Sorry for the delay in getting this up but here at last are my guest blogger’s comments on issues about estrogen and women’s health. First, I should introduce her, Susan Baxter, PhD. is co-author with Jerilynn Prior, MD of the newly published Estrogen Errors. Now for her comments,
In believing that hormones – pills, patches, injectables, bioidentical, you-name-it – will somehow keep you young and vibrant Suzanne Somers and Oprah are part of a long and undistinguished history, one that places estrogen front and centre. Progesterone, the other natural (post-ovulatory) hormone that crucially balances out estrogen during each menstrual cycle, an afterthought, if mentioned at all.
From the synthetic estrogen DES (diethylstilbestrol) in the 1930’s to the estrogen derived from pregnant mares’ urine, Premarin, since the 1950’s, estrogen “replacement” has morphed in our collective imaginations into the fountain of youth. And where it really started was with a 1966 bestseller, Feminine Forever.
Secretly produced by drug companies eager to market their estrogen pills, written by a kindly New York gynecologist Robert Wilson (his son later admitted to the drug company connection), Feminine Forever was blatant propaganda that took America by storm. In no time at all menopause became cemented in the popular imagination as a “deficiency” disease that estrogen could cure. And during an era where midlife women, no longer beautiful or fertile, were losing any status they may have had (as the TV series Mad Men depicts), Wilson’s song was one they wanted to hear. Really, it wasn’t age or the culture treating women badly; it wasn’t economic or social, it was medical. Then, once a handful of epidemiological studies linked taking estrogen with being healthier (bearing in mind that such studies can only show correlation, not cause), millions of women began taking hormone “replacement” therapy or “HRT”.
I use quotes for “HRT”, incidentally, because – as my coauthor endocrinologist Jerilynn Prior has accurately pointed out – how can hormones at menopause be a “replacement” when all women’s hormones naturally wane at this stage of their lives. The term suggests parity with a diabetic taking insulin – except it is not.
The estrogen-is-good-for-you argument should have died, once and for all, in 2002 when the largest clinical trial in history, the Women’s Health Initiative (WHI) was stopped early because the women who were taking the hormones were found to be suffering from ridiculously high levels of breast cancer, heart disease, stroke, blood clots and more. For those women whose perimenopause (the transition into menopause during, usually, the forties) is onerous, progesterone works for symptom relief and doesn’t cause anything dire. But no, here we are again, stuck in the inane and superficial: Oprah, Somers, Newsweek. What we are not hearing is how these women, along with everyone else, have so internalized the fallacy that a woman’s true nature is to be fertile (and with high levels of estrogen) that all else is forgotten. So we continue to argue about the what and the – when the real issue is the why. But, as the late Stephen Jay Gould once said, we believe most fervently in those facts that allow us to believe our social prejudices are true. And there is no prejudice as thoroughly engrained as that of the value of women being equal to their being young and fruitful.
That is the real story.
(My thanks to Frogheart and all the other bloggers – e.g., http://trueslant.com/womenomics/2009/06/08/did-anyone-else-think-the-newsweek-photo-of-oprah-was-mysogenistic-and-just-plain-dumb/ – and other commentators, many linked to on this blog, who have criticized the Newsweek story thoughtfully. However, as a social scientist and medical writer who has studied the subject, I continue to be appalled at our societal love affair with hormones, in general; estrogen, in particular; and our blithe disregard for the natural cycles and stages of a woman’s life.)
As I said in Part 2 of my post, titled Synchronicity, Oprah, Newsweek, and Hormones, it’s not necessary to denigrate someone personally to critique what their ideas. Thank you Susan!