Thirty years later, the Women’s Health Initiative provides researchers with key messages for postmenopausal women

A physician shows a medical tablet to a patient in a clinical setting.

Researchers from the NHLBI-supported Women’s Health Initiative, the largest women’s health study in the U.S., published findings from a 20-year review that underscores the importance of postmenopausal women moving away from a one-size-fits-all approach to making medical decisions. Through this lens, the researchers encourage women and physicians to work together to make shared and individualized decisions based on a woman’s medical history, age, lifestyle, disease risks, symptoms, and health needs and preferences, among other factors. These findings support the concept of “whole-person health” and published in JAMA

After reviewing decades of data following clinical trials that started between 1993 and 1998, the researchers explain that estrogen or a combination of estrogen and progestin, two types of hormone replacement therapies, had varying outcomes with chronic conditions. The evidence does not support using these therapies to reduce risks for chronic diseases, such as heart disease, stroke, cancer, and dementia. However, the authors caution that the study was not designed to assess the effects of FDA-approved hormone therapies for treating menopausal symptoms. These benefits had been established before the WHI study began. 

Another finding from the study is that calcium and vitamin D supplements were not associated with reduced risks for hip fractures among postmenopausal women who had an average risk for osteoporosis. Yet, the authors note women concerned about getting sufficient intake of either nutrient should talk to their doctor. A third finding was that a low-fat dietary pattern with at least five daily servings of fruits and vegetables and increased grains did not reduce the risk of breast or colorectal cancer, but was associated with reduced risks for breast cancer deaths.