If you’re a woman of a certain age, your social media feed is likely filled with advice on what hormones you should take. The promises made by menopause influencers about hormone therapy are expansive: easing hot flashes and night sweats for starters, but also promoting better brain and heart health, improving muscle mass and bone strength, boosting energy, and even enhancing your sex life.

What bone-tired, middle-aged woman balancing childcare, elder care and a job — while also trying to maintain some semblance of a healthy long-term partnership — wouldn’t want all that?

And yet, as women’s health influencers, participants on menopause message boards, and now the head of the U.S. Food and Drug Administration will tell you, doctors have for too long been “gatekeeping” hormone therapy. Millions of women, the narrative goes, are being deprived of something that could help them live longer and feel better.

If only the evidence supporting those claims about hormones were as strong as their conviction in them.

Hormone therapy can help many women, but it’s not the panacea many advocates are promising. And while women’s health has indeed suffered from neglect, it does women a terrible disservice to overpromise on what any single therapy can do for their health.

FDA Commissioner Marty Makary has long been a proponent of expanding access to hormone therapy so that more perimenopausal and menopausal women can benefit from it. (He devotes a chapter to the topic in his most recent book, Blind Spots.) Earlier this month, he directed the FDA to remove the black box warning labels from several forms of hormone therapy, theoretically making it easier for women in midlife and beyond to access these treatments.

A pall was cast over such treatments in 2002, when a large, long-term study — the Women’s Health Initiative — ended abruptly after researchers found hormones increased the risk of heart disease, strokes and breast cancer. Over time, it became clear that those warnings were not only overblown but also wrong: Hormone therapy did not increase the likelihood of a heart attack, and short-term use didn’t increase women’s chances of developing breast cancer. Moreover, new and safer products have emerged that minimize those already small risks.

Yet some doctors spent decades reluctant— or even refusing — to prescribe hormones to alleviate women’s symptoms. In a podcast discussion about the policy change, Makary described the 2002 pullback as “maybe one of the greatest screw-ups of modern medicine.” By getting rid of the black box warnings, he said, “we are getting rid of that fear machine.”

As I’ve written, a corrective to that frustrating period is overdue. And yet by making these changes without nuance, Makary is ushering in a new, equally frustrating era — one where the pendulum swings too far toward treatment for all, regardless of their symptoms or the data, and where expectations for what the therapy can deliver are overstated.

Let’s start with the good in this month’s decision: The FDA removed the so-called black box warning on topical estrogen. Doctors have long argued that this warning mistakenly conflated the risks of systemic medicines with those of a locally applied, low-dose formulation that clinical studies have shown to be very safe. That label has discouraged its use, even though it can help prevent and treat a number of menopause-related conditions.

Doctors are less in agreement on the FDA’s decision to remove the black box warning from other forms of hormone therapy, which deliver estrogen systemically and may carry longer-term risks for some women. While it’s true that many physicians might have been overly cautious, and that the field has needed to do better by women, patients still deserve all the pertinent information when considering a new treatment.

But Makary didn’t stop at removing the labels. During a press conference announcing the labeling change, he and several menopause doctors (who have built vast social media followings — and lucrative private practices — by promoting hormones) significantly overstated the benefits of hormone therapy while minimizing its potential risks.

Research shows that hormone therapy can help relieve many of the symptoms of menopause — including hot flashes, night sweats and vaginal dryness — and can help protect against bone loss and lower the risk of developing diabetes. Yet Makary claimed it has “profound long-term health benefits that few people, even physicians, know about.” Those purported benefits, he said, include cutting their risk of heart disease by as much as half and Alzheimer’s disease by 35%, and even extending the lives of breast cancer patients.

Menopause researchers who have spent years studying the effects of hormone use were stunned by some of the unfounded claims. “They’re making menopause and hormone therapy synonymous,” says Monica Christmas, associate medical director of the Menopause Society. They’re suggesting that hormone therapy is “this magic antidote to aging and it’s not,” she says.

