Jennifer Gunter

So we have two actual studies that used more modern hormone regimens, and they didn't find any benefit from a cardiac prevention standpoint or from a dementia standpoint.

And we also have the long-term follow-up data from that.

I mean, people make a big deal about elite, but the change in CIMT

carotid intima media thickness was really minute compared to what we see with statins.

And that's a secondary outcome measure anyway.

So yeah, we have those data and they don't show this massive benefit.

And I think it's really important for people to understand that there's such a massive healthy user bias with menopause hormone therapy.

So all of the older observational data that showed benefit, when you go back and look, these tend to be

healthier users at baseline, they tend to have more money.

They had to have a higher education level.

And there was a recent, really interesting observational study published in Denmark just last year that showed that women who used menopause hormone therapy before the WHI had a lower all-cause mortality.

After the WHI, people who use menopause hormone therapy had the same all-cause mortality.

And in fact, the women who'd switched from systemic to vaginal

They had the lowest all-cause mortality, and those were the ones that had the highest education.

And so it would suggest that a lot of the older observational data is really confounded by all these biases that we know to be true with health outcomes.

Yeah.

So menopause hormone therapy has absolutely been shown to reduce the incidence of fractures.

I think in the WHI, it was 5 per 10,000 per year, if I remember that accurately.

And I think it's important.

I mean, it's a lightning round, but it's important to look at somebody's underlying risk, right?