Dr. Jen Gunter

And I would say that

Sure, yeah, about the Women's Health Initiative.

So menopause hormone therapy, which is actually what we're trying to call it now, menopause hormone therapy, is replacement, implies that there's a disease.

And that would be an appropriate term for somebody under the age of 45 or someone with primary ovarian insufficiency, but for people age 45 and up.

So the Women's Health Initiative is probably, I think, the largest randomized double-blinded placebo-controlled trial ever.

I might be wrong, but it's pretty large.

And I think in the, and there were four arms to it, looking at Premarin and medroxyprogesterone acetate, which was the PremPro at the time, the most common, I believe it was the single most common prescription.

Then a Premarin only arm, people who don't have a uterus.

And then there were arms to look at diet, low fat diet for risk of breast cancer.

And then calcium and vitamin D for fracture prevention and whatever else they were looking for with that.

And so in the two hormone arms, there were about 27,000 people.

Pretty big, you know, randomized trial.

And the problem is people don't put the trial in context.

And somebody like Dr. Marty McCary, who doesn't see women as a gynecologist in the office, he's not managing menopause care,

I don't know what he was doing in the late 1990s when this came out, but as someone who was seeing patients, what I can tell you is the message that we had received from animal studies and observational studies, and we've talked about the limits of observational studies, was that estrogen may well be cardioprotective, and maybe we should be giving it to everybody for that.

I mean, we had seven-year-olds coming in, and I was like, sure, I want to go to hormone therapy.

It's supposed to be cardioprotective.

That's what we believed, and so that's why

the average age of the population was 63 because we were saying, you know, for all women who are relatively low risk, should we be prescribing this?

And the other reason that that that people were past the age of menopause, but they were really trying to enroll people who didn't have hot flashes or a significant percentage, you did, because obviously you could unblock.