As I blogged previously, the National Institutes of Health Women’s Health Initiative Study (launched in 1993-95) had to be shut down in 2002, when it became clear the women in the Premarin/Prempro arm of the study were experiencing an unacceptably high rate of breast cancer, strokes, heart disease, and dementia (http://stuartbramhall.aegauthorblogs.com/2011/03/25/wyeth-and-the-multibillion-dollar-menopause-industry/). The massive negative publicity this received caused seventy percent of American women to immediately stop their estrogen replacement therapy – resulting in a 7% reduction in new breast cancer cases over the next year.

Predictably, Wyeth’s response to all this negative publicity was to initiate a massive PR campaign discrediting the WHI study. They started with a letter to 500,000 doctors attacking the study, complaining that the women in the Premarin arm had other reasons for developing cancer – they were too old, too menopausal or weren’t checked for pre-existing heart disease (I find this ironic – in 2002 Wyeth was still aggressively promoting Premarin as a way to prevent heart disease). This was followed by articles attacking the study in various medical journals – articles published under the names of doctors specializing in women’s health which were actually ghost written by the company (see http://www.theepochtimes.com/n2/content/view/9804/).

Many of the doctors were affiliated with the notorious Council on Hormone Education at University of Wisconsin (where 44 of the 64 doctors have financial ties to Wyeth) Wyeth founded in response to the 2002 WHI study. In 2006 the Council even began offering a continuing medical education course for doctors called “Quality of Life, Menopausal Changes and Hormonal Therapy” – heavily promoting estrogen replacement.

Consumers’ Only Protection Against Big Pharma

Lawsuits: consumers only weapon against Big Pharma

Wyeth’s massive campaign to discredit the 2002 WHI study, at the expense of tens of thousands who would start or continue estrogen replacement as a result of these misguided efforts, has clearly harmed their defense in the dozens or so of the 5000+ lawsuits that have made it through the courts.

Wyeth has yet to win a single lawsuit brought by women (or families of deceased women) who developed reproductive cancers as a result of taking Premarin or Prempro. Moreover there are still active information websites for affected women and/or families who have yet to file suit. If you or a loved one has developed breast, uterine or ovarian cancer as a result of taking Premarin or Prempro click here:

http://injury-law.freeadvice.com/drug-toxic_chemicals/prempro-lawsuit.htm

It’s Never Too Late to Stop Estrogen Replacement

Even more importantly, the WHI and subsequent studies all make it clear that even women who have been taking hormone replacement for years can still reduce their risk of cancer – if they stop now!

Moreover women can’t assume they reduce their risk of cancer by switching to plant-based or “natural” estrogens. Research strongly suggests that the estrogen itself – rather than it’s source – stimulates tumor growth.

Six Decades of False and Misleading Marketing

Estrogen, a hormone regulating the development and function of the female reproductive system, was first discovered in 1925. In the 1930s, the drug company Wyeth developed a process (viewed as barbaric by animal rights activists) to extract conjugated estrogens from the urine of pregnant mares. They patented their product as the drug Premarin (PREgnantMAresurINe), which first appeared on the market in 1942.

Mares strapped up to produce Premarin

From the beginning Wyeth marketed Premarin, not for temporary relief of menopausal symptoms, but as a lifelong treatment to help all women maintain “healthy” estrogen levels in later life. Obviously this is nonsense, as a “healthy” or natural estrogen level in a post-menopausal woman is virtually zero.

1975: the First Study Linking Premarin with Cancer

The first study linking Premarin with increased uterine cancer appeared in 1975. It was replicated by other researchers in 1977 and 1979. These results were entirely consistent with the discovery of estrogen receptors in the early seventies and the finding that stimulating these receptors caused tumor growth in tissue culture and laboratory animals.

Wyeth responded to these worrisome studies by promoting a small 1980 study that taking progesterone, a second female hormone, reduced the risk of uterine cancer with estrogen replacement. Unfortunately most doctors fell for Wyeth’s slick PR campaign (the free pens, watches, clocks, lunches, trips to overseas conferences may have had something to do with it). They also overlooked the failure of 1980 study to look at the cancer rates in women who took no hormone replacement or to study the possible role of this combination in inducing other hormone sensitive cancers, like breast and ovarian cancer. In fact, their success in selling doctors on the combination, led Wyeth to market a new drug Prempro, which combined Premarin with estrogens.

