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The Greatest Experiment Ever Performed on Women
Exploding the Estrogen Myth
by Barbara Seaman
Copyright © 2003 Barbara Seaman
Introduction: Smart Doctors, Foolish Forecasts
I have a doctor friend who so believed in the value of synthetic estrogens that when the National Institutes of Health announced a large clinical trial to compare these pills with sugar pills, she dismissed it as a waste of money. "Obviously, the women on the hormones will be living longer," she said. "It's unethical to leave volunteers on the placebos for the full eight and a half years of the trial. At some point they'll have to stop the study and offer hormones to everyone."
Her colleagues concurred, but then the opposite came true. On the morning of July 9, 2002, my friend, along with other physicians and the 30 million U.S. patients taking estrogen products woke up to discover that the world, after all, was flat. A safety monitoring board had suddenly halted a part of the study involving 16,608 women because those taking hormones had more breast cancer, heart attacks, strokes, pulmonary embolisms, and blood clots than those taking sugar pills. Yes, these volunteers on real Prempro also had fewer bone fractures and less colon cancer. But not enough to balance out the risks.
My friend initially heard the startling results on Good Morning America, where Dr. Tim Johnson described this "somewhat surprising outcome." He predicted that most women then taking hormone pills would stop "after talking to their physicians today," failing to anticipate that many doctors would take their telephones off the hook. My friend switched the channel to CNN, where Paula Zahn repeatedly exclaimed: "I tell you - women gotta go insane today." Channel surfing, she caught up with the "usual suspects," certain doctors familiar to TV viewers whose spin skills had been developed by public relations coaches at agencies that handle pharmaceutical accounts. It was then my friend got it. These physicians were appearing on stations where paid ads suggested that if only we took estrogen we could look like Lauren Hutton and sing like Patti LaBelle.
That night my friend called me to apologize for having objected to the title I planned for this book. She had called it "over the top and ridiculous," but now she said she could almost agree.
What is the Greatest Experiment?
While the Prempro arm of the Women's Health Initiative, which lasted 5.2 years and included 16,608 women, was a major test, it is only a small part of what I consider to be The Greatest Experiment Ever Performed on Women. The experiment began in England in 1938, and it has continued for sixty-five years. A British biochemist desperate to prevent Nazi Germany from cornering the world market on synthetic sex hormones published his formula for cheap and powerful oral estrogen. Within months, thousands of doctors and scores of drug companies around the world were working with this formula.
That opened the Greatest Experiment. Products made from chemicals that mimicked the feminizing effects of a woman's natural secretions were marketed fresh out of the lab. They were prescribed and sold for a host of concerns - to slow and prevent aging, to stop hot flashes, to avoid pregnancy or miscarriage, and as a morning-after contraceptive.
I call the marketing, prescribing, and sale of these drugs an experiment because, for all these years they have been used, in the main, for what doctors and scientists hope or believe they can do, not what they know the products can do. Medical policy on estrogens has been to "shoot first and apologize later" - to prescribe the drugs for a certain health problem and then see if there is a positive result. Over the years, hundreds of millions, possibly billions of women, from every corner of the world have been lab animals in this unofficial trial. They were not volunteers. They were given no consent forms. And they were put at serious, often devastating risk.
These drugs' risks have been known and documented since the beginning. The British doctor who published his estrogen formula thereafter spent many years warning the world that these drugs, although containing great promise, were serious hazards for endometrial and breast cancer. Despite the ignorance or hypocrisy of many doctors who have said "Who knew?" since the halting of the Prempro trial in July, there is nothing surprising in the recent findings. We have known since day one that these drugs posed threats. And since then science has added to, not subtracted from, the list of estrogen's problems.
How did this happen?
If doctors and scientists have known these dirty secrets for so long, why is the bad press so recent? This is an essential question right now, and this book seeks to present answers. Part of the answer is the vigorous effort by drug companies to protect an invaluable market. These efforts have included underwriting studies and doctors, getting into medical school curriculums, advertising heavily in medical journals, and seeing that continuing medical education is directed by the industry's doctors. It has also entailed on of the most elaborate promotion and advertising campaigns in history. Only through learning how drug companies buy and influence medical opinion can women protect themselves from a new spin, the new claims that will inevitably emerge about these drugs and countless others.
This is not the first time estrogen sales have felt the cold wind of consumer anger. In 1975, the magnitude of estrogen-related endometrial cancer was established; drug sales sank by half in the following years. In this instance, as in every other moment when things have looked bad for estrogen, the drugs managed to revitalize themselves through new claims.
Estrogen products won't go away, and they shouldn't. One can wish, as I do, that they will be used now with caution, based on evidence and facts, not illusion. This book will consider whether hormone supplements are necessary and for whom. It is only through understanding how we got to this point that women can keep it from happening again. Specifically, I hope this knowledge will help women navigate the estrogen issue. But the larger hope is that they can make informed decisions about other drugs as well.
On the sixty-fifth birthday of the Greatest Experiment, I recall a poem by William Butler Yeats entitled "The Coming of Wisdom with Time":
Though leaves are many, the root is one;
Through all the lying days of my youth
I swayed my leaves and flowers in the sun
Now I may wither into the truth.
