Health & Medical: 1) Doctors want women to know the nuanced reality of hormone therapy for menopause; 2)Advocates against HIV criminalization decry Carney silence on reform Trudeau promised

1) Doctors want women to know the nuanced reality of hormone therapy for menopause

Courtesy Barrie360.com and The Associated Press

By Laura Ungar, August 24, 2025

Menopause can usher in a host of disruptive symptoms like hot flashes, night sweats and sleep problems. Hormone therapy promises relief.

But many women wonder about taking it. That’s because the treatment, subject of a recent expert panel convened by the Food and Drug Administration, has long been shrouded in uncertainty.

It was once used routinely. But in 2002, research testing one type was stopped early because of concerns about increased risks of breast cancer and blood clots. Concerns lingered even though later studies showed the benefits of today’s hormone therapies outweigh the risks for many women.

“There is still a lot of confusion and a lot of fear,” said Grayson Leverenz, a 50-year-old from Durham, North Carolina, who hesitated to take it but is glad she did.

Others increasingly are also giving hormone therapy a second look. But experts continue to disagree about how to present the treatment’s pros and cons. The FDA-assembled panel stressed the benefits and suggested health warnings be removed from at least some versions — prompting dozens of experts to call for more input before making any changes.

Doctors say hormone therapy is a great option for many, but not all, menopausal women — and it’s important to understand the nuanced reality of these treatments before deciding what’s best.

How hormone therapy works

It treats symptoms that can arise when menstruation winds down and ends, causing levels of estrogen and progesterone to drop very low.

One type is low-dose vaginal estrogen therapy. Because it’s applied into the vagina, very little circulates in the blood and the risks are far lower. Doctors say it’s a good option for women whose biggest complaint is vaginal dryness.

Whole-body therapy includes pills, patches, sprays, gels or a vaginal ring that deliver doses of hormones into the bloodstream at levels high enough to have significant effects on symptoms like hot flashes. Such systemic hormones include estrogens and progestogens.

Jennifer Zwink, a nurse in Castle Rock, Colorado, began using an estrogen patch more than a year ago and also has an IUD, which gives her progesterone. The treatment has relieved her hot flashes, improved her sleep and eased her joint pain and bloating.

“It’s not like a 100% magic wand,” she said. “But it definitely has made a significant difference.”

The Menopause Society says hormone therapy can lower the risk of cardiovascular disease if started within 10 years of reaching menopause. It may also reduce the risk of Type 2 diabetes and maintain bone density for longer.

“They might have a drop in their bone density at age 60” instead of at age 50, said Dr. MargEva Morris Cole, an OB-GYN with Duke University.

Hormone therapy carries some risks

When Leverenz was first prescribed hormone therapy last year, she kept worrying about the risks she’d heard about — then finally decided: “I can’t live like this anymore.”

With a combination of three medications, her anxiety lifted, her sleep improved, her joint pain and hot flashes went away.

“I just feel like myself again,” she said.

Doctors say many patients hesitate to try hormones, and they try to reassure them.

Women can use estrogen therapy for seven years – and estrogen-progestogen therapy for three to five years – before breast cancer risk goes up, according to the Menopause Society.

The group says both estrogen therapy and estrogen-progestogen therapy increase the risk of stroke, which goes away soon after stopping hormones. The risk of blood clots rises if you take hormones by mouth, but may be lower if you use a patch, gel or spray.

“A lot of these risks are small,” said Dr. Nanette Santoro, an OB-GYN at the University of Colorado. “And they have to be weighed against the benefit of symptom relief.”

Age, medical history and how long women stay on the hormones are also considerations. Many women take them for around five years, and those who’ve had a stroke or certain other conditions may be advised against using them at all.

Debate on changing warnings on hormone medications

Doctors are divided over whether there should be changes in “black box” health warnings on some hormone treatments. All estrogen drugs still carry boxed warnings about the higher rates of stroke, blood clots and cognitive problems among women taking the medications.

Most of the physicians at the recent expert panel meeting convened by the FDA prescribe the hormones or are involved with a pharmaceutical industry campaign opposing the warning label. A letter signed by 76 doctors and researchers argues that “removing label warnings without adequate scientific assessment puts patients at risk,” and asked the agency to hold an advisory committee meeting with a public hearing before making any changes.

In the meantime, doctors urge people to be wary of misinformation, like false claims on social media posts that hormones will prevent dementia and ensure a healthy old age.

“We can’t say that you are going to live a longer, healthier life because you took hormones,” Duke’s Cole said. “I don’t want the pendulum to go so far that people feel that it is promising health for the next 30 to 40 years.”

Alternatives to hormone therapy for menopause

Santoro pointed to a new non-hormonal medication called fezolinetant, marketed as Veozah, for hot flashes and night sweats. The anti-epileptic medication gabapentin, in low doses, can also be used for hot flashes and a moisturizer can improve vaginal dryness.

Experts also say regular exercise and a healthy diet can help manage symptoms.

Santoro urged against the “wild proliferation” of supplements claiming to be menopause cure-alls.

“Everybody is in on the menopause gold rush,” she said. “If it looks too good to be true, it probably is.”

