Do Women Have Short Memories About Hormone Replacement Therapy? Pharma Hopes So
It has been almost ten years since a federal study found that hormone replacement therapy (HRT) did not prevent heart disease and memory loss as advertised but increased the risk of heart attacks by 29 percent and doubled the risk of dementia. Oops.
That was not all the bad news that emerged about HRT. It also increased the risk of breast cancer by 26 percent, stroke by 41 percent, doubled the risk of blood clots and increased the risk of hearing loss, gall bladder disease, urinary incontinence, asthma, the need for joint replacement, melanoma, ovarian, endometrial and lung cancers and non-Hodgkin's lymphoma, according to medical journals.
Not exactly the fountain of youth it was billed as by hormone drug maker Wyeth (now Pfizer) in high-budget menopause awareness TV ads starring model Lauren Hutton.
In fact, HRT was such a scourge against women, in the first year that millions quit, 2003, the incidence of US breast cancer fell seven percent. It fell 15 percent among women whose tumors were fed by estrogen. Fourteen thousand women who were expected to get breast cancer didn't said news reports. And it wasn't just breast cancer women were spared: heart attack and ovarian cancer rates also fell when women quit HRT, said news reports.
The statistics must have been embarrassing to cancer researchers and public health officials. Not only was a major cause of breast cancer hidden in plain sight, the war on cancer should apparently have been a war on cancer-causing drugs!
It was even more embarrassing because the whole sequence happened before! In 1975, an FDA panel found a link between Premarin (a Wyeth HRT drug) and endometrial cancer and when women quit the drug by the millions-the same thing happened. "There was a sharp downward trend in the incidence of endometrial cancer that paralleled a substantial reduction in prescriptions for replacement estrogens," reported the New England Journal of Medicine (NEJM) in 1979.
Not wanting to lose its billion dollar HRT franchise, Wyeth's medical director wrote doctors in the 1970s that HRT still had "proven benefits" at the "the lowest maintenance dose" and that it was "simplistic indeed to attribute an apparent increase in the diagnosis of endometrial carcinoma solely to estrogen therapy."
Thirty years later, when cancer rates again dropped, Wyeth rolled out the "timing theory"-a campaign that said women don't need less HRT, they need more. "The benefits of HRT may outweigh the risks if treatment is given to younger women, but the risks may outweigh benefits if treatment is started at a later age," wrote a Wyeth-linked doc in a medical journal in 2004.
Despite the 29 percent increase in heart attacks correlated with HRT, clinical trials of whether HRT was "cardioprotective" (per the timing theory) were launched at major US medical centers in the mid 2000s. Seven of the study's investigators were Wyeth-linked, though the trials were said to be privately funded.
And despite the doubled risk of dementia correlated with HRT, a timing theory trial exploring if HRT is "neuroprotective" against Alzheimer's Disease was launched, funded by the National Institute on Aging. The New York Times even got into the act, running a magazine article extolling the timing theory ("The Estrogen Dilemma") which its author now admits omitted the Wyeth/Pfizer links of five "experts" cited.
(Nor are animals spared in Pharma's government-abetted efforts to profiteer on women and menopause. Grisly primate experiments into early hormone use are conducted at Wake Forest, Mount Sinai and other medical centers.)
This week a U.S. Preventive Services Task Force reaffirmed the dangers of long-term HRT use. Neither combined estrogen and progestin (as in Wyeth's Prempro) in women without hysterectomies or estrogen alone (as in drugs like Premarin) in women with hysterectomies are safe on a long term basis, said the panel of independent experts after viewing the literature.
Within hours of the report, the hormone franchise bit back. "It is very important that patients understand what this report does not say: it does not recommend against the use of hormone therapy for the relief of menopausal symptoms," commented the HRT-friendly American Society for Reproductive Medicine. Key word "against."
As a new generation of women approach menopause, will the HRT lessons of the 1970s and 2000's be lost amid Pharma's marketing again?
The complete story of marketing of HRT to women is found in "Weapons of Hormonal Therapy," a chapter in Martha Rosenberg's recent book, Born with a Junk Food Deficiency.
Martha Rosenberg is a columnist and cartoonist, who writes about public health Read more stories by Martha Rosenberg.
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