Reversing Hormone Fear

For two decades, menopausal hormone therapy has carried the shadow of the 2002 Women's Health Initiative panic. In this episode, Dr. Wu and Darren unpack a landmark nationwide Danish cohort study, "Menopausal hormone therapy and long term mortality: nationwide, register based cohort study," by Anders Pretzmann Mikkelsen, Thomas Bergholt, Øjvind Lidegaard, and Nikolai Madrid Scheller, published in The BMJ (BMJ 2026;392:e085998). Drawing on data from more than 876,000 women followed for a median of 14.3 years, the study found no increased mortality risk associated with hormone therapy overall, a striking 27–34% lower mortality hazard among women who used it after surgical menopause, and a clear survival advantage for transdermal formulations over oral ones. Tune in for a data-driven conversation about why the original WHI trial misled a generation of doctors and patients, what the new numbers actually show, and what current clinical guidelines now recommend.