Real talk, with receipts.

Last updated: August 2026

Everything Liona says out loud, backed up in writing. These are the receipts behind the numbers on our site and in the Liona Check.

What happened in 2002

The Women's Health Initiative published early results that were reported as "hormones cause breast cancer and heart disease." The study population skewed older and years past menopause, used one specific oral formulation, and the absolute risks were small — but the headlines were not. HRT use collapsed, and a generation of women — and their doctors — were trained to say no before the conversation started. Subsequent re-analyses have substantially revised that picture, especially for women who start near menopause.

Sources: Rossouw JE et al., JAMA. 2002;288(3):321–333 · Manson JE et al., JAMA. 2017;318(10):927–938 · Plain-language history: STAT News, Dec 2024.

The numbers we cite

≌4% of menopausal women use hormone therapy today — down from roughly 1 in 4 before 2002.

Source: Yang & Toriola, JAMA Health Forum 2024 — use fell from 26.9% (1999) to 4.7% (2020) · The Menopause Society, 2024 — under 4% even in women under 60 · Mayo Clinic, 2026 — 1.8% by 2023.

Prescriptions dropped ~80% in the years after the WHI headlines.

Source: Same JAMA Health Forum analysis — a drop from ~27% to under 5% is an ~80% decline in use.

Up to 20% of bone density can be lost in the 5–7 years around menopause; roughly 1 in 2 women over 50 will break a bone due to osteoporosis.

Source: Bone Health & Osteoporosis Foundation — General Facts and What Women Need to Know: up to 20% of bone density lost in the 5–7 years after menopause; about 1 in 2 women over 50 will break a bone due to osteoporosis.

Testosterone declines with age in women — by the 40s, levels are roughly half those of the 20s.

Source: Davison SL et al., J Clin Endocrinol Metab. 2005;90(7):3847–3853 (androgen levels decline steeply with age; mid-40s levels roughly half those of the mid-20s).

About 1 in 3 perimenopausal women are offered antidepressants or anxiolytics for mood symptoms — against guidance.

Source: Kamal et al., Maturitas 2025 ("around 1 in 3 perimenopausal women are offered or prescribed antidepressants and anxiolytics") · Newson Health survey: over a third offered antidepressants instead of HRT first (summary) · NICE Guideline NG23 (nice.org.uk/guidance/ng23): antidepressants are not first-line for low mood associated with menopause.

Hormone therapy remains the most effective treatment for menopausal vasomotor symptoms.

Source: The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause. 2022;29(7):767–794.

Our promise about claims

Liona describes what membership includes and what hormones are associated with — we don't promise outcomes. If we can't source it, we don't say it.