Library

A curated collection of trusted guidelines, landmark research, and expert educators that inform modern hormone, thyroid, metabolic, bone, and brain health care.

Foundations

Avrum Bluming, MD

Medical oncologist/co-author of the most influential modern interpretation of hormone therapy safety.

Why this matters: This work critically re-evaluates earlier interpretations of hormone therapy risks, and highlights the importance of timing, individualized care, and updated evidence in women’s health.

STATEMENTs & Guidelines

These professional organizations provide evidence-based recommendations used in clinical decision-making.

The Menopause Society

Hormone Therapy Position Statements

  • Most effective treatment for vasomotor symptoms

  • Benefits outweigh risks for most women <60 or within 10 years of menopause

  • Transdermal estrogen may reduce clot risk

Endocrine Society

Menopause Clinical Practice Guideline

  • Recommends hormone therapy for moderate–severe symptoms

  • Emphasizes individualized risk assessment

  • Supports transdermal estrogen in higher-risk patients

International Menopause Society

Papers, Recommendations, Statements

  • Confirms hormone therapy as most effective treatment

  • Encourages individualized care

American Urological

Association

Genitourinary Syndrome of Menopause (GSM) Guideline

  • Supports low-dose vaginal estrogen

  • Improves urinary + vaginal symptoms

  • Minimal systemic absorption

International Society for the Study of

Women's Sexual Health

Female Sexual Health & Testosterone Therapy Publications

  • Supports testosterone for Hypoactive Sexual Desire Disorder (HSDD)

  • Recommends physiologic dosing

  • Emphasizes sexual health as essential

Research

These landmark studies shaped the modern understanding of hormone

therapy and women’s health.

Women's Health Initiative

  • Initial data raised concern about risks

  • Later analysis supports importance of timing

  • Outcomes vary based on patient age and therapy type

ELITE Trial

  • Early estrogen → improved vascular outcomes

  • Supports timing hypothesis

  • Reduced atherosclerosis progression

KEEPS Trial

  • Early hormone therapy shows neutral/beneficial cardiovascular impact

  • No increased cardiovascular risk in early menopause

  • Supports lower-dose/transdermal use

SWAN Study

  • A large, multi-site U.S. study following over 3,300 women through the menopause transition.

  • Tracks perimenopause changes

  • Shows symptom variability

  • Identifies metabolic shifts

Danish Osteoporosis Prevention Study (DOPS)

  • Reduced cardiovascular disease and mortality

  • No increased breast cancer risk

  • Supports early initiation of hormone therapy

ESTHER STUDY

  • Oral estrogen increases risk of venous thromboembolism (VTE), while transdermal estrogen does not.

  • Micronized progesterone appears neutral in clot risk compared to some synthetic progestins.

Learning

Areas of ongoing research and evolving evidence:

  • Brain health and menopause

  • Thyroid dysfunction in women

  • Testosterone therapy in women

  • Low-dose vaginal estrogen safety

  • Bone and muscle health in midlife

  • Perimenopause and metabolic health

  • Cardiovascular protection & estrogen timing

A Note from Balance & Blossom Wellness

Hormone science continues to evolve. Our approach is grounded in:

  • Current clinical research

  • Evidence-based guidelines

  • Functional medicine principles

  • Individualized optimized patient care

The goal is to support women in feeling their best while prioritizing long-term health and longevity.

Ready to Feel Like Yourself Again?

Book your consultation today and take the first step toward a healthier, more vibrant you.

Get In Touch

Lauren Zajac, MHS, PA-C, AFMCP

Balance and Blossom Wellness, PLLC

Treating The Women Of Pennsylvania, In-Person & Virtually

2214 N Atherton St., Suite 308

State College, PA 16803

(Inside the Simply Health Wellness Center, rear of building)

Office Hours: Monday-Thursday 9am-4pm

[email protected]

Get In Touch

Lauren Zajac, MHS, PA-C, AFMCP

Balance and Blossom Wellness, PLLC

Treating The Women Of Pennsylvania, In-Person & Virtual

2214 N Atherton St., Suite 308

State College, PA 16803

(Inside the Simply Health Wellness Center, rear of building)

Office Hours: Monday-Thursday 9am-4pm

[email protected]