From the top:
-Back in the day (from sometime in the '30's, up until about 2002), many women used what is called Hormone Replacement Therapy (HRT). HRT has consisted of either estrogen alone, or estrogen in combination with progestin. Although they entail different health risks, for the purposes of this brief background I will consider them together. HRT was primarily used to alleviate discomfort during and after menopause (hot flashes, insomnia, vaginal dryness, etc). However, thanks to aggressive and deceptive marketing by the pharmaceutical industry, it was also widely thought to prevent heart disease, osteoporosis, dementia, and in general to be an elixir of youth. Many, many women took it, often for many, many years.
-In 2002, the results of a very large (16,000 women) long term (5 year) study, known as the Women's Health Initiative (WHI), were released. The results were so dramatic, the study was halted before completion, and the women in the study taking HRT were told to stop, because their health was at risk. The study had found that the women were actually at increased risk of breast cancer, blood clot, stroke, and, later analysis showed, dementia.
-Use of HRT fell off dramatically. Although so far it is only an epidemiological link, breast cancer rates have also dropped significantly during the same period.
-Data from WHI are still being studied. The point of today's post is to draw your attention to a new study, just published in JAMA, which shows that not only does long-term use of HRT increase the risk of getting breast cancer, the women who get it are actually twice as likely to die from it, due to poorer detection by mammography, more positive lymph nodes, and larger tumors. A previous study had showed a similar increased mortality rate from lung cancer.
-I don't think the pharmaceutical industry will ever be held accountable for the damage they've done with HRT, for the lives that have been lost. Of course the American public bought into it, by accepting menopause as a pathology. Hopefully we have learned some important lessons, which cannot bring back our loved ones, or help those now dealing with the consequences, but which we can use going forward. Menopause is not a disease. But as long as we (in the US) have a for-profit medical industry, with the pharmaceutical industry consistently ranking as the most profitable industry in the nation, and a political system in which legislation can essentially be bought and sold, the HRT incident will not be the last of its kind. It certainly wasn't the first: didn't we learn anything from thalidomide, or DES, and isn't baby formula still being sold and aggressively marketed to women in the developing world, as well as here in the US?
-Standing for women, against the forces of big pharma and medical device manufacturers, is the National Women's Health Network. Since 1975, they've not only advocated for us in Washington, they also get information out to the public in readily available, understandable form. Subscribe to their newsletter, and, if you can, send them some financial love.
For some additional reading about HRT and WHI, check out these links.
Long-term HRT doubles risk of dying from breast cancer
History of HRT and how WHI broke the truth
HRT and dementia
Oh, by the way, the estrogen in the most popular forms of HRT (Prempro, Premarin) comes from the urine of pregnant horses. Get it? Pregnant Mare Urine. Here's a little video about it, narrated by Mary Tyler Moore:
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