Medical breakthroughs and mandolin strings: The life of UVA’s JoAnn Pinkerton

September 30, 2025
Dr. JoAnn Pinkerton and Alan Pinkerton sit outside the front door of their home playing mandolin and guitar

Dr. JoAnn Pinkerton and her husband, Alan, play bluegrass on the porch of their Albemarle County home every night after dinner. “It’s what keeps us strong,” said the women’s health pioneer. (Photo by Lathan Goumas, University Communications)

“Please stop harming women.”

Nationally known University of Virginia obstetrics and gynecology professor Dr. JoAnn Pinkerton spoke those words in July, testifying to a special panel convened by Food and Drug Administration Commissioner Dr. Martin Makary.

He’d created the group of 12 preeminent experts for advice regarding the risks and benefits of menopause hormone therapy, with particular attention to breast cancer, uterine cancer and cardiovascular risks.

En masse, the panel – composed mostly of women – urged the FDA to remove or revise the warnings on low-dose vaginal estrogen treatment, a “local” treatment prescribed for vaginal and urinary symptoms. 

Dr. Pinkerton seeing a patient in the exam room at UVA Medical Center

On top of her research and advocacy, Pinkerton sees patients in the clinic four days a week. (Photo by Latham Goumas, University Communications)

Pinkerton spoke plainly. “I am begging, we are all begging the FDA, please remove the black box,” she said, specifically referring to a request to remove the warning on local vaginal estrogen therapies used to treat genitourinary syndrome of menopause. “The boxed warning is not supported by science. It overstates risk.”

The stated risks – cancer and cardiovascular problems – have been listed on all medications with the word “estrogen” for 22 years, the result of a 2002 study that has since been disputed, both for newer types of therapies and for therapies used locally for vaginal symptoms. 

Pinkerton told the FDA panel the warnings have long frightened women away from taking advantage of treatments proven to help with serious vaginal and bladder symptoms such as painful sex and recurrent urinary tract infections that can lead to blood infections. She also addressed the safety of systemic hormone therapy for relief of menopausal symptoms, including hot flashes, night sweats, anxiety, depression, insomnia and memory problems, when given to women who are closer to menopause, under age 60 or within 10 years of menopause. 

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Removing some of the warnings appears possible. The FDA commissioner, a proponent of menopause hormone treatments, said, “We’re trying to move faster than the typical government process,” but he gave no timeline or next steps.

It appears to be another victory for Pinkerton, a national pioneer in the field of women’s health.

Earlier this month, she was a co-author of a paper on elinzanetant, a new nonhormonal pill from Bayer that, in a late-stage study, was shown to greatly ease hot flashes and night sweats in menopausal women. She previously led the 26-week study and the longer-term study confirming the same rapid improvement in hot flashes and night sweats with a very good safety record. “It is currently under review by the FDA, and we should hear something in the fourth quarter … November or December,” she told UVA Today.

The Seldom Scene and the Country Gentlemen

Here is something most people probably don’t know about the woman who founded the UVA Midlife Health Center in 1993 and is the emeritus executive director and past president of The Menopause Society.

Pinkerton loves bluegrass music and is a seasoned mandolin player.

Dr. Pinkerton and Alan Pinkerton sitting in their closed-in porch playing music together. Dr. Pinkerton plays the mandolin and Alan plays the guitar.

The Pinkertons’ favorite musicians include the Seldom Scene and the Country Gentlemen. (Photo by Lathan Goumas, University Communications)

It’s a hard turn from successfully advocating for women’s health to making music, but it’s one she’s been taking since the 1980s, when she married her husband, Alan. The couple – she on the pear-shaped, eight-string instrument and he on guitar or banjo – began performing casually in a band called Hungry Hill early in their marriage. They still unplug from the world nearly every night after dinner, picking up their instruments and playing music, including one of their instrumental favorites, “Jerusalem Ridge” by Bill Monroe and his fiddler, Kenny Baker.

“It’s something that’s very important to our marriage, and has been all of our lives since we first met over attending a bluegrass festival in Staunton,” Pinkerton said of their tradition. “And it is something outside of work and family that we do together. Alan, nicknamed ‘Bro,’ and I play together with ourselves and with friends on the weekends whenever we can. It’s what keeps us strong.”

Favorite musicians include two celebrated Washington, D.C.-area groups, the Seldom Scene and the Country Gentlemen. The Pinkertons recently traveled to Richmond to hear another favorite, Alison Krauss.

JoAnn said she’s not certain she played with Alan at their Albemarle County home the evening after her July FDA testimony in Silver Spring, Maryland, “but I probably did.”

Media Contacts

Jane Kelly

University News Senior Associate Office of University Communications

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