At the age of 50, women go through menopause, which is related with the ending of ovulation and menstrual cycling, and a decline in estrogen and progesterone levels. The conclusion that women needed to “replace” their female hormones after menopause has a long history driven by the idea that a decline in hormones leads to unnatural and unwanted effects on libido, memory, and cardiovascular health, none of which had any foundation in fact.

By Dr. Robert A. Wilson. It was a national runaway success when it was published. Wilson, a British-born gynecologist who experienced in Brooklyn, New York, and later, on Park Avenue in Manhattan, persuaded the public that, “Many physicians simply refuse to recognize menopause for what it is – a serious, painful and often crippling disease.”Hormone Replacement Therapy useful for women

The FDA in fact had permitted Hormone Replacement Therapy in 1942 to take care of the hot flashes, difficulty in sleeping, mood swings and other symptoms that can accompany menopause. Wilson argued that HRT was a near miracle remedy that could stem a woman’s aging process and improve their sex lives. By defining a natural process as a disease he managed to help the pharmaceutical industry push HRT on healthy woman as a drug they needed to take every day for the rest of their lives. For the pharmaceutical industry this concept created a vision condition of finding a huge segment of the normal population that they could sell their pills to. No matter that there was no good research to support their claims. This idea was very popular for many years, before real controlled trials showed that HRT was very bad, and had caused tens of thousands of deaths in women, as well as other problems.

Hormone replacement therapy replacing the body’s natural hormones after normal or surgically induced menopause. Common brand name examples of HRT include premarin (estrogen from a horse), provera (progesterone) and prempro (combination). Concerning 20% of women will develop painful, and sometimes intolerable, hot flashes during the pre-menopausal period. Some women develop other or additional symptoms, such as problems with rational thinking or depression. These symptoms can be treated successfully with HRT. Other hormones, like testosterone, can be used for purposes such as treating low libido in women.

The original evidence that HRT prevented heart attacks was based on what are called observational studies. Women who chose to take HRT were compared to those who didn’t, and were found to have fewer heart attacks. It turned out that women who took HRT also were more concerned about their health. They did other things, like exercise and diet that were beneficial for heart attack. The HRT didn’t do anything. Yet eight years went by from 1995-2003 with major marketing to women and billions of dollars in sales. The pharmaceutical companies had hit on the tend load of all markets. Not just patients with a disease, but all women over age 50.

While HRT has a role in treating hot flashes for a time-limited period, or irregularly depression or insomnia, it has been marketed for a much larger number of women. For much of the history of HRT, it was believed that HRT prevented heart disease, stroke, and osteoporosis, and that it improved well being, sexuality, memory, and mood. However, there was some early evidence from the Nurses’ Health Study published in 1995 that showed a 32% increase in breast cancer with HRT. Nevertheless a great deal of marketing was done on behalf of HRT and pharmaceutical companies made billions of dollars by arguing that all post-menopausal women needed to take it for their health. There was supposedly the added benefit that HRT would make you look better and improve your sex life.

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