach.

    The 51st Street Greenbelt Project will turn a stretch of land on De Forest Avenue between 51st and 52nd Streets into a park featuring pedestrian and cycling paths, fitness equipment, play structures, native plants and green infrastructure.

    The greenbelt, which is part of Long Beach’s infrastructure investment plan , is scheduled to be completed by fall 2026, the project manager said. In recent years, the city has expanded recreational space in the lower Los Angeles River region by dozens of acres. This project represents the latest effort to create more green space in the area.

    During Monday’s groundbreaking ceremony, Rep. Nanette Diaz Barragán, whose Congressional district includes North Long Beach, stepped up to the mic next to a large pile of dirt. “When I was a kid, I didn’t have a park nearby,” she said. “I had to get on a bus to go play Little League and baseball.”

    Barragán’s commitment to broadening access to outdoor recreational space, especially for park-deficient neighborhoods in Long Beach, helped secure millions in federal funding for the project.

    The city will combine those dollars with grants and city funds to build a park that addresses the community’s needs, identified through surveys and meetings, said Councilmember Tunua Thrash-Ntuk, who represents the 8th City Council District.

    Three people walk along a shaded area between trees and a metal fence.
    Three men walk along the 51st Street Greenbelt project with blueprints in hand after the groundbreaking of the park in Long Beach on Monday, Nov. 10, 2025.
    (
    Thomas R. Cordova
    )

    Thrash-Ntuk said the park is intended to serve neighbors of all ages — especially children, as the lot sits near several schools. “Today, I’m pleased to say that one of the district residents that I brought with me is an avid user of local parks, and that’s my son,” she said.

    The greenbelt aims to improve community physical, mental and environmental health, said Stephen Scott, acting director of the Department of Parks, Recreation and Marine. The census tract where the park will be built is among the 5% most environmentally burdened and vulnerable areas in the state, according to CalEnviroScreen , a tool developed by the California Office of Environmental Health Hazard Assessment.

    The Long Beach Climate Action Plan acknowledges that due to “long-standing discriminatory practices,” low-income communities and communities of color in Long Beach are more likely to live in heavily polluted, climate-vulnerable areas without access to parks.

    Congresswoman Nanette Barragán, a woman with medium skin tone wearing a dark blue suit, speaks behind a wooden podium. She is partially covered by flags, including an American flag, which are all out of focus in the foreground. Safety helmets hang on shovels dug in the ground behind her. A small safety sign reads "51st Street Greenbelt" with an illustration of a tree.
    Congresswoman Nanette Barragán speaks at the groundbreaking for the 51st Street Greenbelt project in Long Beach, Monday, Nov. 10, 2025.
    (
    Thomas R. Cordova
    )

    Project manager Tina Cheng said the greenbelt will mitigate some of these issues with new and existing vegetation. The site already has mature, native trees — oaks and sycamores. “We’re lucky to have them, because they’re huge,” said Mina Roades, a landscape architect with design studio City Fabrick. “Otherwise, this would be a park with a bunch of little sticks.”

    The site currently captures its own stormwater, Roades said; “We’re enhancing it with a bioswale,” a vegetated channel that treats and controls stormwater, she added.

    Though ground officially broke Monday, “This work has been underway for a couple of years,” said Joshua Hickman, acting director of Public Works. His team has already completed work on the hardscape — the curb, gutter and sidewalk — to improve accessibility to the eventual park. Once the project is complete, the Public Works team will restore the pavement — and parking — adjacent to the greenbelt, an effort to create a space that “integrates seamlessly with all of the neighborhood,” Hickman said.

    Mayor Rex Richardson, a man with dark skin tone, wearing a black quarter zip sweater, speaks into a microphone as he points. Behind him is a sign that reads "51st Street Greenbelt."
    Mayor Rex Richardson speaks at a groundbreaking pf the 51st Street Greenbelt project in Long Beach, Monday, Nov. 10, 2025.
    (
    Thomas R. Cordova
    )

    “I can’t say how proud I am as a North Long Beach resident to see this project move forward,” said Mayor Rex Richardson. He joined a line of city officials, who donned hard hats and tossed shovelfuls of dirt into the air.

  • Why some are choosing fire-resistant materials
    A woman with medium light skin tone, wearing a hard hat and fluorescent vest, stands in front of a stack of gray concrete blocks on a dirt lot in the Los Angeles County neighborhood of Sunset Mesa.
    Karen Martinez stands in front of a stack of concrete blocks on her property in the neighborhood of Sunset Mesa.

    Topline:

    As rebuilding from the Palisades and Eaton fires gets under way, some homeowners are choosing to build differently. Instead of the usual wood framing, they’re working with a material typically associated with freeways and skyscrapers: concrete.

    The context: Only 7% of homes nationwide are currently built with concrete, according to the National Association of Home Builders. But experts say the popularity of this hardy, non-combustible material could grow in high fire risk areas such as the L.A. neighborhoods where thousands of homes were destroyed at the start of 2025.

    Insurance discounts: Some insurance companies are incentivizing rebuilding with non-combustible materials like concrete. Mercury Insurance offers discounts of up to 50% on the wildfire portion of homeowners’ premiums if they rebuild with fire-resistant materials. But experts say concrete doesn’t automatically make a home fire-proof. Strong sealing in windows and vents is still needed to prevent embers from flying into the home.

    Read on… to learn why one homeowner rebuilding from the Palisades Fire says concrete represents “the future of building.”

