The FDA's removal of the long-standing "black box" warning on vaginal estrogen marks a historic acknowledgment of gender disparity in medicine. Dr. Michael Reed, founder of The Cosmetic Gyn and the Institute of Restorative & Cosmetic Gynecology (IRCG), declares it the beginning of the "Fourth Pillar of Women's Health," calling for equality, evidence-based training, and restorative care
BEVERLY HILLS, Calif., Nov. 12, 2025 /PRNewswire-PRWeb/ -- In a historic move, the U.S. Food and Drug Administration has removed the decades-old "black box" warning from vaginal estrogen products. This action does more than restore prescribing freedom—it acknowledges what many in women's medicine have long known: women's sexual health has been neglected and misunderstood for decades.
For more than twenty years, the warning fueled fear, confusion, and silence. It discouraged physicians from treating even the most basic menopausal symptoms and left millions of women to suffer unnecessarily. The FDA's reversal represents not just a scientific correction but a cultural reckoning.
"This decision finally admits what medicine has quietly avoided saying," said Dr. Michael Reed, board-certified OB-GYN, certified menopause practitioner, and founder of The Cosmetic Gyn and the Institute of Restorative & Cosmetic Gynecology (IRCG).
"That women's health, especially their sexual health, has been abandoned. While men's sexual health has become a celebrated medical journey, women's has been shrouded in shame, silence, or vanity. It's time to level the field."
The Fourth Pillar of Women's Health
Dr. Reed describes this moment as the birth of a new medical frontier—the Fourth Pillar of Women's Health—joining reproductive, oncologic, and menopausal care.
This fourth pillar, Restorative and Functional Gynecology, focuses on preserving the vitality, structure, and sensation of the vulva and vagina throughout a woman's life. It merges surgical artistry with regenerative medicine to sustain comfort, function, and confidence.
"Aging of the vulva and vagina isn't just cosmetic," Dr. Reed explains. "It's a biologic process that affects tissue health, elasticity, and sensation. Just as men receive treatments to preserve testosterone, vascularity, and performance, women deserve equal access to therapies that preserve elasticity, sensation, and confidence. This isn't about vanity or youth — it's about vitality and equality.
Next Steps: From Estrogen to Comprehensive Restoration
The removal of the black box is only the first step. Experts say the next frontier must include:
- FDA-approved testosterone for women, as already seen in Australia and the UK
- Comprehensive physician education in menopause, regenerative and restorative gynecology
- A shift in language—from symptom management toward proactive preservation of sexual health
"Better science demands better training," Dr. Reed said.
"Leaders like Dr. Rachel Rubin have advanced the conversation on sexual medicine. At IRCG, we're extending that work by teaching physicians to integrate surgical precision, biologic therapies, and modern recovery into a single, women-first standard."
A Call for Renewal
The removal of the black box is more than a policy change. It is a public acknowledgment that women's health has been left behind and a call to rebuild it on truth, evidence, and equality.
"This is the moment to stop apologizing for wanting to feel whole," said Dr. Reed. "For women, sexual health is not a luxury. It is a vital sign of overall well-being. The systems that ignored that truth are finally beginning to listen."
Dr. Reed invites physicians, health leaders, and women everywhere to join in defining the next era of care—one that restores confidence, function, and longevity to the most personal parts of a woman's life.
To learn more about restorative gynecology training, media opportunities, or patient resources, visit DrMichaelReed.com or follow @thecosmeticgyn on Instagram and TikTok.
About Dr. Michael Reed
Dr. Michael A. Reed, MD, a board-certified OB/GYN and one of the nation's leading authorities in functional and aesthetic gynecology, is widely known as The Cosmetic Gyn. Fellowship-trained and internationally recognized, Dr. Reed founded the Institute of Restorative & Cosmetic Gynecology (IRCG) to elevate standards of care and advance women's health globally.
He practices in Beverly Hills and Northern California.
Website: DrMichaelReed.com
Instagram and TikTok: @thecosmeticgyn
Media Contact: [email protected]
Media Contact
Dr. Michael A. Reed, MD, 1 5307532787, [email protected], www.drmichaelreed.com
SOURCE Dr. Michael A. Reed, MD
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