Attack of the Hormone Replacement Purveyors (Part 1)

It’s Back.  The marketing plans and medical opinions that convinced millions of women to take little pills derived from the urine of pregnant mares, well, it’s a different kind of pill today, but for women going through menopause, hormone replacement therapy is back.  Even though supplementing with hormones such as estrogen and progesterone has been shown in study after study to increase the risk of all kinds of nasty stuff, including heart attacks and breast cancer.  In fact, when women were finally scared away from hormone replacement, there was a dramatic drop in breast cancer rates.

The researchers attributed the drop in breast cancer to the fact that women STOPPED taking hormone replacement drugs.  Which meant that for decades, breast cancer rates had been going up BECAUSE millions of women were taking estrogen pills and similar stuff.  Like I say, it’s all back again, which makes it instructional to consider what fooled women into gobbling up these dangerous drugs back in the 1960s.  Why’d they do it?  Well, it may have been largely thanks to a blockbuster book that came out in 1965.  It was written by a gynecologist named Michael Wilson.  He called his book, Feminine Forever.

“Many physicians,” Wilson wrote in Feminine Forever, “simply refuse to recognize menopause for what it is — a serious, painful, and often crippling disease.”

Even if a woman didn’t have symptoms such as hot flashes or insomnia, Wilson insisted that if she was menopausal, she should take hormones.

“Every woman alive today has the option of remaining feminine forever,” he wrote. “No longer need she fret about the cruel irony of women aging faster than men . . . ”

And if a woman was foolish enough to ignore his advice, he warned them of the consequences.

“All post-menopausal women are castrates,” Wilson wrote. But, with HRT, a woman’s “breasts and genital organs will not shrivel.  She will be much more pleasant to live with and will not become dull and unattractive.”

Dull and unattractive.  Who wants that?  We’ve spent our entire lives in terror of being dull and unattractive, and this guy in the 1960s warned that if you didn’t take his favorite pill when your periods were starting to wane, that condition of dullness, and unattractiveness, well it would get even worse.

So, the danger of becoming dull and unattractive  was added to the reasons to take hormone therapy.  In addition to those reasons, there were plenty of others.  A surprisingly high number of menopausal women suffer hot flashes and night sweats and mood swings, headaches, loss of sex drive, loss of energy, lack of sleep . . . it’s a scary list!  It’s true that using hormone replacement can soften those symptoms and sometimes make them even go away.  But, probably, you could blunt those symptoms by taking heroin instead.  All right, hormone replacement is probably not as dangerous as heroin.  But here’s the problem — if a woman FINALLY stops taking the hormones, due to a few minor concerns about things like that increased heart attack risk, and the increased risk of cancer, then the symptoms often roar back.  Even if you actually went through menopause when you were 48.  Even if you’ve been taking hormones for over 30 years.  When you stop the hormones, you can start having hot flashes, even if you’re 80.

To me, the dangers of cancer and heart attack from hormone replacement therapy and the likelihood of becoming dependant on the therapies are all good reasons to go ahead, bite the bullet, and do what women have done for hundreds of thousands, maybe millions of years.  Which is to go through natural menopause.  And, if there are some nasty symptoms, look for ways to soften their effects through nurturing health.  After all, in cultures that don’t eat the standard American diet, menopause symptoms are much less common than they are in the United States.  If you’ve got menopause symptoms, you may be hissing under your breath that they’re also much less common if you get a lobotomy.

Well, I obviously don’t know the best answer for someone who’s suffering a lot of symptoms.  But honestly, I HAVE heard that women who have switched to a low-carb, good quality fat diet see a dramatic drop in both premenstrual and menopause symptoms.  So why not try it?

The problem with the hormones is that they notch up the chances that you’ll die earlier than you would have otherwise.  It’s worth repeating:  Heart attacks and cancer BOTH increase among women on hormone replacement therapy.

And yet, and yet, hormone replacement therapy is back in vogue today!  With a new look.  And the term they use is gonadal failure.

Gonadal failure.

It has an ominous ring.  After all, everyone knows that it’s bad to have heart failure.  Kidney failure’s not so good either.  Neither is liver failure.  But what the heck is gonad failure?

Well, that depends on your point of view.  The people who believe in ”gonadal failure” want to get across the point that, when a woman’s ovaries stop producing enough estrogen to make a period happen, it’s a sign that the ovaries have, well, they’ve failed.  You see, a “gonad” is your reproductive organ.  In men, it’s the sperm-producing testicles; In us women, it’s the egg-producing ovaries.

Technically, it’s correct that, after menopause, our ovaries stop producing estrogen.  And so, you can technically say that they have failed.

But failure . . . that’s like giving our ovaries an F.  I mean, if you have heart failure, you’re dead.  If you have liver failure or kidney failure, those can kill you also.  And it doesn’t matter whether you’re a girl of 5 or a woman in your 90s.  If your heart’s failing, or your liver’s failing, your health is in a serious fix.  But a woman’s gonads?  If they’re not producing estrogen, is it really because, somehow, they’ve failed?  Does this mean that if that girl of five is NOT having periods yet, her gonads are failing her?  I know, and you know, that’s ridiculous.  So why isn’t it also ridiculous to say that it’s okay for estrogen levels to drop down in a woman’s age of menopause?

Oh, my head is reeling with all of this, because the “gonadal failure” proponents have been gaining ground.  I know they want me to join their camp, and it’s a distressing time to be hearing it.  You see, I’m 53 and I’m still having periods.  But, statistically I’m overdue for them to end, because most women’s periods stop when they’re 50.  And mine HAVE started to be erratic.

“I’m not going to have my period this month,” I tell my husband.  “I can tell.  I’ve had periods since I was 13.  That’s 40 years.  I’ve known my periods longer than I’ve known you.”

“Well,” he says calmly.  Somehow, he knows to be nonchalant when I bring up things like this.  “I have a feeling that when they end, we’ll have a lot more years to keep getting to know each other.  And besides, I don’t think they’re over yet.”

And then I have another period.

But the gonadal failure people have warned that my window of opportunity is narrowing.  I MUST ACT NOW!!  BEFORE IT’S TOO LATE.  And my choice of therapies is much better than the clumsy stuff that they used in the 1960s.  Back then, the estrogens and other hormones came in pills like Premarin, which was a short way of telling how they made them.  From a Pregnant (Pre) mare’s (mar) urine (in).  That’s right.  The pills that millions of women took in those days came from the urine of a pregnant horse.  And STILL women swallowed them!

These days, I’d have much more sophisticated hormones at my disposal, and it’s probably true that they’d be at least somewhat gentler to my system.  They would be hormones that are “bioidentical” to the natural ones my body makes – so NOT MARE URINE!  any longer.

The catch is, I must put myself on bioidentical hormones NOW to stem the tide of destruction and humiliating aging signs that will manifest themselves if my ovaries aren’t delivered from their impending doom.  And if I don’t ACT NOW.  If I put it off, soon, my periods will stop for good, and then there will be no way to bring them back.  Or . . . oh, I don’t know.  The hormone therapists make it sound pretty nasty.

And if I give in, it will be pretty profitable for those professional purveyors of gonadal failure.  “Use them,” they say. Take them.  BEFORE IT’S TOO LATE!!!!

I’m going to step back, before it’s too late for me to think through the logic of whether hormone replacement therapy should really be for every woman.  After all, there have been millions of years of evolution where women DID go through menopause without hormone therapy.  Well, evolution can’t be right, can it?

That’s enough ranting for now . . . tune in next week . . .