    As rebuilding from the Palisades and Eaton fires gets under way, some homeowners are choosing to build differently. Instead of the usual wood framing, they’re working with a material typically associated with freeways and skyscrapers: concrete.

    Only 7% of homes nationwide are currently built with concrete, according to the National Association of Home Builders. But experts say this hardy, non-combustible material could become more popular in areas with high fire risk, such as the Los Angeles County neighborhoods where thousands of homes were destroyed in January 2025.

    While concrete doesn’t make a home totally fire-proof, insurance companies are recognizing its safety benefits by offering homeowners lower premiums. While cost has been a barrier in the past, some homeowners say the expense of concrete now compares favorably with wood.

    One recent morning on the Sunset Mesa lot where her home burned down, Karen Martinez adjusted her hard hat and flipped through the blueprints for her new home.

    “These are my original chicken scratch drawings, which I love doing,” Martinez said.

    Martinez has overseen the building process for many of her previous homes. But this will be her first project using concrete blocks. Technically called insulating composite concrete forms, the bulky gray blocks stacked all over her property are lighter than they appear.

    “It's about 87% polystyrene and 13% cement,” said Martinez, who is soft-spoken and self-described as “nutty” about building materials.

    “Basically they're non-combustible. So in a fire, you're pretty much safe from the walls burning,” she said.

     Gray concrete bricks called insulated composite concrete forms are stacked on a dirt construction site where construction workers in fluorescent vests are at work.
    These blocks, called insulated composite concrete forms, will be used to form the walls of Karen Martinez's new home.
    (
    David Wagner
    /
    LAist
    )

    ‘There are better ways to build’

    It didn’t take long for Martinez to choose this material after her old wood-framed home was lost in the Palisades Fire.

    “It was just probably a day or two of shock,” she said. “When I finally started thinking about, OK, I have to rebuild, obviously, I'm going to be building with something that's non-combustible.”

    Martinez said there are other benefits beyond fire safety: she said the material can withstand earthquakes, and it won’t get termites because it contains no wood.

    Martinez saw the need to do things differently. The hardest part, she said, was getting others on board. Securing permits from L.A. County, talking her architect into using this kind of concrete, even helping her neighbors with plans for their own concrete homes.

    It all took some convincing.

    “Most architects and contractors don't know how to use it,” Martinez said. “All they know is wood and maybe steel. It's hard to convince people to change their ways. That's my goal. I'm trying to just educate people and say that there are better ways to build.”

    Some insurance companies agree. Victor Joseph, president and chief operating officer of Mercury Insurance, said his company is offering discounts to those who rebuild with fire resistant materials.

    “What we're incentivizing with these types of discounts is really some combination of steel, concrete and glass,” Joseph said.

    He said homeowners can get up to 50% off the wildfire portion of their premium by rebuilding with materials like concrete.

    “In high wildfire areas, that results in a pretty substantial discount,” he said.

    Concrete alone doesn’t fire-proof a home

    Concrete blocks have been used for decades to build homes in other countries, but they are still an unusual building material in Southern California homes.

    Tom Tietz, executive director of the California Nevada Cement Association , said growing awareness of fire risk could help the blocks catch on with more homeowners.

    “There's clearly a desire from folks that have lost their homes to make sure that never happens again,” Tietz said.

    Concrete homes aren’t automatically fire proof. Embers can still fly in through vents or windows. Steve Hawks, senior director for wildfire with the Insurance Institute for Business & Home Safety , said even concrete homes need strong sealing.

    “The structure is only as good as the weakest link,” Hawks said. “If you only address the siding material and don't address the window and the vents and the other components, you still leave the home very vulnerable to these significant, intense wildfires.”

    Learning from L.A.’s concrete home history

    Though rarely used in single-family homes, concrete does have a long history in Southern California architecture.

    Architect R.M. Schindler built L.A.’s first modernist home in 1922 using concrete slabs poured on site and tilted up to form monolithic walls.

     The exterior of the Schindler House in West Hollywood is seen in a photograph highlighting its concrete and redwood materials.
    The Schindler House in West Hollywood was constructed more than a century ago in what is now West Hollywood, using concrete and redwood as its main building materials.
    (
    David Wagner
    /
    LAist
    )

    “I think there's a perceived kind of coldness with concrete,” said Maeve Atkinson, education and engagement manager for the Schindler House through the MAK Center for Art and Architecture.

    Atkinson said Schindler wanted to use new materials to build a new kind of home, one that was open to the outdoors and designed for not one, but two couples.

    “It was about living differently,” Atkinson said. “It was about being much more in tune with the elements and with nature.”

    Schindler decided to leave the raw concrete exposed. Its grooves and cracks remain visible, contrasting with the redwood beams that form the rest of the building’s open structure.

    Homeowners recovering from January’s fires don’t need to go raw and radical like Schindler. Martinez said her home, covered with stucco, will look much like any other modern L.A. home.

    “I'm hoping that this will actually become the future of building,” she said. “I think it's a much, much better way to build, and it's not more expensive. I think actually everybody should be doing it.”

    If all goes according to plan, she said, her home should be done before the two year anniversary of the Palisades Fire — and ready to take on whatever comes next.

  • Six things to know if it's right for you

    Topline:

    Women should not suffer through menopause with hot flashes, night sweats and poor sleep. That's the message from FDA Commissioner Dr. Marty Makary. Here are some things to consider when talking to your healthcare provider about hormone therapy for menopause.

    The upswing of hormone therapy: "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.

    Something to consider: 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. 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.

    Read on . . . for more about how hormone therapy has changed over the years and questions you should be asking your doctor before you begin treatment.

    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