ACOG finally caught up. Now you need a doctor who has too.
10.16.26
Big news for women’s health this week!
On October 15, 2026, the American College of Obstetricians and Gynecologists (ACOG) published its most comprehensive menopause guidance to date (Clinical Practice Guideline 13, “Management of Menopause-Related Vasomotor, Sleep, and Mood Symptoms”). The message is clear: hormone therapy is safe and effective for most healthy women who start it at the right time.
What ACOG now says
For years, hormone therapy carried a reputation it didn’t earn. Most of that fear traces back to early interpretations of the 2002 Women’s Health Initiative, which studied women whose average age was in their 60s, many of them a decade or more past menopause. Follow-up analyses showed that timing matters, and that younger women starting closer to menopause had a much more favorable risk profile.
ACOG’s new guidance reflects that evidence. It recommends starting hormone therapy before age 60 or within 10 years of menopause for women without contraindications, with the decision built on your symptoms, your medical history, and your personal cardiovascular, breast cancer, and clotting risk. ACOG’s own authors acknowledged that misconceptions about risk have kept clinicians from prescribing it and kept patients from asking for it.
The guidance also states that phytoestrogens and herbal supplements, the products marketed hardest to women in menopause, don’t have evidence supporting their safety or effectiveness.
The next hurdle: finding a doctor who will prescribe it
Guidelines don’t change practice overnight. Most primary care physicians and OB-GYNs were never trained to manage menopause. In a Mayo Clinic survey of residents across family medicine, internal medicine, and OB-GYN programs, only 6.8% said they felt adequately prepared to manage women going through menopause, and 1 in 5 reported getting no menopause lectures at all (Kling et al., Mayo Clinic Proceedings, 2019).
Where Sur comes in
Sur physicians are trained through The Menopause Society (formerly NAMS) and manage hormone therapy every day. We care for many women (and men!) on hormone replacement. It’s core to what we do.
We only prescribe bioidentical hormones. Bioidentical means the hormone is molecularly identical to what your body makes on its own: estradiol, progesterone, and testosterone. The goal is to replace what your body is no longer producing, not to introduce something foreign to it.
Every plan starts with comprehensive labs and a full review of your history, so your treatment is based on your numbers and your risk, not a one-size-fits-all prescription. From there, we monitor you over time, with routine follow-up labs and regular physician visits to adjust as your body changes.
Feeling better is the start. Staying there is the goal.
Hot flashes, poor sleep, and mood changes aren’t something you have to wait out. The right therapy, started at the right time and monitored over the long term, can give you years of better sleep, steadier energy, and stronger health.
If you’ve been wondering whether hormone therapy is right for you, let’s talk. Click “Book a Free Consult” at the top of this page to book time with the docs!
- Umang Jain, MD
