For the last month and a half, I’ve been writing a pretty fun “Call the Doctor” column for The Guardian. The first was about perimenopause; the latest, published Sunday, was about menopause hormone therapy.

(RELATED: I’m currently plotting out the next few columns and would especially love to answer your questions! Send them to me at [email protected], or fill out this form if you want to stay totally anonymous.)

I knew I wasn’t an expert on lady parts before reporting these columns. But holy cow, I had no idea just how little I knew. 

You might already be aware that after a decade or so in the medical doghouse, menopause hormone therapy (MHT) — the estrogen patches and pills women take to treat hot flashes and night sweats — is back, baby! That is to say, new evidence, plus a reappraisal of older data, has tipped the scales toward benefit for treating many newly menopausal women with estrogen if they have symptoms. 

But there’s so much nuance to how that actually works. Below, I’m sharing a few of the facts that gave me the most Girl, WHAT face:

In the years before a woman’s last period, hormone therapy specifically tailored for menopause might be useless in managing what OB-GYN Jen Gunter calls “menopause mayhem.” Many experts instead use a pretty counterintuitive strategy for managing that mayhem: