Local doctor weighs in on removal of ‘black box’ warnings from HRT products used to treat menopause

Nia Hinson

COLUMBIA, Mo. (KMIZ)

A local doctor is hopeful a change in warnings on hormone replacement therapy for menopause will lead to more women exploring their options.

The Food and Drug Administration announced in November that it was initiating the removal of “black box” warnings hormone replacement therapy products for menopause. The FDA claimed the warnings were misleading and asked companies to remove references to risks of cardiovascular disease, breast cancer and dementia.

According to Dr. Lisa Brennaman, an OBGYN at MU HealthCare, a study performed in 2000 looked into the risks and benefits of the therapy using a large cohort of women. The biggest flaw in the study was that it contained a group of women that were of older age, leading to an increase in cardiovascular disease, dementia and the possibility of breast cancer.

Follow-up research was conducted that included a younger group of women, who were younger than 60 years old or within 10 years of the onset of menopause and found those risks were significantly reduced or nonexistent.

An analysis was then published in 2015, followed by observational studies which worked to strengthen data regarding the safety of HRT for the majority of women and leading to the FDA’s announcement, according to Brennaman.

“There was a lot of associated media coverage when the findings were initially published in the early 2000s that resulted in a dramatic decrease in the prescribing of hormone replacement therapy,” Brennaman said. “Literally within days to weeks of the published findings, women came to their doctors and abruptly stopped therapy and the rate of prescriptions of hormone replacement therapy plummeted drastically.”

According to the National Library of Medicine, From 1999 to 2020, the prevalence of menopausal hormone therapy use decreased among women of all age groups, from 26.9% in 1999 to 4.7% in 2020.

Brennaman said she believed the hormone therapy was fairly uncommon for women about a year or two ago, but thinks it has risen dramatically in popularity since then as women have gained more awareness.

Brennaman said since the changes were made last fall, women’s healthcare providers and physicians are trying to spread the word to women and doctors about the new safety data. She said the benefits of the therapy likely outweigh the risks for the majority of women younger than 60 years old or within 10 years of initiation.

It’s also something Brennaman said physicians within the OBGYN women’s health community have been lobbying for for a while, and view the change as a “win” for advancing women’s health.

“Women come to my office and say to me often, ‘I’m really suffering. Menopause is impacting my work and my family relationships but I’m so afraid of getting cancer.’ So, I think there are a lot of fears and myths that women have regarding the risk of cancer…and now we know that the risks are actually quite minimal and the benefits are significant,” Brennaman said.

What is HRT and how does it help?

Hormonal replacement therapy takes many different forms, depending on what symptoms women are trying to improve.

Generally, it’s used to treat menopause, which refers to a 12-consecutive-month period when menstruation stops for women, which is on average at age 51. Physicians typically use estrogen to treat symptoms– which can include hot flashes and night sweats– although a form of progesterone is also used in women who still have a uterus.

Estorgen can come in the form of a pill, patch, gel or a vaginal ring and women typically see a 60% to 90% improvement in hot flashes and night sweats when using it, according to Brennaman.

Women will also typically see improvements in symptoms roughly within seven days of using HRT, followed by peak control with any initiation and dose change around eight to 12 weeks of therapy.

Menopause symptoms also include sleep disturbance, changes in cognitive function or brain fog and an overall decline in quality of life. Some women will also experience bone thinning or osteoporosis, urogenital symptoms or vaginal dryness.

Brennaman said there isn’t a set amount of time that people should use the therapy, but said most women will use treatment for a number of years until they soften the transition to menopause. When treatment is stopped, a resurgence of symptoms is likely.

A slight increased risk of breast cancer is also possible for women who use estrogen and progesterone together for years. Brennaman said some women will choose to lower their dose, wean off of therapy or continue to use it for life.

Who should use it?

Although more research has been done striking down previous beliefs about HRT, doctors say the therapy should still be used on a case-by-case basis. According to Brennaman, HRT slightly increases the risk of having a blood clot in the legs or lungs and can also slightly increase the risk of irregular bleeding.

Women who have ever had a blood clot, have uncontrolled hypertension, significant lung disease or any form of active cancer should weigh those before being prescribed hormone therapy.

“Your physician or provider should sit down with you and review your medical history, exactly what symptoms you want to be targeting, your family history, your overall preventive care and then kind of arrive at an option that hopefully meets your needs in the safest way possible,” Brennaman said.

Brennaman also said that cost is typically not a barrier for women who choose to use HRT. Oral pills are typically the cheapest form, while patch therapy tends to be more expensive. However, that is usually covered by most insurance plans.

A generic local topical estrogen cream used to treat genital urinary symptoms is also affordable, she said.

Most women can be prescribed HRT by their OBGYN, but can also receive it from general practitioners who do a significant amount of women’s health within their practice.

Brennaman said she recommends people consult a physician before using products to treat menopause and said she doesn’t think it’s necessary for all women, but thinks people should ask for help sooner, rather than later.

“I think patients who are having symptoms do not need to wait until the time of severe disability or negative consequences like job loss, relationship loss, sleep exhaustion, osteoporotic fracture before they seek help,” Brennaman said.

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Local business comments on safety following weekend shooting at door-to-door salesman

Marie Moyer

COLUMBIA, Mo. (KMIZ)

An everyday sale took a turn last Friday after a man pulled a shotgun and shot at a salesman in Boone County, according to authorities.

Boone County Sheriff’s Office Capt. Brian Leer said 69-year-old Mark Streeter allegedly confronted a salesman and later fired shots at him as the salesman was leaving.

Deputies were called to the 6000 block of East Route HH where the shooting occurred and arrested Streeter on suspicion of unlawful use of a weapon. Streeter later bonded out of the Boone County Jail and no charges were filed on Casenet as of Monday evening.

Leer said the office has occasionally received calls about door-to-door sales in the county, with Route HH not standing out in calls for complaints compared to other areas.

Shawn Noordsy, owner of Quality Cut Lawncare in Columbia, told ABC 17 News safety concerns were a reason the company stepped away from door-to-door sales.

“We don’t utilize that practice anymore, it’s more for the safety of our employees of just random door knocking,” Noordsy said. “It’s kind of gone away and to the wayside with the new era we’re in.”

Noordsy added recent business operations have customers typically reaching out first.

“You’d contact us, we would come out with, meet with you, schedule [an] appointment, or you would know we’re coming by to your house to take a look at the property,” Noordsy said. “So you’re not surprised that we’re showing up, it’s all well documented that we’re coming.”

Quality Cut Lawncare also sometimes leaves signs, but continues to keep knocking down.

“Sometimes we do hang a door hanger on the neighbor’s yard if we feel like they’ll be a good fit for us, but again, we don’t knock, we don’t pressure anything,” Noordsy said.

According to the Better Business Bureau, if a homeowner is worried about a salesperson at their door, reputable sellers will often have a license and identification that they can show. The license and ID can also be verified by the city, county or seller’s business.

If a homeowner is interested in a sale, it’s recommended to note details of the agreement including price, contract details and all other terms and conditions. Homeowners can also contact local law enforcement if a salesperson does not get off their property when asked.

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Area experts give safe ticket-buying tips ahead of Mizzou’s March Madness game in St. Louis

Haley Swaino

COLUMBIA, Mo. (KMIZ)

The Mizzou men’s basketball team has punched its ticket to the NCAA Tournament, and fans are looking to get theirs.

The Tigers are set to face the Miami Hurricanes at 9:10 p.m. in an opening round game at the Enterprise Center in St. Louis.

“We were over-the-moon excited,” said Morgan Hackney, who is the assistant director of Alumni Engagement with the Mizzou Alumni Association. “I know our fans feel the same way. I know that’s how the team’s feeling right now.”

She said having March Madness in the state was the best-case scenario.

“One in five Tigers hails from the St. Louis area, so it was so exciting to think that this event that people get so excited about and usually have to take off work or find time to travel to is just like right in the backyard of one of our biggest cities,” Hackney said.

Fans looking to go need to first know what ticket to buy to see the black and gold.

“Tickets are always tricky when it comes to March Madness because they sell it by the session,” Hackney said. “When you buy a ticket for a session, you actually technically have tickets for both of those games. Even if you’re only interested in going to one or the other.”

