HJAR Jan/Feb 2026

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2026 13 administration. This knowledge gap directly impacts patient care: Although millions of women experience debilitating vasomotor symptoms, sleep disruption, mood changes, and genitourinary symptoms, only a frac- tion receive hormone therapy — often due to provider hesitation rather than clinical contraindication. Training equips clinicians with the tools to confidently stratify risk, ini- tiate therapy safely, and monitor ongoing use. It also helps dispel persistent myths, ensuring we do not inadvertently perpetu- ate the same misunderstandings that arose in the wake of the WHI. As evidence-based prescribing becomes more accessible and better supported by regulatory language, expanding provider competency is essential to meeting the needs of midlife and meno- pausal women. A Call to Action for Clinicians The removal of the boxed warning marks a pivotal moment in the evolution of meno- pause care — one that invites us, as clini- cians, to reconsider long-held assumptions and reaffirm our commitment to evidence- based practice. Equipping ourselves with up-to-date training is not merely an academic exercise; it is an act of advocacy for our patients. Women deserve accurate information, individualized care, and access to therapies that can meaningfully improve their qual- ity of life. By embracing current and past evidence, pursuing structured education in hormone therapy, and engaging openly with patients about their symptoms and goals, we can help reverse decades of confusion and undertreatment. The science is clear. The regulatory landscape has evolved. Now it is our turn to ensure that women receive the informed, compassionate care they have long deserved. n REFERENCES Harlow, S. D., et al. “Executive Summary of the Stages of Reproductive Aging Workshop +10: Addressing the Unfinished Agenda of Staging Reproductive Aging.” Menopause 19, no. 4 (2012): 387–95. Soules, M. R., et al. “Executive Summary: Stages of Reproductive Aging Workshop (STRAW).” Fertility and Sterility 76, no. 5 (2001): 874–8. Greene, R.A. “Discovery and Early Development of Conjugated Estrogens.” In M. Notelovtiz (ed.), Estrogen Therapy. CRC Press, 1979. Ayerst Laboratories. Husbands, Too, Like Prema- rin [print advertisement]. New York State Journal of Medicine, 1950. Wilson, R. Feminine Forever. M. Evans & Com- pany, 1966. Smith, D. C., et al. “Association of Exogenous Estrogen and Endometrial Carcinoma. The New England Journal of Medicine 293, no. 23 (1975): 1164–7. Weiss, N. S., et al. “Endometrial Cancer in Wom- en Receiving Exogenous Estrogens.” The New England Journal of Medicine 294, no. 25 (1976): 1256–61. American College of Obstetricians and Gynecol- ogists. “ACOG Committee Opinion No. 141: Man- agement of Menopausal Symptoms.” Obstetrics & Gynecology 123, no. 1 (2014): 202–16. Rossouw, J. E., et al. “Risks and Benefits of Estro- gen Plus Progestin in Healthy Postmenopausal Women: Principal Results from the Women’s Health Initiative Randomized Controlled Trial. JAMA 288, no. 3 (2002): 321–33. Anderson, G. L., et al. “Effects of Conjugated Equine Estrogen in Postmenopausal Women with Hysterectomy: The Women’s Health Initia- tive Randomized Controlled Trial.” JAMA 291, no. 14 (2004): 1701–12. Chlebowski, R. T., et al. “Association of Meno- pausal Hormone Therapy with Breast Cancer In- cidence and Mortality During Long-Term Follow- Up of the Women’s Health Initiative Randomized Clinical Trials.” JAMA 324, no. 4 (2020): 369–80. North American Menopause Society. “The 2022 Hormone Therapy Position Statement of the North American Menopause Society.” Meno- pause 29, no. 7 (2022): 767–94. Stuenkel, C. A., et al. “Treatment of Symptoms of the Menopause: An Endocrine Society Clini- cal Practice Guideline.” Journal of Clinical En- docrinology & Metabolism 100, no. 11 (2015): 3975–4011. Mandy Burton, FNP-C, APRN, MSCP, is a women’s health nurse practitioner with 28 years of clinical experience and a distinguished record of post-graduate achievement in menopausal and hormonal medicine. After completing her APRN in 2021, she became Baptist Health’s first urogynecology nurse practitioner. She has since pursued extensive advanced training, including multiple specialized certifications and coursework in menopausal management, sexual health, and hormone therapy across complex clinical conditions. She is dedicated to advancing informed, safe hormone care through clinical practice, education, and professional outreach.