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The hype was enough to draw Pauline Maki, director of the University of Illinois College of Medicine’s Women’s Mental Health Research Program, off the social media sidelines. In an Instagram video — one of only six posts she’s ever made — Maki walks through the results of a randomized study she conducted comparing brain function and memory in women taking hormones with those receiving a placebo. She found no difference between the groups — and neither did three larger studies conducted by other researchers in her field. “Not one of them found an improvement in cognition,” she says. “Zero, zip, zero.”

In subsequent research, Maki found that hormone therapy may improve cognition — but only in women experiencing the most severe symptoms. “They’re having these hot flashes and waking up in the middle of the night,” she says. “You don’t need me and all my decades (of research) to tell you that if you’re not sleeping well, your cognition is bad.”

A more open conversation about menopause and greater access to therapies for women who might truly benefit from them should be welcomed. But women also deserve accurate, evidence-based information so they can make informed decisions about their health. Anything short of that isn’t progress, it’s more paternalism.

Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.

Minnesota business leaders gathered this week to hear harsh truths about the state’s economy in order to chart a path forward.

The Minnesota Chamber of Commerce on Wednesday invited business leaders and lawmakers to its 2025 Economic Summit where it highlighted several areas where the state’s economy has fallen behind and introduced a potential antidote called “Economic Imperative for Growth.”

The initiative is a call to action for employers and policymakers to confront barriers facing the state’s economy. The barriers include lagging tech growth, slowing innovation and the loss of talent, according to the Chamber’s 2026 Business Benchmarks report, which was released Wednesday.

“Minnesota’s economy is not keeping pace. Our state has fallen behind on nearly every measure of growth,” said Doug Loon, president and CEO of the Minnesota Chamber of Commerce, at the event.

“The overall initiative is not a one-and-done strategy. … We see this as a multi-year strategy for the Chamber and the business community,” Loon said, emphasizing the importance of ongoing conversations between stakeholders.

“We are not broken. It is not too late to work together,” Loon said. “I firmly believe our best days are not behind us.”

EARLIER: Slowing economic growth, ongoing ‘war for talent’ worry Minneapolis-St. Paul business leaders

Here’s a look at some of the factors impacting Minnesota’s economy.

Slowing GDP

After decades of handily outperforming the nation, Minnesota’s lead in gross domestic product per capita is slipping, said Sean O’Neil, senior director of economic development and research for the Minnesota Chamber Foundation.

Over the past decade, Minnesota’s per capita GDP grew at just 1% annually, compared to 1.8% nationally, according to the report.

Minnesota ranked 18th in the nation for GDP growth from 2007 to 2019. From 2019 to 2024, the state dropped to 33rd.

Minnesota Rep. Matt Norris, a Democrat who represents Blaine and Lexington, asked why Minnesota’s GDP did not rebound as quickly as the national GDP in the years immediately following the onset of the COVID-19 pandemic.

“A lot of (national) growth has been on the tech side of the economy … but that is an area that we call out in the report where (Minnesota) has not been growing as fast,” O’Neil said.

According to the report, Minnesota ranked 44th in the nation in tech job growth in 2024. “That is one explanation for why our overall economy hasn’t been growing as fast.”

Innovation momentum is also slowing in Minnesota.

While the state produces the fifth-highest number of patents per capita in the nation, patent activity has dropped off over the last decade, putting Minnesota in 47th for patent growth over the last decade, per the report.

Business climate challenges

Employers have growing concerns about Minnesota’s tax and regulatory environment discouraging investment, according to the report.

Minnesota ranks 44th for overall tax competitiveness with the second-highest corporate rate and sixth-highest personal income tax rate.

New labor mandates are also contributing to the uphill battle of doing business in Minnesota.

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“Paid family medical leave kicks in Jan. 1,” Loon said. “I can’t go out and visit a business right now without having a really difficult conversation about how this law is disrupting their business.”

Starting next year, most employers will be required to offer employees 12 weeks of family leave and 12 weeks of medical leave, with annual time capped at 20 weeks.

The paid leave program’s initial costs are covered by $668 million from the historic $18 billion surplus during the 2023 legislative session. The rest will be funded by a new 0.88% payroll tax on most employers, though the tax can be split by employers and employees.

“There are more companies that would like to expand and invest here than we are enabling,” O’Neil said.

