Noll Physiological Research Seminar Series: Lessons Learned from the Women's Health Initiative Hormone (WHI) Trials

Published results of the WHI Menopausal Hormone Therapy (MHT) placebo-controlled randomized trials of postmenopausal women aged 50-79 years at enrollment (1993-1998), for estrogen plus progestin (E+P) in women with a uterus (JAMA, 2002) and estrogen only (E only) in women with prior hysterectomy (JAMA, 2004), shocked the medical community and generated considerable controversy and debate, which continue to this day. Findings of greater health risks of E+P (increased heart attacks, strokes, serious blood clots and breast cancer; and, in women aged 65-80 at baseline, increased dementia) than benefits (reduced hip fractures and colo-rectal cancer) and although a more neutral risk/benefit balance of E only, increased stroke with no benefit to heart attacks was not expected in light of observational data suggesting cardiovascular benefit of MHT. A historical and “20+ year later” perspective will be presented by the former Chair (from 1998-2011) of the WHI Steering Committee, noting that the WHI cohort is still being followed.