Menopause, as Brought to You by Big PharmaThe New York Times: Menopausal hormone therapy has long been pitched as a way to stave off what some doctors viewed as the undesirable aspects of female aging. In the popular 1966 book Feminine Forever, Dr. Robert A. Wilson, a gynecologist, used disparaging descriptions of aging women ('flabby,' 'shrunken,' 'dull-minded,' 'desexed') to upend the prevailing idea of menopause as a normal stage of life. Women an their physicians, Dr. Wilson wrote, should regard menopause as a degenerative disease that could be prevented or cured with the use of hormone drugs.
'No woman can be sure of escaping the horror of this living decay,' Dr. Wilson wrote. 'There is no need for either valor or pretense. The need is for hormones.'...
Dr. Wilson's book propelled the idea of hormone 'replacement' into the popular consciousness and onto physicians' prescription pads... As the popularity of estrogen grew, an increasing number of women developed cancer of the uterine lining, the endometrium. In 1975, an FDA panel concluded there was a link between Premarin and endometrial cancer. The company then sent a letter to doctors trying to mitigate such concerns... But the company never conducted further studies...
The company instead focused its risk research on the possibility of breast cancers associated with hormone replacement therapy. But two studies published in the mid-1970s in The New England Journal of Medicine reported that taking estrogen therapy had increased the risk of endometrial cancer by at least five times...
In 1980, researchers at Boston University Medical Center estimated that the use of hormone therapy (.pdf) had caused more than 15,000 cases of endometrial cancer in the United States between 1971 and 1975 alone. 'This represents one of the largest epidemics of serious iatrogenic disease' -- meaning disease caused by physician-administered treatments -- 'that has ever occurred in this country.'...
Wyeth used proxies to promote a wide range of heath benefits from hormone therapy, paying millions of dollars to influential doctors and medical groups and helping them develop abstracts for medical conferences and articles for medical journals... In 1996, for example, a federal study reported that breast cancer risk may have been 'substantially underestimated.' Wyeth reacted with plans to dismiss it as 'just one more paper,' and try to 'overshadow' it by directing journalists to other studies...
The National Institutes of Health ultimately decided to start using the term 'menopausal hormone therapy' instead of 'hormone replacement therapy,' says Marcia L. Stefanick, a professor of medicine at the Stanford University medical school who was principal investigator on the Women's Health Initiative study at her institution... She says the word 'replacement' implies that women need hormone drugs after menopause. 'But there is no good evidence that women need this after menopause.'
