Study after 40 years of hormone replacement therapy
proves
Profits are hazardous to women's health
By Bev Hiestand, R.N.
The Women's Health Initiative has stopped its clinical trial
on the risks and benefits of the most widely used hormone
replacement therapy (HRT), known as Prempro, for menopausal
women. The proposed eight-year study was halted after only five
years when statistically significant evidence of the dangers of
HRT became evident. The findings are published in the July
issue of the Journal of the American Medical Association.
The WHI study of 16,000 participants found significantly
serious risks for those who received HRT compared to those who
received placebos.
The study revealed that women receiving HRT had 29 percent
more heart attacks, 26 percent more cases of breast cancers, 41
percent more strokes and 112 percent more blood clots in the
lungs than those assigned the placebo, according to the July 9
National Institutes of Health News Release.
Study directors had told participating women twice
before--in 2000 and 2001--that those taking the drugs seemed to
face slightly more health risks, but claimed it was not serious
enough to stop the research.
However, in May researchers decided that the dangers to
women taking these drugs outweighed the benefits of slight
reduction in the risk of bone fracture and colorectal cancers.
The study reported that 1 out of 1,000 of those who took HRT
faced hip fractures as opposed to 1.5 out of 1,000 per year who
did not.
Of approximately 50 million postmenopausal women in the
United States, about 14 million are taking hormone treatment.
(Washington Post, July 10) For years, women have been told that
HRT could keep them young, keep their skin youthful, prevent
heart disease, prevent brittle bones and maintain their mental
acuity.
It has been known for some time that women in their 30s and
40s are less likely to have heart attacks and strokes than men
the same age. While this led some to believe that declining
estrogen levels during menopause may be a contributing factor,
this was never proven. Nor was it proved that HRT would prevent
heart attacks.
The findings from the WHI support recent American Heart
Association recommendations that postmenopausal women should
not take hormone therapy to lower their risk of heart disease.
(Reuters Health Information, July 2) Investigators in an
earlier trial reported as early as 1998 that there was a higher
risk of heart attack and death during the first year of
therapy. Later analysis of that study showed there was also
increased risk of blood clots that could cause heart attacks
and strokes.
In addition to the WHI study, the June 27 Reuters Health
reported an Italian study has found a link between HRT and
increased gallbladder cancer risk.
Earlier observational studies had indicated that women who
took HRT were healthier than those who did not. But in the
early 1990s, women's groups--including the National Women's
Health Network--pointed out that the problem with observational
studies is that women who choose to take hormones may start out
healthier than women who choose not to. They also pointed out
that since observational trials don't include dead people, they
would not have included data about women who died as a result
of hormone use.
Women's groups and some physicians became increasingly aware
that there were no definitive scientific studies in scientific
literature and they pressed to focus more attention on women's
health issues. The efforts of these activists led to the
Women's Health Initiative study, which enrolled more than
160,000 U.S. women to investigate strategies for preventing
diseases associated with aging--including heart disease, cancer
and osteoporosis.
One of these studies was the HRT research, which is the only
prospective, randomized controlled trial of the effect of
hormone replacement on disease incidence in healthy women.
'Vapid cow' theory: A lot of bull!
How did menopause become a "disease" automatically requiring
drug treatment, rather than a natural life transition? An
article entitled "The Truth About Hormones" in the July 14 Time
magazine provides a little medical history on the question.
"About 40 years ago, attention was focused on just one
female hormone, estrogen. Its greatest popularizer was a
gynecologist named Robert Wilson, who thought the hormone could
serve as an all-purpose rejuvenator for women of a certain
age.
"In his hugely successful book, 'Feminine Forever,'
published in 1966, Wilson wrote of menopause as a 'living
decay' in which women descended into a 'vapid cow-like' state.
Supplemental estrogen, Wilson insisted, would almost magically
transform the dull cow into a supple, younger-looking wife and
mother. She would not only feel better but also make those
around her feel better--especially, it was implied, her partner
in bed."
Over the years, these arguments for HRT were updated. "The
vapid cow-like state was gone, and there was very scientific
language about bone density and heart disease," explains
Cynthia Pearson, executive director of the National Women's
Health Network, and a long-time skeptic of HRT.
However, the main message was always sexist and ageist, says
Pearson. It had a constant refrain: "Stay young. Stay healthy.
Stay sexually vital. Be less of a pain to your husband." (New
York Times, July 10)
After Dr. Wilson died in 1981, his son Ronald Wilson
revealed that pharmaceutical giant Wyeth-Ayerst had paid all
the expenses of writing "Feminine Forever" and financed his
father's organization--the Wilson Research Foundation--that had
offices on Park Avenue in Manhattan. (New York Times, July
10)
Prempro is made by Wyeth Pharmaceuticals. Wyeth earned about
$900 million in sales of this drug last year. (New York Times,
July 17)
By 1975, Wyeth's product Premarin had become the
fifth-leading prescription drug in the U.S., reports Nadine
Marks, an associate professor at the University of Wisconsin at
Madison. "Even textbooks for gynecologists and obstetricians in
the 1960s would explain how a woman's life could be destroyed
if she didn't have estrogen in her body." (New York Times, July
10)
In the 1970s, studies indicated that estrogen replacement by
itself promoted uterine cancers. The drug companies found a way
around that by combining progestin with estrogen.
In the 1980s, sales soared with the promise that hormone
replacement could prevent osteoporosis.
Hormone replacement drugs continue to bring in huge profits
for the pharmaceutical companies and these businesses do
everything they can to protect those profits.
