Women are furious. For decades they have been told to take hormone replacement therapy (HRT), not only to relieve symptoms of menopause, but also to protect their hearts and preserve their bones. Some doctors have even hinted that hormones could prevent Alzheimer’s disease.
Millions of women followed doctors’ orders, but now they feel betrayed.
One husband related: “My wife is so angry at her physician that she can barely bring herself to schedule a visit. For years she was told to take Premarin and Provera. When reports surfaced that there might be a problem with breast cancer, she asked her doctor about this risk. He repeatedly reassured her that there was nothing to worry about. Hormones were so safe, he claimed, that his own wife was taking them.”
She was not alone. Many other women expressed their fears to their physicians only to be met with the message that the benefits of HRT outweighed the risks.
Doctors may be feeling as though they were left holding the bag. They were frequently assured by respected colleagues that prescribing HRT was the best thing they could do for their postmenopausal patients. Articles and ads emphasized heart disease as the number one killer of women and estrogen as the solution.
There was just one problem with this full-court press by the pharmaceutical firms. The research showing estrogen’s benefits was flawed. We now know that HRT actually increases the risk of heart disease, blood clots and strokes as well as breast cancer. At least that was the conclusion of the experts overseeing the Women’s Health Initiative.
They ended this large, long-term study prematurely because the results were so disappointing. They felt it would be inappropriate to continue exposing women to Prempro, a combination of estrogen and medroxyprogesterone.
Doctors should be as outraged as their patients. They were all sold a bill of goods.
It may take a lot of women a very long time to reestablish trust in what their doctors are telling them. And doctors should be very concerned about paying attention to opinion leaders who take money from the pharmaceutical industry to promote unproven uses of medications.
Premarin can hardly be considered a new drug. It has been on the market since 1942. More than 30 billion doses have been dispensed over the decades. Hundreds of studies have been done over half a century.
If the research on this medication was inadequate, how good is the evidence on much newer drugs? And where has the FDA been all of this time? The watch-dog agency is supposed to protect consumers from this kind of debacle.
If there is a lesson to be learned, it is that the long-term pros and cons of popular prescriptions may not be as clear as the drug companies would like us to believe. For the FDA’s stamp of approval, most medicines are studied for a relatively short period of time-a few weeks or months, but not years.
If it had not been for the federally-funded Women’s Health Initiative, doctors would not yet know that the risks of HRT apparently outweigh the benefits over the long term. Patients should demand to see the evidence before they take any drug on faith.