The WHI study may go down in history as one of the most poorly constructed yet widely accepted of our time. In multiple observational studies prior, women’s cardiovascular and bone health was noted to be better on HRT. The WHI wanted to ask if women should be started on HRT for the purpose of reducing ASCVD due to its well known observational status. However, the WHI had several serious flaws, and the outcomes started to show higher ASCVD events in HRT patients. So much so, that the trial was stopped early and a tidal shift of treatment recommendations came down in one fell swoop. HRT bad, HRT dangerous, stop HRT. Which everyone did. Despite poor symptom control of menopause, fast forward 2 decades and women are experiencing higher rates of osteoporosis and pathologic fracture as well as worsening ASCVD outcomes. It’s crazy, one study, o matter how poor its methodology and all of the heavy criticism in opposition to its conclusions can create a sea change in an entire field of high persists despite emerging evidence to the contrary.