The 20+ Year Ripple Effect For more than 20 years, women’s health has been shaped by a ripple effect that started in 2002 with the Women’s Health Initiative. The headlines that followed were scary and spread quickly, and many women stopped hormone therapy almost overnight. Clinicians became more cautious too, and over time, menopause care quietly took a step back. What followed was a ripple effect of less education, less comfort having these conversations, and a lot of women