Menopause & Estrogen After The Women’s Health Initiative

Millions of women in menopause are afraid to take estrogen and struggle to deal with their symptoms. But for many, that isn’t necessary. In the 10 years since one of the most significant papers in women’s health was published – a study on the risks and benefits of estrogen plus progestin in healthy postmenopausal women – many of the original conclusions that scared the hell out of women and many of their doctors (see below) have been disproved.  But harm was done for women; fear prevented many women from taking estrogen that could have prevented terrible symptoms, and those women suffered. I want to help you make sense of these important studies.

First, let’s look at what the two studies were supposed to do.

At that time, estrogen plus progestin (notice, not progesterone which is the natural hormone, but progestin, a synthetic substance that the woman’s body responds to similarly to how it responds to progesterone) were being recommended for all women in menopause to lower the risk of heart disease as well as treat symptoms of menopause such as hot flashes and vaginal dryness. Postmenopausal women ages 50 to 79 (mean age 63) were given different formulations of the most common estrogen and progestin medications in use at the time.

Giving hormones to older women, they thought, would lower their risk of heart disease and so the study didn’t take into account how old the women were, how long it had been since they started going through menopause, or if they were at risk for any other diseases. Hormone Therapy (HT) was considered both good and safe.

There were two hormone studies that were started about the same time. The first involved giving some 16,000 women either estrogen and progestin (Prempro – the most commonly used hormone of this type at the time) or placebo. That study was stopped 3 years early because the risks were greater than the benefits.  Not only did HT not protect women from heart disease, the study reported an increased risk of blood clots, stroke, heart attack and breast cancer. There was however, an equally lower risk of colon cancer and risk of breaking your hip.

The second study also followed a large number of women. But this group of women had their uterus removed (hysterectomy), as well as their ovaries. Women who have their uterus removed do not need to take progesterone or progestin – only estrogen. Once again, the study was stopped early because the women taking estrogen had an increased risk of stroke compared to those who took a placebo. However, compared to the women in the first study who took estrogen and progestin, these women who took estrogen only didn’t have an increase of breast cancer or heart disease.

Postmenopausal women threw away their estrogen in droves and endured a very challenging window of time. So challenging in fact that many of my patients who initially went off their hormones called me up and within 3 to 6 months, wanted to get back on them. But in that year after the WHI was first published, between 25% and 72% of women stopped taking HT.

Over the past decade since those initial WHI studies were done, many of their conclusions have changed. Here are my thoughts on the highlights and where we are today.

If you are interested in taking estrogen and/or progesterone or want to consider it as a possible treatment for your symptoms, talk with someone who is knowledgeable about these medications. It isn’t the same as going in for an antibiotic – it will take time for the health professional to understand your personal risks, explain what the benefits and risks are for you, and provide you with an explanation of your options. When I see patients for these types of discussions, I allot nearly an hour to go over everything. Make sure you find the right person to work with you.

To help you prepare, CLICK HERE for a FREE EBOOK on How To Take Estrogen.


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Barbara Agnello
Barbara Agnello5 years ago

There needs to be more research in this area to empower women to make informed decisions.

Vicky Pitchford
Vicky P5 years ago


Mary Emmons
Mary Emmons5 years ago

Thanks. . . I will take note of all comments when it comes to my time. . .of the wonderful, dreaded, menopause.

Kirsten B.
Past Member 5 years ago

Interesting, thank you.

Patti K.
Anne K5 years ago

I have taken estrogen now for over six years using the lightest dose and through a patch. I feel wonderful after some horrible symptoms of menopause; I am back to my ordinary self. I do watch what I eat no saturated fat or butter just olive oil. No red meat and I monitor my blood pressure which is at a normal rate. I am over fifty and I hope to take it the rest of my life.

Sandi C.
Sandi C5 years ago


Brenda Towers
Brenda T5 years ago

Stick to natural help, and avoid hormone treatment if possible. I regret taking it, as I developed breast cancer last year. Fortunately it was caught early on, and I have made a.good recovery. I feel very blessed.
Please avoid using creams, lotions , shampoos, toothpaste, make-up,etc with PARABENS in them. These chemicals mimic oestrogen, and are possible causes of breast cancer. Check products before you buy them, please. I feel I want to warn everyone about the risk.

Christine C.
Chandra C5 years ago


Abbe A.
Azaima A5 years ago


Teresa Wlosowicz
Teresa W5 years ago

thank you