“HRT in Menopause: A candidate for a case study of epistemology in epidemiology, statistics & medicine” by foodforthought

I recently came across a 2024 update on a 2018 book making the still-controversial case that hormone replacement therapy (HRT) after menopause is highly beneficial and that rumors of its risks are unfounded, or at least highly exaggerated.

According to their narrative (apparently not contested), HRT started with the physiologically reasonable idea that menopausal symptoms could be treated with estrogens (which at the time were extracted from pregnant horse urine). Early observational epidemiological studies reported that taking estrogen during menopause was associated with considerable benefits and minimal risks, leading to its widespread use by menopausal women. Then a huge randomized controlled trial (RCT) by the Women's Health Initiative (WHI) famously overturned that prevailing wisdom, debunking the purported benefits and establishing considerable risks. Publication of those conclusions in 2002 led to a drastic reduction in the use of HRT. This segment of the history of HRT became a stock [...]

The original text contained 5 footnotes which were omitted from this narration.

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First published:
July 21st, 2025

Source:
https://www.lesswrong.com/posts/D8ELLgzmmeHTQwGE2/hrt-in-menopause-a-candidate-for-a-case-study-of

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Narrated by TYPE III AUDIO.