Profitable Pills in Search of a Disease

One year ago, 20 million American women woke up and read the shocking news that combined hormone therapy, instead of offering protection from major diseases, actually increases the risk for breast cancer, heart attack, blood clots and stroke. Since then, we've also learned that these drugs offer no benefit for mood or sexual function and double the risk for developing dementia.

Some women, such as Joan Levinson of Berkeley, have greeted this news as a confirmation of a lifelong skepticism of taking unnecessary drugs. "When I reached menopause," Levinson says, "every doctor was ready to pull out the prescription pad for pills. I always said no. Reason? I believe in the body and that the Original Designer knows better than mere mortals who have gone to medical school. So, barring life-and-death medical situations, I usually do not allow wonder drugs to enter my sacred body."

But many women, for their own personal reasons, followed their doctor's recommendation and now, with varying degrees of difficulty, are weaning themselves off hormone pills.

Not surprisingly, some women now feel betrayed. The drug industry and many doctors had promised that hormone therapy would give postmenopausal women protection from serious medical problems -- not to mention the glow of eternal youthfulness.

How could the drug industry and medical profession have been so wrong?

This is the question that Barbara Seaman addresses in her forthcoming book, "The Greatest Experiment Ever Performed on Women" (Hyperion, 2003), a splendid history that exposes how menopause was transformed into a medical problem and who was responsible for identifying hormone therapy as the medication for this "disease."

Seaman is a veteran health advocate and journalist who, in 1971, authored the famous "Doctor's Case Against the Pill," an inquiry into the dangers posed by birth control pills.

In a telephone interview from New York, she explained why she wrote this book. "I have a compulsion to disclose the true history of these drugs and the hidden knowledge that was kept from users. Many of the risks, especially blood clots, had long been known by research scientists. Research on hormone therapy was mostly smoke and mirrors and science by press release."

Seaman blames this "great experiment" on specific scientists, researchers and drug companies who created "one of the most elaborate promotional and advertising campaigns in the history of the media."

The drug industry, in particular, not only lobbied doctors, but also subsidized research that would support their claims. They also tried to discredit medical researchers, doctors and health advocates who raised serious doubts about tampering with women's hormones.

What lessons should we learn from this cautionary tale?

Cynthia Pearson, executive director of the National Women's Health Network, says, "We have to ensure that our regulatory agencies have the resources they need to protect us and we have to demand that doctors prescribe based on evidence, not on drug company marketing."

Seaman notes that "two-thirds of the women who have gone off hormones are doing just fine. Now we need research that can identify which women really need hormone therapy, instead of giving it to everyone who turns 50."

In addition, she also warns that "everyone's desperately looking for alternatives." So we should expect a growth industry in all kinds of alternatives -- including "the estrogen patch," herbal supplements, and topical and inserted use of hormonal products.

"Women should remember," she says, "that no one knows the long-term health effects of any of these products. In the case of herbal supplements, which are unregulated, we often don't even know what's in them."

So what should women do? Seaman suggests we be cautious and skeptical and never, ever, believe any ad that promises an easy life and eternal happiness.