The earliest studies linking Premarin with breast cancer appeared in early 1980. As Nik Ismail points out in “Hormone Replacement Therapy and Gynaecological Cancers,” between 1975 and 1995, there were at least fifty studies linking estrogen replacement (also known as HRT) with breast and uterine cancer. Some were cross cultural studies revealing American women had more than ten times the incidence of breast cancer than Asian women, who don’t take estrogen replacement (see http://www.gfmer.ch/Books/bookmp/113.htm).

The Multibillion Dollar Wyeth Cover-up

Wyeth responded to the breast cancer studies with a new PR blitz. In addition to flooding doctors’ offices with literature claiming studies linking Premarin to cancer were “contradictory,” they promoted numerous company-funded studies allegedly showing that estrogen replacement prevents osteoporosis and hip fractures, dementia and heart disease. (Note: the role of estrogen replacement in reducing osteoporosis has been replicated in other studies, but so far, none of them control for long term fluoride ingestion or epidemic Vitamin D deficiency in elderly Americans – which both have a documented role in high US rates of osteoporosis and hip fracture).

The spin Wyeth gave doctors was that the effect of reducing cardiovascular disease (heart disease and strokes) – the most common cause of death in Americans – outweighed the somewhat lower risk of developing breast cancer. Predictably, the claim that Premarin and Prempro reduce elderly women;s risk of cardiovascular disease proved to be false. In fact this was one of the main reasons the WHI study was stopped: the women in the Premarin/Prempro arm of the study were developing significantly more heart attacks, strokes and dementia.

The marketing blitz aimed at doctors was accompanied by an even more powerful PR campaign in Harper’s Bazaar, the Ladies Home Journal and other women’s magazines, appealing to American women’s (largely manufactured) terror of aging by emphasizing the value of estrogen replacement in preserving sexual attractiveness by preventing the skin changes and vaginal drying associated with aging.

Wyeth Stock Soars

The result of Wyeth’s public relations effort was to make Premarin was the most commonly prescribed drug in the US in 1992. Yet by the mid-nineties, even the mainstream media was starting to take note of the preponderance of studies linking estrogen replacement to cancer. In 1995 this resulted in a Time magazine article (Wallis, C. “A Risky Elixir of Youth” Time. (26), 46-56, 1995), followed by a Tom Brokaw feature on NBC’s nightly news.

To be continued, with a description of the PR blitz Wyeth launched to counter the frightening results of the 2002 WHI study.

Historically 80% of Premarin and Prempro sales have occurred in the US. Even in the US, the cessation of menstruation is a non-event in 75% of women, producing no physical symptoms whatsoever. In fact, most languages and cultures have no word for menopause. In Chinese medicine, so-called menopausal symptoms are considered a manifestation of an underlying “imbalance” and disappear with  a few days of herbal treatment. Even untreated, the hot flashes, night sweats, mood swings and insomnia some women experience rarely last longer than a few months. In fact, many women report an overall improvement in their health and well-being when they stop having periods.

Senior Women are Honored in Non-Western Cultures

There are interesting cross cultural studies of the “menopause” phenomenon. Non-western cultures typically view the cessation of monthly cycles as a milestone signaling transition to the role of community elder. The Filipino women Berger and Wenzel studied in Women, Body and Society: Cross-cultural Differences in Menopause (http://www.ldb.org/menopaus.htm) were extremely pleased with their freedom from the inconvenience of menstruation. They saw it as an initiation into the joys of old age – better sex (estrogens produced during the menstrual cycle suppress libido – see below*), improved mood and energy and increase in productive time. However most of all they appreciated the new love and respect they enjoyed, as an elder, outside the family. I see this attitude here in New Zealand in the Maori culture, where senior women receive the title of “kuia” or “whaia” both designating immense esteem, prestige, and influence over community affairs.

The Female Body: a Reservoir of Aberrations

As Berger and Wenzel describe, western society’s medicalization of this totally natural life process stems in part from a stereotypical attitude American (mostly male) doctors have had toward the female body as a “reservoir of aberrations” which require constant treatment.” The most extreme example, of course, was the view in Victorian times that the spasms women experience during orgasm were indicative of dangerous pathology that could lead to insanity. The recommended treatment was to sedate them during intercourse.

The apparent male need to control the power of reproduction has also been seen in excessive and often harmful medical intervention during labor and delivery (which women rebelled against by creating the natural birth movement) and infant care. As late as the 1950s, the latter took the form of pressure to abandon breast feeding and demand feeding (i.e. when babies are hungry) for “scientific” formula feeding according to fixed timetables; scare mongering about mothers co-sleeping with babies (preferred practice in non-western cultures); and insistence that breastfed babies be weaned by 12 months (the World Health Organization recommends breast feeding, supplemented by solids, until age four).

