The WHI (Women's Health Initiative) trial on postmenopausal hormone therapy revealed which of the following key findings that changed prescribing practice?

• A Estrogen-only HRT increased breast cancer risk similar to combined HRT
• B HRT was beneficial for secondary prevention of cardiovascular disease
• C The trial showed HRT reduced all-cause mortality and should be given to all postmenopausal women
• D Combined estrogen-progestogen HRT increased risk of breast cancer, coronary heart disease, stroke, and VTE ✓

Explanation

The WHI trial (2002, CEE + MPA arm) demonstrated that combined continuous estrogen-progestogen HRT increased risks of invasive breast cancer (HR 1.26), coronary heart disease (HR 1.29), stroke (HR 1.41), and pulmonary embolism (HR 2.13). This led to a major shift away from long-term preventive use of HRT. The estrogen-only arm (hysterectomized women) did not show increased breast cancer risk and had reduced CHD in younger women (timing hypothesis). Current guidelines recommend HRT for symptom management at the lowest effective dose for the shortest necessary duration.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.