The North American Menopause Society, which bills itself as "the world's leading non-profit organization dedicated to promoting women's health through an understanding of menopause," has done a very strange thing. The Menopause Society, at its annual meeting this month in Chicago, announced the results of a Gallup Poll it commissioned asking women how Hormone Replacement Therapy (HRT) affects their quality of life, despite groundbreaking scientific findings about the harm of HRT, specifically the drug Prempro. In other words, despite the fact that HRT increases the risk of heart disease, breast cancer, stroke and blood clots, the group believed women should be asked if the drugs make them feel good.
Some 6 million American women take the Wyeth product Prempro, a combination of estrogen and progestin, to replace hormones lost in menopause. Until July, the conventional wisdom held that HRT not only relieves hot flashes but also helps prevent problems such as heart disease. That changed when scientists with the federal Women's Health Initiative (WHI) stopped its combination HRT investigation, involving 16,000 women, three years early because of the dramatic results indicating not only that Prempro is not a cure-all for post-menopausal women, but it actually increases the risk of heart attack (the very thing Wyeth claimed it could help prevent) and other diseases including invasive breast cancer. Simply put, the risks of HRT outweigh the benefits.
That is what makes this type of irresponsible media ploy so stunning. Of course HRT makes many women feel good, but that is not the basis on which people should make decisions about what medications to take. Heroin also makes people feel good, yet we know the risks associated with that drug outweigh any remote benefit related to pleasure.
We'll be hearing more about WHI's findings this week when the National Institutes of Health (NIH) holds a scientific workshop on menopausal hormone therapy. HRT advocates, including the Menopause Society, will be there. Let's hope sound science prevails over "feelings."
The fascination with hormone replacement therapy began in 1966 with a best-selling book, "Forever Feminine," by Dr. Robert Wilson. He promoted the book aggressively to both doctors and the public and doctors insisting that "replacing" estrogen lost during menopause was like diabetics replacing insulin. In 1972 Dr. Wilson's promotion of the drugs included the sentiment that women who take hormones, "will be much more pleasant to live with and will not become dull and unattractive." And you thought the Stone Age ended in the Stone Age.
Considering the early influence of Dr. Wilson's book and message on the acceptance of hormone replacement in women, it was especially revealing when the New York Times recently reported that "Wyeth-Ayerst had paid all the expenses of writing "Feminine Forever" and financed [Dr. Wilson's] organization...[the] company had also paid [him] to lecture to women's groups on the book."
This fact sheds some light on how the pharmaceutical giant worked to shape opinion and acceptance of its hormone drug early on, even without clinical trials assessing the long-term impact on women's health.
Feminists and others concerned about women's health and effects of drugs on our bodies have lobbied for years for the medical community to take women seriously and include us in clinical trials. It was due only to Dr. Bernadine Healy, then the head of the NIH, that the WHI emerged and with it the first large-scale clinical trial of the therapy.
For the Menopause Society, an organization which women look to for guidance, to send a message which dilutes the importance of those scientific trials is disappointing, and indeed perplexing. So perplexing, in fact, I wondered what other factor may be involved in its reticence to take the WHI results seriously.
Given Wyeth's history of funding Dr. Wilson as a supposedly objective cheerleader for its product in the 60s and 70s, what I found did not surprise me. One of the Menopause Society's major financial benefactors is--you guessed it--Wyeth. I was even less surprised to find that it was actually a Wyeth grant which funded the "feel good" Gallup survey.
Why does this matter? The WHI tested Wyeth's drug Prempro and the clinical trial puts the safety of it in question. If women take seriously the WHI findings, they may not want to take that estrogen-progestin drug. But, if a trusted "unbiased" menopause non-profit suggests that if it makes you feel good, take it, perhaps Prempro will not be assigned to the dustbin of mistakes.
Besides the health risks associated with Prempro, it's clear that HRT is not a "cure" for menopause. Don't get me wrong--I'm all for science making life easier. We simply must get out of our heads the idea that menopause is a disease. Women and their doctors need to consider drugs which do not contain hormones but do address real diseases-such as SERMs (selective estrogen receptor modulators) for osteoporosis and statins for heart-threatening high cholesterol.
With the Menopause Society's reliance on pharmaceutical companies, Wyeth in particular, I wondered if it can tell the whole truth to American women about the impact of HRT, so I called the organization. A representative insisted that the Menopause Society is unbiased and the funds it receives from Wyeth are "unrestricted," maintaining the company does not control its work. Further, as a non-profit, she explained, financial relationships with companies like Wyeth make the Menopause Society's work possible.
As a former head of a feminist non-profit, I know money makes the difference. But I would refuse support offered by companies and organizations which had an interest in the positions my organization would take, thus eliminating even the appearances of influence or impropriety. Unfortunately for women, the Menopause Society has not made that same decision.