Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Jay Metzger


Hormone replacement therapy; Hormone therapy; Menopause; Osteoporosis; Cardiovascular disease


The Women's Health Initiative (WHI) studies were a catalyst for the dramatic decline in the number of postmenopausal women being prescribed hormone therapy (HT). The WHI published the largest randomized, double-blind, placebo-controlled trial regarding HT use in postmenopausal women. The WHI studies treated postmenopausal women with HT with a mean age of 63 years. Premature and early menopausal women have frequently not utilized HT based on the results of the WHI studies. The purpose of this literature review was to compare the WHI studies' results to studies that examined coronary heart disease (CHD) and bone health benefits and risks of HT use in premature or early menopause. Articles published in the last 22 years were initially incorporated to include the WHI studies. Articles were then further eliminated if they did not discuss CHD or osteoporosis in postmenopausal women less than 45 years of age. This systematic review recommends individualizing the use of HT in premature and early menopausal women by investigating their risk factors for breast cancer, deep vein thrombosis (DVTs), strokes, and CHD, along with performing a thorough review of their family history. If none of these risk factors exist, premature and early menopausal women should not be denied HT based on the WHI studies' results. Further random controlled trials (RCTs) and longitudinal studies need to be completed specifically on premature and early menopausal women to confidently substantiate the benefits of HT in the prevention of chronic diseases.