A survey by Impact Rx to determine how Wyeth and makers of
competing products were reacting to the WHI study showed that
sales representative visits to doctors tripled in the week of
the study result's announcement. Some of its competitors jumped
at the opportunity to gain sales of similar products. But while
the hormonal products that compete with Prempro contain
chemically different forms of estrogen and progestin, there is
no evidence yet that they are safer. ( New York Times, July
17)
Merck & Company ran a full-page ad promoting Fosamax,
another drug that treats osteoporosis, in the July 14 New York
Times. The practice of promoting drugs directly to the consumer
is banned throughout the world except in the United States and
New Zealand. (www.policyalternatives.ca)
Pearson stresses, "Pharmaceutical companies have used
statistical smoke and mirrors to tout unproven benefits,
minimize risks and mislead physicians into being an
unsuspecting marketing force for a regimen that harms healthy
women. There was never one single clinical trial that showed
that HRT prevented cardiovascular disease or stroke. This is
not a story of science moving sedately forward, carefully
adding pieces to a puzzle before making recommendations to
patients. This is a story of the corruption of the medical and
scientific community. The belief that hormones are good
preventive medicine has been a triumph of marketing over
science." (www.womenshealthnetwork.org)
The National Women's Health Network's book, "The Truth About
Hormone Replacement Therapy," documents how drug companies
entice physicians with free cruises and expensive dinners.
Pharmaceutical presentations at scientific conferences,
articles in eminent medical journals and continuing medical
education programs influence doctors.
And, the book notes, "Pharmaceutical companies control what
studies get funded, who gets paid for doing them, where (and
whether or not) those studies are published, and how the
studies are interpreted. Drug companies, who provide beautiful
slides along with a prefab perspective, often pay the
physicians and researchers invited to give talks at scientific
conferences."
On average, pharmaceutical companies spend $10,000 to
$15,000 per physician per year on marketing. (Family Therapy
Networker, March 2000) A July 12, 2001, report issued by
Families USA, a Washington, D.C.-based healthcare consumers'
group, says that leading pharmaceutical companies spend more
than twice as much on advertising and marketing as they do on
research. (www.gayhealth.com)
And it pays off, richly. From 1990 to the year 2000, per
capita spending on prescription drugs in the U.S. increased by
more than 206 percent. (Family Therapy Networker, March
2000)
Capitalism: Hazardous to health
How can women find objective, truthful, scientific
information about drugs?
A survey of some of the following accounts of pharmaceutical
company criminal activity in the pursuit of super profits can
be found on the Public Citizen Health Research Group website
www.citizen.org.
Abbott Laboratories illegally withheld information
concerning eight deaths and other adverse effects of the drug
Meridia.
Schering-Plough knowingly shipped millions of asthma drug
inhalers that did not contain any active ingredients; inactive
medication could be fatal to an asthmatic.
Editors of the most prestigious medical journals--such as
the New England Journal of Medicine, the Lancet, the Annals of
Internal Medicine and the American Medical Association
Journal--found a large number of published articles fail to
disclose ties to drug companies. The editors have adopted a
uniform policy that reserves the right to refuse to publish
drug-company-sponsored studies unless the researchers involved
are guaranteed scientific independence. The editors acted after
recent charges that drug companies tried to withhold negative
research results or present them in the most favorable way.
(www.mercola.com)
New statistics reveal that 96 percent of studies sponsored
by the pharmaceutical industry find the drug under
investigation helpful, while only 37 percent of
government-funded studies do. (Family Therapy Networker, March
2000).
No wonder polls are finding women scared and angry about the
WHI results. Millions of women are left to wonder what can be
done to protect them from the unscrupulous practices of the
drugs-for-profit industry.
Many of these women have taken hormone replacement therapy
because their physicians told them it would prevent heart
disease--the biggest killer of women. Now, they are learning
that HRT can CAUSE heart disease.
How can any patients trust their doctors when it has been
shown that the greatest influence on physicians' prescribing
practices is the visit from pharmaceutical reps? (Family
Therapy Networker, March 2000)
Cynthia Person concludes, "The lesson we need to learn for
the future is that we need unbiased research. We need to remove
drug company influence from all medical education. And
pharmaceutical interventions should not be inflicted on healthy
people until these interventions are proven safe and effective
in randomized controlled trials."
(www.womenshealthnetwork.org)
There also needs to be a thoroughgoing struggle against
sexism in the delivery of medical care--as well as ongoing
battles against racism, homophobia and other barriers to
treatment, like lack of health insurance and poverty.
"The idea that our bodies fail us at menopause is
ludicrous, extremely sexist and just plain wrong," says Vicki
Meyer, founder of a cybercommunity called the International
Organization to Reclaim Menopause. (Time, July 14)
But ultimately, the answer is to remove health care--and all
other forms of capitalist industry--out of the hands of private
ownership by a wealthy handful and into the hands of the vast
laboring class that built it with their toil. Under a planned
economy--even in the poorest countries trying to build
socialism, like Cuba--health care is free for everyone.
Removing the capitalist profit motive--the insatiable drive
that is so hazardous to health--lays the basis to explore
numerous ways that society can support physical, emotional and
mental healthy living through the entire life spectrum from
infancy to old age.
Hiestand is chief steward of CWA 1168 in Buffalo. She is
also a women's rights activist who, during a right-wing
mobilization in Buffalo in the 1990s, helped organize coalition
defense of women's clinics that performed abortions.
Reprinted from the Aug. 1, 2002, issue of
Workers World newspaper
This article is copyright under a Creative
Commons License.
Workers World, 55 W. 17 St., NY, NY 10011
Email: ww@workers.org
Subscribe wwnews-subscribe@workersworld.net
Support independent news http://www.workers.org/orders/donate.php)
HOME
:: U.S. NEWS ::
WORLD NEWS ::
EDITORIALS ::
SUBSCRIBE ::
DONATE
Email
this article
Printable
page