A rchive Date
[ 14-07-2002 ]
Category
[ Science ]
sub-Categoy
[ Medicine ]
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[http://www.canoe.ca/Columnists/williamson.html
Womanhood is not an illness to be treated
By LINDA WILLIAMSON -- Toronto Sun
July 14, 2002
Hell hath no fury, it seems, like menopausal women - who've just been told the drugs millions of them are taking don't actually prevent cancer or heart disease but actually make them worse. Oops.
Reaction to last week's news of the alarming findings in the first major study of HRT, or Hormone Replacement Therapy (details will be published this week in the Journal of the American Medical Association), hit doctors' offices - and newsrooms - with the force of a hot flash.
To quote one friend of mine - an angry HRT patient who grabbed male editors here by their, er, lapels to impress on them that this story was a Big Deal - either you're a woman who stands to be affected by this story, or you know one.
Screaming headlines (and women) aside, though, let's not panic. The worst thing women on HRT can do is to end it cold turkey without talking it over with their doctors.
After all, it's not as if one pill more or less will kill you. What this is really about is whether or not they're worth the risk.
To me, what underlies the whole HRT debate is the same thing that haunts women's medicine in general: a sense that womanhood is a disease to be treated.
Ever since Aristotle's day, when women were viewed as nothing more than "incomplete" men, there's been a disturbing tendency to overmedicate and under-inform us.
Popping hormone pills has become as common to modern women's lives as the natural stages they're meant to control - menses and menopause. We are a drug company's dream.
We take pills for years on end to prevent pregnancy. Then, should we want to have a baby but can't, more pills to stimulate fertility. Why stop there? Now we have HRT to keep the estrogen flowing and our libido up, banishing the dreaded flashes, memory loss and mood swings.
(Already a mini-industry has sprung up to tell those of us in our 30s and 40s that we may already be in "perimenopause" and not know it - isn't that splendid? - but not to worry, there are lots of little pharmaceutical helpers in the works.)
Through it all, as the medical wizards have tinkered with the various hormone formulas (most commonly derived from the urine of pregnant mares), we've heard warnings similar to the ones raised by this latest study - some increased risk of breast cancer, heart disease, stroke, etc.
Yet we kept on taking the pills, since it's better than the alternatives. Or is it? Gee, could all those years of ingesting "horse pee," as my friend cheerfully calls it, possibly have affected our minds?
As Pulitzer-Prize-winning science writer Natalie Angier presciently said of this very study in her wonderful 1999 book, Woman: An Intimate Geography, "whatever results emerge ... they almost surely will be complicated. Hormones have much to offer, but still they smirk ever so slightly. They're a little dangerous, a little threatening. They're not Flintstone vitamins; they're hormones, strong messengers, and their shoes are cockily winged." HRT should be a personal choice, she says. The problem arises when doctors push it as necessary for all women, as they would insulin to a diabetic.
Trouble is, these days, as Flare editor Suzanne Boyd writes in this month's issue, "40 is the new 20." So 50 is the new 30, and so on. As silly as that sounds, it's dead serious for millions of women who see no reason to go gently into night sweats and old age, not when they can continue to feel young and sexy and healthy as long as possible. (These are, let's not forget, many of the same women who don't bat an eye at injecting botulism - botox - into their faces to look younger.)
Common sense
Surely what we all need here, aside from good doctors who will give us the straight goods, and as many safe, natural medical options as possible, is some common sense.
Consider: This study found a healthy woman taking HRT was 26% more likely to get breast cancer than if she didn't take it. Disturbing, yes, although in real terms, it means out of 10,000 women on HRT, eight would get cancer.
By comparison, smoking increases an average woman's risk of breast cancer by 100%, and heart disease or stroke by a whopping 500%! Yet millions choose to smoke anyway.
Then they go on HRT, thinking it will protect their hearts and breasts. Now that the study has proven that assumption wrong, docs are saying it's better to exercise, quit smoking and eat healthier. Well, no kidding.
As for relieving the symptoms of menopause, many women will decide the benefits of HRT are worth the short-term risks. But others will weather "The Change" as their mothers did - some even embracing it as a new stage of life, not an illness.
Either way, I say go, girls. But to be honest, I just hope this is all sorted out by the time I get there.
Linda Williamson is the Toronto Sun senior associate editor. She can be reached by e-mail at linda.williamson@tor.sunpub.com.
Letters to the editor should be sent to editor@sunpub.com]
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