Mizzou is set to play in the last session of round one. While there are many ways to go about buying a ticket, some are safer then others.

“Be in the driver’s seat and initiate the contact,” Columbia Regional Director for the Better Business Bureau Khesha Duncan said. “You want to do your research.”

Some safe buying tips, according to Duncan, includes using reputable sellers from sites like Ticketmaster, which was shared by official Mizzou Athletics social media accounts on Sunday.

“Buying the parking pass as well as the tickets all at the same time based on the recommendations and guidance from the Enterprise Center, I think is a good vote of confidence,” Duncan said.

Buying from an online source can leave consumers vulnerable to scammers who thrive in times like March Madness.

“Last year our scam tracker tool had like 140 reports of fake ticket sales of one kind or another,” Duncan said. “With AI, it’s more easy to duplicate websites and duplicate platforms that look like they’re real and they’re not.”

Duncan warned of pop-up ads or prices that seem too good to be true. When buying resale from a third-party seller, you can check if they’re accredited on the Better Business Bureau’s website.

The alumni association is also urging people to purchase from verified vendors. They invite fans to stop by Ball Park Village on Friday, which is about 10 minutes from the Enterprise Center, for a Mizzou Headquarters Party.

“Fans can stop by and get free giveaway items. We’ll have a spirit rally with Golden Girls, Truman, all of those things. We’ll have a deejay and be able to have almost like a block party type feel for fans to gather before they go down to the game,” Hackney said.

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Jefferson City moves forward with Ward 2 vacancy process, officials eye changes

Mitchell Kaminski

JEFFERSON CITY, Mo. (KMIZ)

The Jefferson City Council is moving forward with filling the vacant Ward 2 seat following Councilman Aaron Mealy’s resignation earlier this month, though city officials say the process may need to be changed moving forward.

During Monday’s meeting, City Attorney Nathan Nickolaus outlined how the process works under the current city code, while also acknowledging concerns about how it has been handled in the past.

Nickolaus explained that under the city charter, the mayor is supposed to nominate a candidate subject to council approval, however the ordinance expands that process.

Under the ordinance, council members must make nominations at their next meeting on April 6. Each nomination requires a second, and once nominated, candidates will have four days to file a declaration of candidacy with the city clerk, including a cover letter and resume. 

Ward 2 Councilman Mike Lester raised concerns that the process was handled differently the last time the council filled a vacancy and proposed updating the ordinance before holding a public session. 

However, Nickolaus said any changes would have to be made at the April 6 meeting, which could create a longer meeting focused on both nominations and ordinance changes. 

“You can look at the ordinance, and it’s very clear. Step one, nominations, it says when those nominations have to take place. Step two is declaration of candidacy, it says when those has to take place, and then the public session, which it doesn’t say that’s set by the council,” Nickolaus said in response to Lester’s concerns. “Then there’s the election and it says when that takes place. You can’t progress them all in one meeting. The ordinance doesn’t allow it.” 

Under the current ordinance, the city must also hold a public session between April 10 and April 20. 

After a lengthy discussion, the council voted 8-1 to hold that session on April 13, with Ward 3 Councilman Derek Thomas voting no due to a scheduling conflict. During that public session, candidates will have an opportunity to address and answer questions from the city council. 

Nickolaus said the earliest the council can vote on a replacement is April 20, and a candidate must receive a majority of the nine-member council. Voting will continue until a majority is reached. An official election date, which can take place anytime after April 20th, has not been set. 

Nickolaus also noted that some practices used during previous vacancies, such as inviting candidates to speak and answer questions during the nomination process, are not included in the current ordinance. He added that the ordinance, last updated in 2009, should likely be changed, but cannot be amended before this appointment process is completed.

“We’re trying really hard to make sure we follow this code book. So when we hear about these processes, and we are not following our code, it’s really disappointing to me,” City Administrator Brian Crane said during the meeting. “I just want everybody to understand we’re trying best we can to follow the laws that are in place if we don’t like the laws, we change the laws, but we don’t just ignore the laws.” 

The city has already begun accepting letters of interest for the position. City spokeswoman Molly Bryan said Monday afternoon that two letters had been submitted.