Let us hope.
Author's Biography
In 1960, Barbara Seaman introduced a new style of health reporting that centered more on the patient, and less on the medical fads of the day. She was first to reveal that women lacked the information to make informed decisions on contraception, childbirth, even breast-feeding, (in an age where infant formula companies claimed their products were nutritionally superior to mothers milk.) Well received by a mass audience, Seaman became a columnist and contributing editor at Bride's Magazine, The Ladies Home Journal, Family Circle and Ms. Magazine. She also contributed Op. Eds. and reviews to newspapers, including the New York Times, The Washington Post, and Newsday, and consulted for TV medical programs such as ABC's FYI, which won a special Emmy for daytime programming.
In 1967-68, Seaman, a graduate of Oberlin, won a Sloan-Rockefeller Science Writing Fellowship at the Columbia University School of Journalism. While there she began her first book The Doctors' Case Against the Pill, which was published in 1969, and became the basis for a U.S. Senate hearing, conducted by Gaylord Nelson in January-March 1970. Young feminists led by Alice Wolfson repeatedly disrupted the hearing, demanding to know why patients were not testifying, and why there was no pill for men. These demonstrations, widely covered by the international press, are looked back upon as the "Boston Tea Party" of the women's health movement. As a result of Seaman's book, and the brouhaha that followed, a warning to patients was placed on oral contraceptives, the first on any prescription drug. After the publication of her second book, Free and Female in 1972, Seaman was cited by the Library of Congress as the author who raised sexism in healthcare as a worldwide issue. Her third book, Women and the Crisis In Sex Hormones, coauthored with Gideon Seaman, persuaded the Secretary of HEW to convene a government task force (on which Seaman served) on an estrogen called DES (diethylstilbestrol) which caused cancer in the daughters of women given it by their doctors to prevent miscarriages.
In the 1980s, Seaman was, to an extent, blacklisted by pharmaceutical advertisers in women's magazines. She turned her attention to biography. Her fourth book, Lovely Me, The life of Jacqueline Susann, published in 1987 was made into a TV movie starring Michelle Lee. Seaman was drawn to Susann when she learned that the failed actress did not acquire the discipline to write her #1 best selling novel, Valley of the Dolls, until she was diagnosed with breast cancer.
In 1995 The Doctors' Case Against the Pill was reissued in a 25th anniversary edition. In a cover story, Science Magazine named it as the book that fueled women's health activism, patient information and a "blossoming of women's health research" while JAMA (the Journal of the American Medical Association) assigned it for review, 27 years after original publication, to a doctor with a major financial conflict of interest, who dismissed it as: "a strange book not particularly recommended. I cannot in all good conscience recommend it for either the public or the profession."
In For Women Only, Your Guide to Health Empowerment, 2000, co-edited with Gary Null, Seaman collected hundreds of consciousness raising articles, stories, and poems dating back to Elizabeth Cady-Stanton.
The Greatest Experiment Ever Performed on Women, Exploding the Estrogen Myth is due to be published in July 2003. Seaman is presently the Health Watch columnist at Hadassah Magazine.
In 1975 Seaman co-founded the National Women's Health Network (NWHN) in Washington DC with Alice Wolfson, Belita Cowan, Dr. Mary Howell and Dr. Phyllis Chesler. Since 1997, she has been a National Judge of the Project Censored Awards.
Books to which Seaman has contributed chapters include: Rooms With No View, 1974, Women and Men, 1975, Seizing Our Bodies, 1978, Women's Healthcare: A Guide to Alternatives, 1984, Encyclopedia of Childbirth, 1992, Lawyers' Manual on Domestic Violence: Representing the Victim, 1995, The Conversation Begins, 1996, Real Majority, Media Minority, 1997, Readers' Companion to U.S. Women's History, 1997, Jewish Women in America: A Historical Encyclopedia, 1997, Women's Health, 1991, Routledge International Encyclopedia of Women, 2001, Hands On! 33 More Things Ever Girl Should Know, 2001, and the Project Censored annual collections.
Books to which Seaman has contributed introductions include Lunaception, 1975, The Bisexuals, 1974, Career and Motherhood, 1979, The Menopause Industry, 1994.
Seaman contributed to the play, I Am a Woman, 1972, and to many documentaries beginning with Taking Our Bodies Back (narrator) 1974, and most recently The American Experience Presents the Pill, 2003.
On March 13, 2000, Seaman was named an honoree in the dedication of the U.S Postal Service's 1970's Women's Rights Movement stamp.
Barbara Seaman link:
The Media and the Menopause Industry
Did media miss early evidence that Hormone Replacement Therapy does women more harm than good? FAIR presents "The Media and the Menopause Industry," an article from our archives that lays out some disturbing facts about how advertising pressures distorted crucial health reporting on menopause and hormones.
From the March/April 1997 issue of FAIR's magazine, Extra!
Title of book: The Greatest Experiment Ever Performed on Women
Author: Barbara Seaman
Publication Date: July 9, 2003
Price: $24.95
ISBN #: 0-7868-6853-8
This book is the sequel to Women and the Crisis in Sex Hormones which received the Matrix Award in books in 1978. Everything that Barbara foresaw has come true.
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