Researchers have conducted a comprehensive analysis of the findings and clinical messages derived from the Women’s Health Initiative, three decades after its inception.

A recent review published in JAMA highlights the significant findings and clinical implications of the Women’s Health Initiative (WHI), which is the largest women’s health study in the United States. Supported by the National Institutes of Women’s Health National Heart, Lung, and Blood Institute (NHLBI), the WHI was established to investigate factors that could potentially lower the risks of cardiovascular disease, cancer, hip fractures, and other conditions in postmenopausal women. Over 68,000 women participated in clinical trials between 1993 and 1998, and their progress was monitored for up to 20 years.

Upon analyzing the long-term data, the researchers have elucidated the primary findings:

1. Hormone therapy and menopause: The WHI study revealed that estrogen or a combination of estrogen and progestin, which are two types of hormone replacement therapies, yielded varying outcomes in relation to chronic conditions. The evidence does not support the use of these therapies to reduce the risks of chronic diseases such as heart disease, stroke, cancer, and dementia. It is important to note that the study was not specifically designed to evaluate the effects of FDA-approved hormone therapies for managing menopausal symptoms, the benefits of which had already been established prior to the initiation of the WHI study.

The authors emphasize the significance of women engaging in shared decision-making with their physicians regarding the potential benefits and risks associated with hormone therapy during menopause. For instance, women below the age of 60 with a low-to-average risk of cardiovascular disease and breast cancer, who wish to undergo hormone therapy, may experience greater health benefits than risks during early menopause, particularly for the management of moderate-to-severe symptoms like bothersome hot flashes or night sweats.

2. Calcium and vitamin D supplements and bone fractures: According to the study, a combined calcium and vitamin D supplement did not demonstrate a reduced risk of hip fractures among postmenopausal women with an average risk of osteoporosis. However, the authors do acknowledge that supplements can be beneficial in bridging nutrient gaps for women who fail to meet the recommended daily intake of these nutrients.