© 2002 by Oxford University Press
Journal of the National Cancer Institute, Vol. 94, No. 15, 1117,
August 7, 2002
© 2002 Oxford University Press
NEWS |
Menopause Is ‘By No Means Confined to the Woman,’ Doctor Said
"Menopause covers such a wide range of physical and emotional symptoms that the implications are by no means confined to the woman. Her husband, her family and her entire relationship to the outside world are affected almost as strongly as her own body. Only in this broader context can the problem of menopause—as well as the benefits of a hormonal cure—be properly appreciated."—from Feminine Forever, Robert A. Wilson, 1966, Evans (with Lippincott); New York.
In today’s world, it is doubtful that sentiments so sexist and assertions so unsupported would see print without causing a considerable outcry. But when Robert A. Wilson, M.D., a fellow of the American College of Surgeons and the American College of Obstetrics and Gynecology put them into his book, Feminine Forever, it was 1966, and few thought to question them, much less protest.
Instead, Feminine Forever—which, unbeknownst to its readers, was bankrolled and heavily promoted by Wyeth, a pharmaceutical company that was and still is a leading purveyor of female hormone pills—became very popular. Thanks largely to the book and to Wilson’s research foundation (also bankrolled by Wyeth), demand for the hormone treatment of older women soared. With that, estrogen, which had been in modest use since the late 1930s (chiefly for women who had had a surgical menopause), was propelled onto the list of America’s best-selling prescription drugs and stayed there.
The discovery in the mid-1970s that ongoing estrogen use was linked to an increased risk of cancer of the uterine lining might have been expected to dampen sales. But by then the idea that menopause was a deficiency disease remediable by hormones—originally proposed before World War II by (among others) Fuller Albright, M.D, an eminent Harvard Medical School professor—was entrenched. However, it was soon discovered that the addition of progestin to the regimen dramatically reduced the risk of uterine cancer.
The conventional wisdom in those days was that the risks, if any, were outweighed by the benefits it conferred—protection not only against osteoporosis but also, as it was thought at the time (mistakenly, it turns out), against heart disease, by far the greatest killer of older women.
Cindy Pearson, director of the National Women’s Health Network, an advocacy group based in Washington, D.C., recalls that so much lip service was given to this premise that many doctors thought that it was unethical to put HRT to the test of a placebo-controlled trial. Not surprisingly, she is among the many women and physicians of both sexes who feel vindicated by the trial’s having, at last, been done.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||