Millions of women are suffering from symptoms that are treatable, avoiding a therapy that is safe, because of a study that was misread — and a medical culture that never bothered to correct the record.
In 2002, the Women's Health Initiative published findings that sent physicians across the country reaching for their prescription pads — to cancel hormone prescriptions, not write them. The study suggested that hormone replacement therapy increased the risk of breast cancer, heart disease, and stroke. Within months, HRT prescriptions dropped by more than half.
The problem is that the study's findings were misinterpreted, overgeneralized, and applied to populations for whom they were never intended. The women in the WHI were older — average age 63 — and had been postmenopausal for years. They were not the women most doctors were treating with HRT: in their late forties and early fifties in the throes of perimenopause.
It is not too late. For most women, it is precisely the right time. The question is whether their doctors have kept up with the science.
In the two decades since the WHI, the science has been substantially revised. Multiple large studies have found that for healthy women under 60 who are within ten years of menopause onset, hormone therapy reduces the risk of cardiovascular disease, osteoporosis, dementia, and all-cause mortality. It dramatically improves quality of life.
And yet the fear persists. Women arrive in my clinic who have been told by well-meaning physicians that hormones are “too risky”—women who are losing sleep, losing bone density, losing cognitive sharpness, losing desire, losing themselves—because a study published 20 years ago was reported incorrectly and the correction never received the same headlines.
Medicine has a duty to revise its recommendations when the evidence changes. On hormone therapy, that revision is long overdue. Women deserve better than fear-based medicine.
Amy Killen, M.D., is a longevity physician and co-founder of Humanaut Health.