2)Advocates against HIV criminalization decry Carney silence on reform Trudeau promised

Courtesy Barrie360.com and Canadian Press

By Dylan Robertson, August 23, 2025

HIV activists say there is mounting frustration in communities affected by the virus, amid near-silence from the federal government nearly 10 years after the Liberals pledged to reform laws surrounding HIV disclosure.

“We’re coming up on a decade,” said Muluba Habanyama, head of the Canadian Coalition to Reform HIV Criminalization. “There definitely has been some exhaustion.”

Canadians living with HIV can be prosecuted for not disclosing their status to sexual partners, even when they are taking prescription drugs that the Public Health Agency of Canada says renders HIV “untransmittable” to someone without the virus.

The HIV Legal Network says more than 220 people have been charged in Canada for allegedly not disclosing their HIV status since 1989.

The Liberals have been promising to fix the issue since 2016, and issued advice to prosecutors in 2018 meant to prevent them from laying criminal charges when there is no realistic possibility of transmission.

Still, HIV service organizations in Habanyama’s coalition encounter situations every few months, such as someone being arrested when an aggrieved ex-partner claims they were exposed to the virus.

A prosecution under sexual assault can put them on the National Sex Offender Registry.

“We are demonized,” said Habanyama, who has had HIV since birth. 

She has watched for 32 years as medical experts developed increasingly effective tools to treat and prevent the virus.

“I’ve literally grown up with the science, but then seeing the law be exactly the same,” she said.

Even if people aren’t being criminally charged for non-disclosure, the experience of police questioning someone or taking them into custody sends a message to others who suspect they have HIV that they might be better off not getting a test.

“People are like ‘well, I don’t know my status; I can’t get charged,'” Habanyama said. “If they don’t have a record of you getting tested, you can’t prove that you knew.”

The Department of Justice acknowledged the issue in an October 2022 notice, when it launched consultations for legal reforms, six years after the Liberals first pledged action on the issue.

“Criminalization can lead to the stigmatization of people living with HIV, which can often discourage individuals from being tested or seeking treatment,” the department wrote at the time.

Other countries have reformed their laws, in recognition that the threat of prosecution prevents reaching global public-health targets of having 95 per cent of people who have HIV aware of their status and on medication.

Only 89 per cent of people with HIV in Canada know their status, according to 2022 data.

A 2022 study of 600 Canadian women living with HIV found one-fifth faced more verbal, physical or sexual violence because of HIV criminalization, such as a man who rapes a woman and threatens to report they’ve been exposed to HIV if the woman files assault charges.

“This is really affecting the lives of people living with HIV, and stops them from taking care of themselves,” Habanyama said.

The Liberals have pledged to table legislation, but put froze those plans last fall, blaming Conservative filibustering for a logjam in Parliament. The government then prorogued Parliament and went into an election, followed by a brief spring sitting.

Prime Minister Mark Carney’s government has given no indication if it will table legislation.

Justice Minister Sean Fraser was not available for an interview despite repeated requests from The Canadian Press over several weeks. He has also not agreed to meet with the coalition, instead offering a meeting with his staff members.

“Our work is ongoing and we are engaging with stakeholders at this time,” wrote Lola Dandybaeva, a spokeswoman for Fraser.

André Capretti, a policy analyst with the HIV Legal Network, said it has been “mostly radio silence” since Carney took office, though he said it’s possible the government is still getting its business in order through the summer break.

“We were making a lot of progress with the Liberal government, who was very much committed to reform on this issue and showed real commitment to engaging us,” he said, noting Justin Trudeau’s justice ministers seemed attentive.

Still, there is inconsistent enforcement across provinces, with some largely ignoring Ottawa’s 2018 advice to prosecutors, which is only binding in the territories.

“We still know of cases in the past year, of prosecutions having been initiated against people living with HIV for non-disclosure,” Capretti said.

“There is definitely frustration that has built up, just based on how long this has been ongoing and the number of repeated commitments … from different justice ministers.”

Habanyama said Canada needs a rethink in how it legislates and thinks about HIV.

She recalls her Catholic elementary school in Oakville, Ont. teaching her in the mid-2000s that HIV meant death and was the result of reckless sex, with no mention that people like her contracted it in the womb or from their mother’s breast milk.

“I was raised (to understand) this is a shameful secret that we can’t tell anybody, that this is a really bad thing.”

When she visits schools to talk about HIV, she asks students what someone with HIV looks like, and the students often say they’d expect someone bald with scars on their body. They’re often surprised when she tells them she has HIV.

The threat of criminalization looms large among Black women and gay men. Multiple woman with roots in the Caribbean who live with HIV have told Habanyama to preserve evidence in case a sexual partner ever accuses her of exposing them to HIV — including their DNA.

“These groups of women were telling me that when I have sex, I should put the man’s condom in the freezer so that I have proof if the police ever come, that we used protection.”

She said Canadians should ask their politicians to do more, particularly when they show up at events like this weekend’s Pride parade in Ottawa.

“HIV can happen to anybody,” Habanyama said. “We are all supposed to be in this together.”