New Outcome Data from WHI: Reflection and Commentary

By: Red Hot Mamas

Published: April 11, 2011

Entitled, Health Outcomes After Stopping Conjugated Equine Estrogens Among Postmenopausal Women With Prior Hysterectomy, this study by the WHI Investigating Group providing on-going analysis after almost 11 years follow-up of women who took oral estrogen (Premarin™) found that indeed their incidence of breast cancer was certainly not higher, but in fact was significantly lower than for women who took no hormone therapy, and that this (small) protection seemed to continue over time, even after they had stopped therapy.

These findings run contrary to the findings that women who consumed Premarin™ plus the potent progestin (synthetic progesterone) medroxyprogesterone (Provera™) experienced a slight increase in breast cancer rate, and that this small increase also appeared to hold over time… Additionally, and of equal and perhaps greater importance (since > 50% of women die of cardiovascular disease), this long-term re-analysis of data showed a parallel diminishment in cardiovascular disease, along with no increase in stroke! Interestingly, it was what initially appeared to be an increase in incidence of stroke that caused the investigators to prematurely stop this part of the study at 7.1 years.

Ongoing analyses of the data have proven many of the initial findings (splashed over the headlines in 2002) wrong, making the principal investigator and many so-called “pundits” look a bit foolish, and the multitude of non-hormone specialist docs who told their patients to stop hormones look like the Emperor with no clothes… This continued analysis vindicates the menopause specialists (doctors who are Certified Menopause Practitioners), the North American Menopause Society and its President Emeritus Dr. Wulf Utian M.D. and a scattering of other practitioners who truly analyzed the data nine years ago when the study first came out and did not recommend HT discontinuance en masse, but analyzed their patients on an individual basis.

Importantly also, these findings further highlight the “window of time” hypothesis, confirming that women who start hormone therapy early (within a few/several years of menopause) have greater health protection.

Sooo… what can you do at this place in time?? Find a health care provider that is savvy about menopause (a good place to start is by reading the info on this website, and going to to find a Certified Menopause Practitioner in your area).

Dr. Goodman is Advisor to Red Hot Mamas and has been practicing women’s healthcare since finishing his OB/GYN residency at Stanford University in 1972. Following a transition from his full-time OB practice in 1988, he began devoting his career to Women’s Integrative Health and emerged as a pioneer in the development and advancement of Minimally Invasive Gynecologic Surgery. A critically-acclaimed author, Dr. Goodman has published two consumer-oriented books on menopause: “The midlife Bible—A Woman’s Survival Guide” and “MEN-opause: The Book for Men.” For more information, visit