Before analyzing any situation, I want to gather as much information as possible for making an informed decision. What baffled me 7-9 months ago when I started working on this blog was that I could not find many studies on HRT use, benefits – risks, outcomes based on the age therapy was started at and the length of use, long term side effects, mechanisms of adverse events etc. There is of course THE STUDY (WHI) – I just can’t let go! – but not much else out there. So I started investigating further as I have many questions here: why did we not continue researching on such an important topic as treatment for menopause, why isn’t there a centralized, global resource with studies on use of HRT from all over the world, why there is not much data on changes in women’s quality of life once in menopause and clear, globally synchronized standards of care, why, given that more than 1 billion women will be in this stage of life, is this topic not considered a priority?

In my diligent google-ing, I came across Frontiers (https://www.frontiersin.org/about/mission). It’s an open science platform that doesn’t follow the rigorous standards of academic publishing. The articles are written by professionals in their respective field and peer -reviewed. I found there what I haven’t found anywhere else: a study on trends on research regarding HRT/MHT (https://www.frontiersin.org/articles/10.3389/fmed.2022.952487/full). The authors of the study state that” “The results showed that (1) MHT-related research had a very slow increase in the past 22 years, and the trend fluctuated. Sum of times cited and average citations per item had the same trend: a sharp decline from 2002 to 2003, and a rapid increase from 2003 to 2006, reaching the peak in 2006, then following a downward trend.” I do not need to remind everyone that 2003 -2006 were the results of THE STUDY, right?

A pleasant surprise was to find recent articles that state the opposite of the past trend. HRT is beneficial and safe for most women, says an article published by MedicalNewsToday on May 15, 2023 (https://www.medicalnewstoday.com/articles/managing-menopause-hormone-therapy-is-back).  “Hormone therapy benefits may outweigh risks for many younger menopausal women” was the conclusion of JoAnn Manson professor in the Department of Epidemiology at Harvard T.H. Chan School of Public Health (https://www.hsph.harvard.edu/news/hsph-in-the-news/hormonal-therapy-menopause/). A very interesting article was published in New York Times on February 1, 2023: “Women have been misled about menopause”. The Cancer Journal has an article from May-June 2022: “Menopausal Hormone Replacement Therapy and Reduction of All-Cause Mortality and Cardiovascular Disease: It’s about time and timing” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178928/ ) that states: “Initiated in women <60 years of age and/or at or near menopause, HRT significantly reduces all-cause mortality and cardiovascular disease (CVD) whereas other primary CVD prevention therapies such as lipid-lowering fail to do so”.

More and more professionals are discussing the flaws of the WHI study (https://www.npr.org/sections/health-shots/2024/05/01/1248525256/hormones-menopause-hormone-therapy-hot-flashes) and are agreeing on HRT being beneficial for women. Great! Now what? From the change in mentality to implementing the new information in carrying for the patients, there are still many steps to take and obstacles. Dear conventional medical world we have been neglected for the past 20 years. It is now time to move and move fast!