Update on Hormones, Menopause, and Heart Disease: Evaluating Professional Responses to the Women's Health Initiative

The Women's Health Initiative (WHI) randomized controlled clinical trials provided evidence that, contrary to the common wisdom and clinical practice of the day, estrogen and estrogen/progestin hormone therapies (HT) were not safe or effective interventions to prevent chronic illnesses, especially heart disease, among postmenopausal women. A recent criticism of WHI, the timing hypothesis, asserts that HT would be cardioprotective if started around the time of menopause. This article critiques the timing hypothesis. The hypothesis relies on rejecting traditional criteria for scientific evidence, overinterpreting weak evidence, underemphasizing harm, and valuing the metatheory that menopause is an estrogen deficiency disease.