Modern Medicine, Midlife Women and 18 Years of Research
Last month, The Journal of The American Medical Association (JAMA) published the findings of an 18-year clinical trial, which investigated the safety of hormone therapies. If you consult with your doctor about perimenoapuse and menopause in the near future, the findings of this trial will likely influence what she tells you.
For decades, modern medicine has encouraged women to take hormone replacement therapy at midlife, not only to relieve perimenopause and menopause symptoms, but also to lower the risk of chronic disease such as breast cancer, heart disease, and dementia.
The assumption has been that women left in their natural state are unhealthier than women with a boost of hormones.
Following years of controversy surrounding the safety of hormone therapies, the recently published trial compared the mortality rates of women who took hormone replacement therapy for a median of six to seven years with women who received a placebo.
Promoters of HRT claim the trial finally proves hormone therapy to be safe: the study found that the women who received hormone therapy were no more likely to die of any cause than the women who received a placebo.
And yet the study also found that the women who received hormone therapy were no less likely to die of any cause than the women who received a placebo. In other words, and as expressed by the study’s authors they “would not support use of hormone therapy for reducing chronic disease or mortality.”
So how did modern medicine conjure up the idea that hormone therapy could lower the risk of chronic disease?
In the editorial accompanying the research, Dr McNeil begins her historical summary of the use of hormone therapies by quoting "one of the early hormone advocates," Robert Wilson, MD, a gynecologist and author of the influential book Feminine Forever (1966).
In his work, Wilson promoted theories relating to midlife women’s health that created the foundation on which today’s multi billion dollar HRT industry is based. Only decades after the publication of Feminine Forever, did it become apparent that the funding for the book was provided by the pharmaceutical company Wyeth. By 1975, Wyeth's hormone replacement product, Premarin, had become the fifth leading prescription drug in the United States.
In Feminine Forever, Wilson asked his readers why women must tolerate “castration” – he was talking about menopause.
Wilson also described menopausal women as “living decay” and “sexual neuters.”
You can tell he had a real affinity for his patients.
Wilson promised his readers that a “wonder pill” (estrogen therapy) would allow women to:
Alleviate the symptoms of nervousness, irritability, anxiety, apprehension, hot flushes, night sweats, joint pains, melancholia, palpitations, crying spells, weakness, dizziness, severe headaches, poor concentration, loss of memory, chronic indigestion, insomnia, frequent urination, itching of the skin, dryness of eye, nose and mouth, backache, dry skin, weak muscles and brittle bones, flabby and shrinking breasts and a stiff and unyielding vagina.
Reduce the chance of heart disease, stroke and cancer.
Avoid alcoholism, sleeping pills, suicide and even murder at the hands of her husband.
Last but not least (although Wilson included this on the first page of his introduction): at 50, “still look attractive in tennis shorts or sleeveless dresses.”
Currently the North American Menopause Society only feels confident recommending HRT for treating vasomotor symptoms (night sweats and hot flashes); genitourinary syndromes of menopause (changes to the labia, vagina, urethra, and bladder); and preventing bone loss and fractures. The undeniable trend over time has been to downplay the benefits of HRT.
Wilson claimed that approximately 85% of women were suffering from menopausal symptoms because women were never supposed to live beyond 40.
Menopause was not a problem in ancient Rome, Wilson argued at the start of Chapter 1, because the average life expectancy for girls born in Rome was 23.
The average life expectancy was low in ancient Rome, as it has been through the ages, not because women were never supposed to live beyond menopause, but because child mortality rates were horrific, with approximately one third of children dying before the age of six. However, once a girl survived through to adulthood, she was expected to live beyond menopause.
Indeed, influential medical texts written in Roman times covered menopause. Yet the discussion was not about how a select few women beat the odds and lived into their fifties. Instead, writers of the time questioned whether the cessation of menstruation, which in their eyes marked the end of a woman's femininity, was good or bad since it brought menopausal women closer to the “superior” male!
What happens when the founding theories of a whole industry are so shaky?
Back to the JAMA-published research.
One could argue that if hormone replacement therapy won’t increase your risk of chronic disease, then why not receive relief for at least some of your symptoms?
Well, here’s what I find strange.
Living with menopausal symptoms is stressful, and stress can promote the development and progression of disease.
If you remove stressful elements of a woman’s life for approximately seven years by providing symptom relief, wouldn’t one expect a positive outcome on overall life expectancy?
The problem with medical research around perimenopause and menopause is that the best options for midlife women are not being researched.
As the primary author of this latest research said while being interviewed on the issue of hormone replacement therapy in 2014: “All medications do have risks and it really comes down to a balance of benefits and risks.” (at 2:53 in the interview).
When research shows that the risk of taking medication (in this case HRT) is equal to the risk of living with stressful symptoms for about seven years, it’s clear that modern medicine is not serving women.
Midlife women’s health will continue to be misunderstood by the medical community as long as doctors and researchers hold on to earlier theories of the naturally malfunctioning female and feel confident to quote Wilson as "one of the early hormone advocates" rather than call him an estrogen pusher with frankly dodgy ideas about menopausal women.
For the overwhelming majority of women, hormone replacement therapies can never cure the wide variety of perimenopause and menopause symptoms because our symptoms are not created by our fluctuating hormones! Symptoms arise because something in our lives is out of balance; symptoms are signals from our bodies designed to encourage us to take healthy steps to return to balance. Our fluctuating hormones create a sensitive environment to allow us to take note of our bodies’ messages. Giving women HRT at midlife just desensitizes the environment allowing women to ignore the parts of her life that, for the sake of her health, require her attention.
We experience fluctuating hormones in our teenage years, when we are pregnant, and during perimenopause and menopause for good reason! At these times, we are designed to become more sensitive beings and thus more susceptible to experiencing symptoms because: when we are teenagers, our bodies want to push us beyond our comfort zones and out into the adult world, so we can find our passions; when we are pregnant, our bodies want to protect us and our babies as we carry them inside; and at midlife our bodies want us to balance our lives for healthier living post-menopause.
Midlife women’s health is all about female body brilliance and cures for perimenopause and menopause symptoms can only come when women learn to listen to the messages their bodies are sending them.
And what are the side effects of this 100% natural cure, which can't be packaged and sold as a pill, cream, patch or potion? Simple: better health, more joy!
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