Interested residents must submit a letter of interest outlining their qualifications to the city clerk. Candidates must be U.S. citizens at least 21 years old, have lived in the city for at least one year and in the ward for six months, and meet additional eligibility requirements.

Mealy, who was elected in 2023 and had one year remaining in his term, announced his resignation in an email to local media on March 2.

“It has been an honor to serve the residents of this community. However, I can no longer in good conscience continue in this role due to ongoing trust, honesty, and accountability issues with city hall administration,” the email states.

His replacement will serve the remainder of his term.

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Man shot by Columbia police on Christmas Day put in hospice care

Ryan Shiner

COLUMBIA, Mo. (KMIZ)

A man who was shot by Columbia police on Christmas Day is currently in hospice care, according to court documents.

Marc Lucas, of the state of California, is now charged with first-degree arson, misdemeanor first-degree trespassing, two counts of unlawful use of a weapon and a pair of misdemeanor fourth-degree assault counts. His case was refiled on Monday, which dropped a count of armed criminal action.

Lucas was in the Boone County Jail earlier this month following a grand jury indictment. His bond memo says he was released under his own recognizance because he is in hospice care at Landmark Hospital and cannot be in the jail because of the extent of his injuries from the shooting. The bond memo says he is being tracked with a GPS monitor.  

Court documents in previous reporting say Lucas allegedly set a couch on fire at the Courtyard by Marriott hotel at Grindstone Parkway and Highway 63. He then got into a fight with Holiday Inn Express employees after he was denied a room at that hotel, previous reporting indicates. He had also allegedly pulled out a knife during some point in the encounter.

Lucas then allegedly walked to a nearby Break Time gas station, pulled out the knife and threatened to assault someone while officers were there, the statement says.

Officers allegedly tried to use a stun gun while detaining Lucas, but Lucas then allegedly tried to attack one of the officers with a knife and he was shot, police wrote in a December press release.

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Man accused in 2023 Jefferson City park shooting sentenced to probation

Ryan Shiner

COLUMBIA, Mo. (KMIZ)

A man who was accused in the 2023 McClung Park shooting in Jefferson City pleaded guilty to a felony on Friday.

Dayjaun Crossland, of Jefferson City, pleaded guilty to unlawful use of a weapon and was sentenced to five years of probation. He was previously charged with accessory to first-degree assault, accessory to unlawful use of a weapon and armed criminal action.

Previous reporting says Crossland was injured in the shooting, but was accused of pulling a gun and firing during an argument at a party with about 100 people at McClung Park. Police found at three least calibers of ammunition at the park.

Raymond White-Murry, of Fulton, pleaded guilty in 2024 to aiding and abetting a shooting and was sentenced to five years of supervised probation. He originally faced that charge and a count of armed criminal action.

Laquan Boose, of Jefferson City, pleaded guilty last year to accessory to unlawful use of a weapon and was sentenced to five years of supervised probation.

Syvonn Byrd, of Jefferson City, also pleaded guilty last year to unlawful use of a weapon and was sentenced to five years of supervised probation. He was previously charged with first-degree assault, unlawful use of a weapon and armed criminal action. 

One witness had identified Byrd, according to the probable cause statement described in previous reporting. The witness allegedly told police that Byrd took out a gun from his waistband on Oct. 5, pointed it at several people at a party and shot, court documents in previous reporting say. Court documents say the witness’ account lined up with video recordings seen by law enforcement.

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Jefferson City man accused of pointing gun at minor, laser pointer at cop

Ryan Shiner

COLUMBIA, Mo. (KMIZ)

A Jefferson City man has been arrested and charged after police say he pointed a gun at a minor and a laser pointer at a cop on Thursday.

Christian Prody, 20, was charged with unlawful use of a weapon and second-degree harassment, a misdemeanor. He is being held at the Cole County Jail without bond. An arraignment was held on Monday and Prody pleaded not guilty by video from the jail. A counsel status hearing was scheduled for 2 p.m. Wednesday.

