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For at least one decade, women have increasingly been avoiding hormone replacement therapy, also known as menopausal hormone therapy, which is used to treat the symptoms of menopause. In 2002, the Women's Health Initiative ended a study, the Estrogen Plus Progestin Trial, early due to the potentially dangerous side effects of taking two-hormone therapy. The researchers of this study found that women on two-hormone therapy treatment had a greater mortality rate. Since this study, women have decided to avoid hormone replacement therapies in general. Now, according to a team of researchers from the Yale School of Medicine located in New Haven, CT, the avoidance of this type of therapy could actually be putting women at risk.

"What has happened is an avoidance of use of estrogen not because of the [study] findings, but because of the way they were communicated and understood," Dr. Philip Sarrel said according to the Yale video interview.

For this study, the researchers evaluated a separate group of women who were between the ages of 50 and 59. All of the women had hysterectomies. The research team calculated that from 2002 to 2011, choosing not to have estrogen-only hormone therapy led to the early deaths of around 50,000 women. The researchers were able to estimate the number of deaths based on the mortality rate data. The researchers believed that the 2002 study, even though it focused on two-hormone replacement therapy, could have influenced women to avoid even one hormone replacement therapy. Due to the lack of information provided to women about the differences between the two types of therapy, women are putting themselves at risk of an early death.

"None of those women lived to be 70 years old. They were all women aged 50-59 who would have used estrogen but did not use it," Sarrel said.

Before 2002, the researchers stated that the majority of women who had hysterectomies would have opted for estrogen therapy for around five years post procedure. Now, that 90 percent rate has dropped to just one third of the female population who opt for hormone replacement therapy. The researchers believe that better communication needs to occur between medical professionals and their female patients. Several studies since 2002 have found that hormone replacement therapy helped reduced the risk of early death. Despite these finds, it appears that women are still unaware of the potential factors involved when it comes to rejecting hormone therapy.

The researchers believe that the 2002 findings are distorted due to the fact that the Women's Health Initiative results do not point out differences between hormone therapy treatments and how one of the two treatment options could benefit women aged 50 to 59 who had undergone a hysterectomy. Despite this distinction, critics of this new study were quick to remind people that this study was a review and did not present new clinical data.

"This paper does not present any new clinical trial results," Dr. Rowan Chlebowski, who is an investigator at the Los Angeles Biomedical Research Institute, warned according to the LA Times. "Rather it is an analysis based on aggressive assumptions."

The study was published in the American Journal of Public Health.