Beyond the Black Box Warning: What Women Deserve to Know About Estrogen, Hormone Balance, and Aging Well
It’s time to talk about what science has shown all along — that fear never matched physiology, and that balanced hormones have always helped women age better, not worse. The removal of the black box warning is an important correction, but it doesn’t change the fundamental truth: estrogen didn’t suddenly become “safe.” It always was when used in physiologic, balanced ways.
Yet instead of creating clarity, the recent announcement has unleashed another wave of confusion. Many voices online are speaking loudly but without context, without physiology, and without acknowledging how hormones actually work together inside the body. Women are being told to fear the very hormones that support their brains, hearts, bones, mood, and metabolism for most of their lives. And as the conversation gets louder, it becomes harder for women to know what’s true.
Join biochemist Phyllis Bronson, PhD, and host Jill Chmielewski, RN, BSN, for a meaningful conversation for women who feel overwhelmed by the noise, fear, and conflicting messages about hormones. This webinar is for women who want to understand what hormone balance actually means — how estrogen, progesterone, and testosterone work together, how they support long-term health, and how these signals shape the way women age. Together, we’ll bring the science back into the conversation in a way that feels human, grounded, and aligned with how women truly make decisions about their bodies.
About Phyllis Bronson, PhD
Phyllis Bronson, Ph.D., holds a doctorate in biochemistry. Her ongoing research involves studying the biological impact of molecules on mood and emotion. Dr. Bronson works with women who have hormone-based mood disorders, utilizing her original research on human identical hormones. She lives in Aspen, Colorado, and is President of Biochemical Consulting and The Biochemical Research Foundation, and is on the Medical Advisory Board at the Institute for Bioidentical Medicine.
Dr. Bronson is the author of Moods, Emotions, and Aging: Hormones and the Mind-Body Connection, and has authored many articles, which can be found here.
Video Timestamps
[00:06] Why We Held This Webinar: Clearing Fear After the Black Box News
The removal of the vaginal estrogen black box warning sparked unexpected backlash, with influencers and some clinicians doubling down on fear-based messaging about estrogen.
Within 48 hours, hundreds of women messaged saying they were excited to start HRT… until online posts made them more afraid than before.
Dr. Bronson emphasizes the need to return to biochemistry, not influencer narratives—women are N=1, and misinformation from poorly trained “experts” is driving confusion and unnecessary fear.
[04:35] Transdermal Progesterone: Why It Works (Even When Blood Tests Say It Doesn’t)
80% is converted immediately to allopregnanolone in the epidermis, creating calm by activating the brain’s inhibitory chloride channel; the remaining 20% is typically sufficient for endometrial protection.
You can’t measure what isn’t there: because most progesterone has already converted to neurosteroids, blood levels will never reach “6 ng/mL”—making influencer claims about “non-absorption” a false equivalency.
Both forms work, but differently: oral = sleepy before calm (first-pass metabolism, delayed spikes); transdermal = calm without sedation, flexible dosing, difficult to overdose, and supported by decades of biochemical and clinical experience.
[14:09] Proliferation, Context & the Premarin Problem
You can’t collapse domains: Estradiol’s “proliferative” action is normal, physiologic, and context-dependent. Proliferation in the right tissue is healthy, not dangerous.
Premarin ≠ safer: Some doctors are claiming that horse-urine estrogen is the “only safe” option, based on randomized trial data; Premarin is 49–62% estrone salts—the most toxic, E1-dominant estrogen.
Why E2 matters: Estradiol (E2) is the key driver of mood, cognition, and brain aging. Estradiol preserves bone by slowing resorption, while progesterone actually builds new bone.
[19:35] Why the Estrogen Series Exists (E1 • E2 • E3)
E1, E2, and E3 are a purposeful biochemical series: E2 is the primary, symptom-relieving estrogen; E3 adds additional benefits, and E1 exists but is not needed in compounded formulas.
Women thrive when they get enough estradiol (E2) to handle symptoms, mood, cognition, and brain aging. E3 can ideally be added for support, but E2 is the central molecule.
Anytime estrogen is used, progesterone must be used too. It counterbalances proliferation, protects tissue, and stabilizes neurochemistry; no cycling or high-E2 “fake periods” are needed.
