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Midlife and Menopause

Menopause and Hormone Therapy

The Greatest Experiment Ever Performed on Women: Exploding the Estrogen Myth

The following article is a review by Cynthia Pearson of Barbara Seaman's book, The Greatest Experiment Ever Performed on Women: Exploding the Estrogen Myth (Hyperion, 2003). It was previously published in the April 2004 edition of The Women's Review of Books and is posted here with permission.

In July 2002, I spent day after day talking to reporters about the results of the Women’s Health Initiative study of menopausal hormone therapy.  As the director of the National Women’s Health Network, I was called on to respond to the study’s finding that hormones increased the risk of breast cancer and didn’t prevent heart disease.  The drugs being studied, Premarin and Prempro, are blockbusters bringing in over a billion dollars each year to their manufacturer, Wyeth.  The news that the very drugs used by so many women caused cancer was shocking to many, and the media treated this study as front-page news.  I was asked over and over again what this meant for the millions of women currently taking hormones and what they should do.  But like many feminists, I found myself trying to give answers to questions that weren’t being asked.  I wanted to talk about the medicalization of menopause and women’s right to know the real truth their bodies, and about the drugs and medical procedures recommended to them. 

I had only limited success in 2002.  A few journalists made the connection between Wyeth’s celebrity-studded advertising campaigns and women’s mistaken belief that hormones prevented heart disease, Alzheimer’s, wrinkles and sexual decline.  And the occasional writer credited the Network, or Dr. Susan Love with presciently warning that what doctors were telling women about hormone therapy wasn’t necessarily the full truth.

But the bigger story wasn’t really told and I believe it’s an important one.  The assertions made by health feminists – that women have the right to know all relevant information about drugs, medical procedures and bodily functions and that menopause, childbirth, puberty are natural conditions that don’t always need medical management relate directly to one of the key issues of the modern women’s liberation movement – Who controls women’s bodies?          

Now, though, we have a chance to hear the full story, thanks to Barbara Seaman and her new book, The Greatest Experiment Ever Performed on Women.  Barbara tells, in vivid detail, the history of both menopausal hormone therapy and oral contraceptives.  In both cases, she argues that there exists a mythology of estrogen, one that misleads, disempowers and physically harms women.  In the tradition of Gerda Lerner, who wrote The Creation of Patriarchy  (Oxford University Press, 1987) to inspire us with the knowledge that patriarchy is not an unalterable facet of human nature, Barbara Seaman describes how the mythology of estrogen was created, so that women today can take it apart.  In her words, she is “exploding the estrogen myth”.

Seaman, now a columnist for Hadassah magazine, has covered this beat for 40 years, having personally interviewed most of the key figures and attended many of the key events.  She begins by sharing a personal story.  Seaman’s Aunt Sally died of endometrial cancer shortly before her 50th birthday.  The young doctor taking care of her aunt warned Barbara and Sally’s other female relatives never to take Premarin.  He was certain, he said, that Premarin caused Sally’s cancer.  “It’s a special cancer.  An estrogen cancer”, he told Barbara.  (Page 15)  At the time, in 1959, Seaman was 23 and just starting out as a freelance writer on women’s health and sexuality.  She started a file on Premarin and cancer, but for the time being could do little about the warning she’d received.

Meanwhile, many other women who hadn’t received any warnings about estrogen causing cancer were being offered estrogen pills by their physicians.  To women who turned to their doctors for help with disruptive hot flashes and night sweats, estrogen was effective medicine they appreciated.  But unbeknownst to these women, their doctors were being encouraged to think of estrogen as far more than just a treatment for hot flashes.  Premarin was the most popular brand of estrogen from the start and remains so to this day.  “The Premarin ads were charming….Designed to foster fantasies of a fountain of youth, they featured women of a certain age having fun, being admired, sometimes waltzing with impeccably dressed handsome gentlemen who (you could tell) adored them.” (Page 48)   Doctors responded by steadily increasing the number of prescriptions they wrote for Premarin and other estrogen drugs.  

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