Cost of living

Minnesota’s cost of living ranks 19th highest in the nation.

“If you look at overall cost of living, Minnesota is a little more affordable than the U.S. overall,” O’Neil said. “But we’re in a region that has lower costs of living than we have in (Minnesota).”

As for the cost of living in Minnesota’s neighboring states: Wisconsin ranks 30th, Iowa ranks 44th, North Dakota ranks 45th and South Dakota ranks 48th, per the report.

Limited housing and ongoing childcare shortages in Minnesota are also driving up costs and, in turn, constraining the state’s ability to attract new residents.

“Affordability is a key factor here in where people choose to live,” Loon said.

Workforce challenges

A lack of workers is making it harder for businesses to grow and expand in Minnesota, according to local business leaders.

From 1976 to 2000, Minnesota’s labor force grew by about 1.7% annually. Between 2019 and 2024, the workforce grew by 0.2% annually.

Part of that change can be attributed to declining birth rates: As the state’s baby boomer generation continues to retire, there are fewer young adults entering the workforce to replace them.

Another contributing factor is net migration. Minnesota loses about 8,300 college-age students to other states each year, according to a 2024 report from the Minnesota State Demographic Center. While some do return after graduation, their numbers fall short of offsetting the initial outflow, according to the report.

While Minnesota ranks sixth in the nation for labor force participation, or the percentage of the working-age population either employed or actively seeking work, that can be seen as a double-edged sword, O’Neil said.

With nearly 80% of working-age adults in this group, “there is a relatively small pool of working-age adults still on the sidelines,” per the report.

“These challenges have been increasingly intensified this decade,” said O’Neil. “Think back to the pandemic, we lost close to 100,000 people in the labor force.”

While talking about workforce shortages, one event attendee drew attention to the Trump Administration’s deportation efforts when he asked if the U.S. Chamber of Commerce was working on a “rational” immigration policy.

“Yes they are. That’s been a key area of focus for them — how to make the legal immigration system work better,” Loon said.

“They are trying to take this 1970s chassis that is our legal immigration system and really turn it into a modern vehicle that works for the economy,” Loon said, adding that the Minnesota Chamber of Commerce is a part of that national conversation.

Not all bad

While the state does have its work cut out as far as areas to improve, there are also benchmarks where Minnesota is leading the nation.

Here are four areas where Minnesota is improving.

• Minnesota ranks among the top 10 states in the share of adults with at least a bachelor’s degree and with an associate or higher, per the report, which notes the high ranking as “a strong foundation for innovation, productivity and long-term growth.”

• Minnesota is home to 17 Fortune 500 corporate headquarters, the largest concentration of “management of companies” jobs in the U.S., per the report, and leads in key areas such as life sciences and food and agriculture innovation.

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• Minnesota’s labor force participation among working-age people of color has risen by more than 11 percentage points since 2011 – from 62.4% to 73.5% in 2024. Similarly, participation among individuals with disabilities increased by 11 points between 2012 and 2023, reaching a record high of 60%, according to the report.

Minnesota is well-positioned to attract investment in fast-growing sectors, the report states. “Companies are still expanding in the state … in highly advanced and high value-added sectors like clean tech, data centers, R&D, health care and medical devices,” O’Neil said. “These are things where Minnesota does have some significant competitive advantages.”

It was a December day in 2024 and Danny Klecko was alone in Gallery 357 at the Minneapolis Institute of Art, looking at a painting of Jesus surrounded by the brokenhearted.

“I remember saying to Jesus, “Give me 100 hours and watch what I am going to do for you,” Klecko recalls.

Klecko, a poet who has written more than 15 books, kept his word with a project he calls Exhausting Jesus.

Inspired by the New York Times’ 10-Minute Challenge, which invites people to look at a painting for 10 minutes, Klecko decided, as usual, to go bigger by spending 100 hours viewing Ary Scheffer’s 1851 painting “Christus Consolator” at MIA, completing the project last Sunday. The copy of Scheffer’s popular painting, valued at worth more than $30,000, was found in a storage closet in Gethsemane Lutheran Church in Dassel, Minn., and later donated to MIA.