[28:18] FSH, Oxidative Stress & Cognitive Decline
Low estradiol → rising oxidative stress, which accelerates the “rusting” of the brain and drives cognitive decline in aging women.
FSH climbs as estradiol falls, just like TSH rises when thyroid hormone is low—an internal signal of deficiency.
Adequate estradiol is essential for protecting the aging brain, supporting cognition, and preventing the oxidative processes that erode function over time.
[39:32] Why We Have an Estrogen Series (E1 • E2 • E3)
Estrone (E1) has a purpose: it acts as an anchoring molecule that helps estradiol (E2) maintain proper biochemistry, so the goal isn’t to eliminate it, but to keep it in balance.
Aging shifts the ratio: larger midlife fat cells aromatize more estrone, creating a more toxic estrogenic pattern, which is why replicating E1-dominant chemistry (like Premarin) is not ideal.
Spectroscopy confirms the issue: Premarin shares estrone’s carbonyl signature, reinforcing the same E1-heavy pathway, underscoring why supporting E2 is critical.
[54:38] Alpha vs. Beta Receptors: Why “Proliferation = Cancer” Is Wrong
Estradiol signals primarily through the alpha receptor, which drives healthy proliferation (the same physiology that allows fetal growth). Progesterone provides the counterbalance, inhibiting excess proliferation; you always need both.
Estriol and fermented soy activate the beta receptor, an immune-protective, anti-proliferative pathway. This beta signaling acts like a biochemical “brake,” supporting balance, safety, and healthy estrogen metabolism.
The estrogen series works as a coordinated system: E2 handles cognition/mood; E3 supports immune protection via beta signaling; progesterone anchors the antiproliferative effect. Reducing everything to “estrogen = proliferation = cancer” strips away all context and fuels unnecessary fear.
[01:04:00] Estradiol + Progesterone + Testosterone: The Real Partnership
Estradiol drives growth; progesterone counterbalances it with anti-proliferative, calming, mood-stabilizing effects—you need both, uterus or not.
Many women without a uterus thrive on progesterone alone at first, but full recovery from anxiety, depression, and low mood often requires adding estradiol
Dose targets don’t matter as much as getting “enough” for symptom resolution; influencers who fixate on serum numbers miss the biochemistry. Progesterone, estrogen, and testosterone work as a synergistic trio supporting mood, proliferation control, and psychological resilience.
[01:15:34] How Much Progesterone Is “Too Much”?
You’ve hit the limit when calm turns into sleepiness. That’s the only real indicator you’ve gone past your personal threshold.
Many women safely use 300–400 mg at night and 100 mg multiple times during the day during more anxious periods, then taper as needed.
Transdermal is ideal for daytime because it calms without sedating and remains powerfully antiproliferative.
[01:22:31] Closing & Key Takeaways
Hormones are containers for mood—balance matters. Women need education, not fear.
Resources shared: Phyllis’s book, Jeffrey Dach’s book, and websites for deeper learning.
Final reflection: Health is a dance—balance hormones and heal the psyche.
Links mentioned in the webinar
The Institute of Bioidentical Medicine (IOBIM) was founded by Dr. Daved Rosensweet
Books
Moods, Emotions, and Aging: Hormones and the Mind-Body Connection, by Dr. Bronson
Bioidentical Hormones 101 by Dr. Jeffrey Dach
The Pregnant Virgin, by Marian Woodman
It’s Not Your Money, By Tosha Silver (also Living Outrageous Openness forum)
For more information on this topic, see our other webinars:
Missing the Mark on Progesterone: What Most Menopause Doctors Get Wrong
Defending all forms of bioidentical progesterone
Disclaimer: This webinar is for educational and informational purposes only and is not intended to replace personalized medical advice or individualized care. It is meant to help you understand your physiology, explore evidence-based options, and make informed choices about your health and wellness. Healthcare should be a partnership, not a permission slip, and proactive care is just as essential as treatment. Use this information to engage in open, collaborative discussions with your provider or to make empowered decisions that align with your own values, goals, and comfort level. You are the ultimate authority on your body.