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Stressed, tired, moody? This one’s for you
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Bye-Bye, Black Box

Yesterday, the FDA instructed drugmakers to remove the long-standing “black box” warnings from many forms of hormone replacement therapy (HRT)—think pills, patches, creams. The shift reflects what research has shown for years: When HRT is started before age 60 or within 10 years of menopause, the risks are far lower than once believed. Labels will still note potential risks (heart problems, clotting issues, breast cancer), but without the highest level warning that has long fueled confusion.


What this could mean for you: For women ages 40+, this update won’t change whether HRT is right for you (your personal health history still matters), but it should help shift the conversation from fear to facts.


At Midi, we see every day the impact HRT can have on women’s lives when they finally get relief from hot flashes, night sweats, sleep issues, brain fog, genitourinary symptoms, and more.

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Ask a Midi Clinician

The expert: Kathleen Jordan, MD, Midi’s Chief Medical Officer


Q: “I keep hearing about high cortisol. How do I know if my cortisol is actually elevated—and what can I do to block it?”


A: Cortisol is having a moment online. But let’s clear something up: Cortisol isn’t something you want to “block”—it’s your body’s main stress hormone, and it’s vital for managing energy, metabolism, immunity, and blood sugar. The issue is when cortisol stays too high for too long.


That’s especially common during perimenopause and menopause, when hormonal shifts, poor sleep, and daily stress all pile up. The result? Fatigue, stubborn belly fat, anxiety, mood changes, and more.


At Midi, we take a holistic approach to balancing cortisol levels with our Cortisol Care Stack, which can include:

  • Hormone replacement therapy: HRT can help lower cortisol indirectly by improving your sleep, mood, and stress response.

  • Supplements: Midi’s Daily Cortisol Support is designed to regulate your stress response and promote better sleep.

  • Lifestyle support: Midi helps you optimize stress management, strength training, and sleep hygiene to better balance cortisol.

  • Testing: Salivary cortisol testing gives a personalized picture of your cortisol pattern throughout the day, helping your clinician determine the best course of treatment. 

  • Other targeted treatments: In some cases, we may use low-dose naltrexone or microdosed GLP-1s to help reduce inflammation. 

If you’re stressed, having trouble losing weight, or dealing with other frustrating symptoms and are wondering if cortisol is to blame, skip the guesswork. Midi’s clinicians can test and build a personalized plan so you can feel more like yourself again.

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