Klecko and Exhausting Jesus intrigued Larry Buchanan, a New York Times reporter and graphics editor who selects artwork for the Times’ 10-Minute Challenge, so he flew into Minneapolis last weekend to interview Klecko and his wife, Erica Christ, on the last day of the project.

Klecko had never met Buchanan, but that didn’t stop him from sending an email at the beginning of the project explaining that he was a master bread baker for more than 40 years and a poet who didn’t finish high school, and how the 10-Minute Challenge inspired Exhausting Jesus. (Klecko used the same “you-don’t-know-me-but” message when he sent his first poem to Buchanan’s colleague Ed Shanahan, who has published nine of Klecko’s poems in the Times’ Metropolitan Diary feature.)

“During the course of my project, I kept inviting Buchanan to Minneapolis to spend an hour with Jesus and me,” Klecko said. “He kept telling me to keep him in the loop and as the hours ticked down to 100, he said he was coming for the final hour.”

Klecko and Christ, who were married in August, had a wonderful time with the recently wed Buchanan.

“Larry was great,” Klecko says. “When you do emails you never know what to expect. I expected a literary kind of guy, but Larry looks like a young Russell Crowe. He’s funny and at ease. I have dealt with a lot of reporters and can’t recall being in the company of someone who was so comfortable with himself — relaxed, on point, professional.”

Klecko and Buchanan spent several hours at MIA with Buchanan filming their interview. With them was Heather Hofmeister, MIA public relations manager, one of the museum’s staff with whom Klecko formed friendly connections, including Galina Olmsted, associate curator of European art. He knows the guards and the information desk folks who got used to answering visitors’ questions about “the 100-hour painting” or “the 100-hour man.”

Buchanan asked to see Klecko’s notes for the book he’s writing about the Exhausting Jesus project. They walked to Klecko and Christ’s nearby house to grab Klecko’s computer and allow Buchanan to be a hero to the family dog, FiFi, because he had treats.

“I showed Larry my notebook on the computer, explaining the book is practically finished,” Klecko recalled. “People don’t realize that after each viewing session I spent several hours writing a synopsis of what happened that day.”

Klecko and Christ took Buchanan to the Black Forest Inn in Minneapolis, owned by Christ’s family, where Buchanan and Klecko played an impromptu game.

“Larry would challenge me to read at random from my notebook, like viewing hour number 32,” Klecko says with amusement. “So I’d read it to him and everyone in the restaurant. It must have been a surreal experience for him to be in an Old World restaurant listening to a big Polish guy wearing pink plastic pants and a raggedy hoodie.”

Buchanan emailed the Pioneer Press that he had “a fantastic time” with Klecko and Christ.

“The hour-plus we stood and talked in front of the painting he’s chosen flew by and included a number of strangers who decided to join in. I was very moved by the way Danny spoke of his time at the museum, especially when he spoke about what he views as his two jobs as a poet — ‘to observe and to love’ — and how his experiences strengthen his commitment  to both.”

Looking back at Jesus

Minnesota poet Danny Klecko, left, with New York Times reporter Larry Buchanan at the Minneapolis Institute of Arts on Sunday, Nov. 16, 2025. Inspired by the New York Times’ 10-Minute Challenge, which invites people to look at a painting for 10 minutes, Klecko decided, as usual, to go bigger by spending 100 hours viewing Ary Scheffer’s 1851 painting “Christus Consolator” at the museum in Minneapolis. (Courtesy of Erica Christ)

For Klecko, who’s 62, Exhausting Jesus taught some personal lessons.

“The main thing I learned is that no matter how much I focus or attention I pay to something, there is so much I am missing,” he admits. “There are things in life I might miss, just like looking at the painting. For instance, it took somewhere around hour 68 for my wife and I to notice stigmata on Jesus’ chest.”

Buchanan asked Erica Christ, who was with her husband for about 30 viewing hours, what she thought about the project. Her no-nonsense reply: “I never liked that painting.”

Klecko admits he was somewhat surprised at people’s interest as the project got more publicity, including an article picked up by PBS.

