How did the Women’s Health Initiative cause so much unnecessary anxiety?

 

How did the Women’s Health Initiative cause so much unnecessary anxiety?

 

The Women’s Health Initiative (WHI) inaccurately researchers provided sensationalized media reports that hormone replacement therapy causes breast cancer.  While death and taxes are the only sure things, I’m as confident as I can possibly be that hormone replacement therapy does NOT cause breast cancer.  The vast majority of evidence suggests estrogen actually LOWERS the risk of breast cancer. 

 

Here’s where the WHI went wrong:

  1. The participants in the study were not representative of menopausal women.  The participants were many years past menopause (average age 63).  We’ve learned that women who start hormone therapy during menopause and stay on it have better quality of life and live longer;  but, women who did not start hormone therapy and who are over 10 years past menopause don’t seem to have the same benefits if they start hormone therapy later in life.

  2. The participants were not healthy.  They were hypertensive, overweight/obese smokers.

  3. The WHI failed to report the information clearly for women on Estrogen plus Progestin versus women on Estrogen alone.  AND, they failed to calm the public with the good news about breast cancer:  In 2003, the WHI reported a nonsignificant increase in breast cancer in women in the PremPro (estrogen plus progestin) arm of the trial, but in 2006, after further follow up, that nonsignificant risk VANISHED.  The medical community was not clearly informed that the risk in the first place was NONSIGNIFICANT and then later that the nonsignificant risk vanished.   Additionally, there was very little effort to announce to the public that estrogen alone was associated with a LOWER risk of breast cancer.

  4. The WHI investigators manipulated data to try to find evidence supporting their beliefs.

  5. The WHI alarmed the medical community about the supposed increased risk of heart disease, but what they failed to tell us was that the increased risk was ONLY seen in women who were over 20 years past menopause and who had NOT been taking hormone therapy for over 10 years after menopause.   It took the WHI investigators FIVE years to finally announce that women who started hormone therapy within 10 years of menopause had a DECREASED risk of heart disease.

  6. Reanalysis of the data regarding stroke showed NO increased risk of stroke with hormone therapy. 

 

 

References:

Estrogen Matters by Dr. Avrum Bluming and Dr. Carol Tavris

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