The probable cause statement says the minor victim and another person described as a witness drove toward a smoke shop around 7 p.m. Thursday in the 1000 block of Jefferson Street. The pair noticed Prody in the parking lot. The victim claimed he had prior “disagreements” with Prody and that Prody had previously pulled out a gun and pointed it at him, police wrote in the statement.

The victim and witness decided to keep driving around until they did not see Prody in that parking lot, the statement says. Prody allegedly went across the street and pointed a gun at the vehicle containing the victim and witness, the statement says.

The victim’s mother allegedly told police that Prody had started texting the victim threatening messages while the officer spoke with them, the statement says.

After the officer stepped out of the home, he noticed a green laser being pointed at him from a white SUV parked down the road, the statement says.

The officer performed a traffic stop on the vehicle and Prody allegedly admitted to pulling out the gun at the smoke shop and using the laser pointer “to scare the Victim, making him think he was pointing a gun at him,” court documents say. The officer found the laser pointer and gun in the vehicle.

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Rolla man charged with armed robbery in Phelps County

Ryan Shiner

COLUMBIA, Mo. (KMIZ)

A man is in jail after authorities claim he robbed a Rolla gas station convenience store at gunpoint on March 10.

Allen White Jr. was charged Friday in Phelps County with first-degree robbery, armed criminal action and first-degree kidnapping. Police confirmed in a Monday news release that White is being held without bond at the Phelps County Jail.

The probable cause statement says police were called at 1:48 a.m. March 10 for an armed robbery at a gas station in the 1900 block of North Bishop Avenue. White allegedly demanded the cashier give him all of the money from registers, took the victim’s phone and demanded they stay in a back room before counting to 20, the statement. He allegedly took $279.

The statement says the victim claimed White had altered his voice and wore a mask while making demands. He allegedly also frequents the store, the statement says.

Someone on camera was allegedly seen walking out of the store matching clothing worn by White around the time of the robbery, the statement says. He was seen entering a Nissan Frontier, which was allegedly identified as his vehicle by people interviewed by police, the statement says.

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71-year-old Pilot Grove woman killed in Cooper County crash

Ryan Shiner

COLUMBIA, Mo. (KMIZ)

A 71-year-old woman from Pilot Grove was killed in a Monday morning crash on Highway 135 at Route E in Cooper County, according to a crash report from the Missouri State Highway Patrol

The report says the woman was a passenger in a 2014 Toyota Venza that was driven by a 74-year-old Pilot Grove man. The vehicle was heading south on Highway 135 when a 2012 Ford F-250 – driven by a 32-year-old Moberly man – was heading west.

The driver of the Toyota stopped at a stop sign at the intersection before driving straight and the Ford F-250 “slid and failed to stop” as it hit the Toyota, the report says.

The Toyota then slid, went off the road and hit a stop sign while the Ford “came to a controlled stop at Highway 135,” the report says.

The victim in the crash and the driver of the Toyota wore seatbelts, while the driver of the Ford did not wear one, the report says. The woman was pronounced dead at the scene and was brought to Meisenheimer-Page- Dady Funeral Home, the report says. The 74-year-old man had minor injuries and was brought to University Hospital by ambulance.

A social media post from the Missouri State Highway Patrol’s Troop F – which covers most of Mid-Missouri – stated two people were injured in addition to the fatality.

MSHP reports do not name those involved in crashes.

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No injuries reported in Moniteau County processing plant fire

Ryan Shiner

COLUMBIA, Mo. (KMIZ)

No injuries were reported after a processing plant in California, Missouri, caught fire on Sunday night, according to a social media post from the California Fire Department.

Crews were called at 11 p.m. to Pitman Family Farms on East Smith Street for a fire that was “visible in the lunchroom area and possibly above the ceiling,” the post says. The department wrote that responding crews determined the fire involved an air conditioning unit above the breakroom.

“Fire crews arrived and made entry into the facility, where visible smoke was present in the lower level of the building,” the post says. “Crews advanced to a second-floor mechanical area and located a large industrial condenser unit with visible flames. Water was quickly applied, and the fire was extinguished. Crews then verified the fire had not extended into the roof structure before shifting operations to smoke removal and ventilation.”

The fire was brought under control within 15 minutes and was “contained to the condenser unit and its immediate surroundings,” the post says.

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