“Around hour 50 or so an entourage started to form around me, which was nice,” he recalls. “By hours 85 and 90 people came out of the woodwork. When Buchanan was here Sunday, I purposely selected a time at MIA I had never gone before because I wanted privacy. But people waited around throughout the day. People mean well and are gracious. They want to support what I am doing and be part of it. Two years ago I began having poems published in the New York Times. Now I have a writer flying across the country to be with me. I’m not bragging, but I’m in the company of two Times staff members.”

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Now that Exhausting Jesus is completed (except for finishing the book), Klecko says he feels calm and happy at being surrounded by people who wanted respectful conversation about what could be seen as a controversial painting because some of the figures surrounding Jesus were victims of war or atrocities.

“At no time did people get angry or out of control, which could have happened in a political or religious environment,” he says. “Now I have lost my faith in religion and politics. With all my heart I believe the only way to save ourselves is through art.”

Klecko’s book, titled “Exhausting Jesus at Minneapolis Institute of Art,” will be published in spring by Julie Pfitzinger’s Twin Cities-based Paris Morning Publications.

Two Minnesota students will be performing at Carnegie Hall in New York City next month in celebration of an international recognition.

Laila Elazab, center, of White Bear Lake, as Morticia Addams in the White Bear Lake Children’s Performing Arts 2022 production of “The Addams Family.” Elazab will perform Dec. 20 at Carnegie Hall in New York City. (Courtesy of the MacPhail Center for Music)

Earlier this year, the two MacPhail Center for Music vocal students won international awards at the American Protege International Vocal Competition. They will be celebrating the win with performances at Carnegie Hall.

Sixteen-year-old Laila Elazab, a high school student from White Bear Lake, took first place in the category and 13-year-old Max Zhang, of Wayzata, took second place. Both performed classical songs in Italian and competed through video submissions. Their Carnegie Hall performances will take place Dec. 20, with Elazab also performing on Dec. 17 as well.

“I feel super honored and it’s really so exciting,” Elazab said. “And it’s crazy to see another student from MacPhail got it, too.”

Zhang, who is in eighth grade, said he found a deep connection with music at an early age.

Max Zhang, of Wayzata, will be performing Dec. 20 at Carnegie Hall in New York City. (Courtesy of the MacPhail Center for Music)

“My first introduction to MacPhail was my mom wanting to seek more opportunities for me to perform on stage,” Zhang said. “I used to just sing Chinese poems with my local teacher, but my mom felt like it was too little for me, so she looked for better opportunities for me and found MacPhail.”

MacPhail Center for Music serves a diverse group of more than 15,000 students yearly from across Minnesota. The center offers group and individual lessons in more than 35 instruments as well as voice lessons and other musical arts.

The center has physical locations in Minneapolis, Chanhassen, Apple Valley, Austin, Minn., and Wisconsin’s Madeline Island, and also offers online courses.

“MacPhail Center for Music provides access to diverse and relevant music learning experiences, delivered by extraordinary faculty,” according to the center’s mission statement.

Elazab and Zhang are both students of Mikyoung Park at MacPhail, and have studied with her for a majority of their lives.

“I always recommend to send my students on the stage because learning in the classroom versus on the stage is different,” Park said.

Park began singing when she was young, one of her earliest memories being the sound of a piano from a musical academy in her hometown in South Korea. Since that time, she has pursued music, coming to the United States in 2000 and graduating from the University of Minnesota with a doctorate in musical arts and a voice pedagogy certification.

Joining MacPhail in 2014, she is now an instructor leading courses in voice, piano, opera, musical theater and K-pop.

“I can’t even describe how much I’ve learned,” Elazab said. “I don’t think I would have ever been the singer I am without her, for sure. I learn so much every single time I go, and all of her advice, like, I never disagree.”

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Elazab has been performing since she was young, originally studying piano with Park before singing in a piano performance. From that moment, Park and Elazab both agreed she was meant to be singing.

Today, she dreams of studying musical performance in college, and maybe one day performing on Broadway.

“I really do love New York and love the opportunities for music there,” Elazab said.

Similarly, Zhang looks forward to performing at Carnegie Hall in December, and hopes to one day return.

“I’ve done a lot of music, so it’s kind of like my second home to me,” Zhang said.

“I am just really excited to see all these different performers perform and learn something from them,” Elazab said.