Over 68,000 women in a decades-old study have spoken. It only took us 20 years to hear them.
Let’s travel back in time to the infamous clinical trials designed by the Women’s Health Initiative (WHI). It was the research that stopped mainstream hormone replacement therapy (HRT) in its tracks.
How the Women’s Health Initiative changed hormone therapy
Misleading data from the WHI studies drastically changed the landscape for menopausal hormone therapy across the world.
For many years, hormone therapy had been considered a trusted source of relief to address frustrating menopausal symptoms. But after the media released the flawed information from the study, hormones became taboo overnight—the prescribing of hormones rapidly diminished.
Fear of HRT took hold, and millions of women were left adrift without a way to cope with the health issues related to perimenopause, menopause, and postmenopause.
But a breaking review is changing all that.
New evidence is reshaping the conversation around HRT
Analyzing data spanning over two decades, the Journal of the American Medical Association (JAMA) concludes hormone replacement therapy is appropriate and beneficial for women under 60 struggling with problematic issues, like vasomotor symptoms. This is an important step toward recognizing the impact of estrogen and progesterone support during unpredictable hormonal shifts in menopause.
Specifically citing the “significant quality of life benefits from symptom relief” in younger menopausal women, the information presented in JAMA’s, The Women’s Health Initiative Randomized Trials and Clinical Practice: A Review, is a long time coming—literally.
What the updated WHI findings mean for women
Results over the last 20 years highlight that the chronic diseases investigated by the original WHI studies are significantly less likely for younger women who are interested in starting hormone replacement in early menopause.
On average, hormone therapy appears to result in less than one additional adverse event per 1,000 women, per year. Certainly not the risky business patients and providers were historically led to believe.
And the news keeps getting better, as experts reassess the risks of HRT. Study investigators point out that many of the risks in the WHI study may have been related to a type of hormone replacement regularly prescribed in the late 90s (looking at you, medroxyprogesterone).
Estrogen therapy and long-term health outcomes
Estrogen replacement can benefit many women’s health. For instance, women who had a hysterectomy (and therefore were eligible for estrogen therapy alone), experienced a reduced rate of breast cancer both 10 and 20 years later when compared to placebo. Estrogen replacement therapy in these populations didn’t just play nice; it caused all-cause mortality rates in women aged 50-59 to go down.
Synthetic progestin (brand name, Provera) appears to paint a different picture, but we’ll let the evidence speak for itself.
Looking beyond the original WHI study
While this new JAMA review is certainly a breath of fresh air for women everywhere, many would argue there’s a lot more that conventional medicine could do to strip the stigma of HRT.
One thing is for certain: When the time comes for them to try HRT, women will be better equipped to make the choice that’s right for them…
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References
- Manson JE, Crandall CJ, Rossouw JE, Chlebowski RT, Anderson GL, Stefanick ML, Aragaki AK, Cauley JA, Wells GL, LaCroix AZ, Thomson CA, Neuhouser ML, Van Horn L, Kooperberg C, Howard BV, Tinker LF, Wactawski-Wende J, Shumaker SA, Prentice RL. The Women’s Health Initiative Randomized Trials and Clinical Practice: A Review. JAMA. 2024 May 1. doi: 10.1001/jama.2024.6542. Epub ahead of print. PMID: 38691368.