Berger and Wenzel also note the strong association of western medicine with the military – with constant reference to “fighting” illness and to “battles” with cancer and other diseases.

America’s Aggressive Marketing of Youth

As Berger and Wenzel’s and other cross cultural studies note, attitudes in the US and other English speaking countries are also heavily influenced by a multibillion dollar PR industry that bombards women constantly with messages glorifying youth, thinness and sexual attractiveness – and engendering frank terror of gray hair, facial wrinkles, weight gain and cellulite. Aggressive marketing preys very effectively on the insecurities these messages create to sell billions of dollars of wrinkle removing creams and lotions, age concealing make-up, hair coloring, botox, diet products and programs and plastic surgery.

"You're Worth It"

***

*Despite popular misconception, sexual drive in women isn’t regulated by the female hormone estrogen, but by testosterone (a male hormone) and oxytocin (a feel-good hormone in both men and women associated with social intimacy – and milk ejection in nursing women). Estrogen has a powerful suppressant effect on both hormones. Thus female libido is driven by a steep drop in estrogen levels in the middle of the menstrual cycle, which triggers ovulation. The result is an intense testosterone/oxytocin effect (and surge in libido) during the time of the month when a woman is most fertile.

To be continued with a discussion of Wyeth’s discovery and aggressive marketing of Premarin – despite its known cancer risks.

(this is the first of several posts regarding the “corporatization” of the US health care system – and its harmful effects on human health)

I have blogged previously about the ingenious – and deadly – strategy by pharmaceutical companies and other corporate interests of inventing fictitious illnesses to market highly profitable drugs that allegedly “treat” them. The technical terms for this are “medicalizing” or “disease mongering.”

In May (http://stuartbramhall.aegauthorblogs.com/2010/05/24/marketing-serotonin-deficiency/), I wrote about so-called “serotonin deficiency syndrome,” the alleged cause of depression, which is used to promote the multibillion dollar serotonin reuptake inhibitor industry (with SSRIs like Prozac, Zololft and Paxil). In November (http://stuartbramhall.aegauthorblogs.com/2010/11/30/fluoride-the-new-lead/), I wrote about the even more dangerous “fluoride deficiency” syndrome, which has led dozens of American cities to mass medicate their residents with the industrial poison fluorosilicic acid, in the misguided belief that taking it internally prevents tooth decay (in spite of research showing that fluoride must be applied directly to teeth to strengthen enamel).

Dr Marcia Angell, in her 2004 The Truth About the Drug Companies: How They Deceive Us and What To Do About It, also talks about “generalized anxiety disorder,” “erectile dysfunction,” “premenstrual dysphoric disorder,” and “gastro-esophogeal reflux disorder (heartburn)” as examples of common complaints that drug companies have reinvented as chronic illnesses requiring lifelong treatment (see http://www.cmaj.ca/cgi/content/full/171/12/1451).

Estrogen Deficiency Syndrome

The marketing of so-called “estrogen deficiency syndrome,” which is known as “menopause” in English-speaking countries (other cultures have no word for it) and Premarin and Prempro as “hormone replacement therapy (HRT)” has been far more lethal, in view of 30 years of research linking it to reproductive cancers. The number of premature deaths caused by inappropriate estrogen replacement is estimated in the millions.

In this case the culprit is a single company, Wyeth, who unlike Eli Lily (the manufacturer of Prozac, the first SSRI), managed to beat off competitors with their “me-too” drugs.

Hiding the Cancer Link from Doctors and the Public

In 1996, I supported a friend through the agony of a breast cancer diagnosis and treatment. In Marsha’s case, the pain and disfigurement of mastectomy, the agonizing nausea and malaise of chemotherapy was vastly compounded by extreme anger that no one – not her doctor, the FDA, nor Wyeth – had informed her that she was doubling her risk of breast cancer by taking Premarin.

Although the medical community (and Wyeth) have been aware of links between estrogen replacement and breast, uterine and ovarian cancer since the 1970s, the research was effectively concealed from public view – until the frightening results of the Women’s Health Initiative (WHI) study hit the front page in 2002. Between 1993 and 1995, the National Institutes of Health enrolled 161,809 women in the double blind WHI study. In 2002 the NHI shut down the study, originally scheduled to finish in 2005, when it became clear that the women taking HRT were experiencing a 26% increase in breast cancer (with the risk doubling after five years), a 41% increase in strokes and a 29% increase in heart disease (see http://www.theepochtimes.com/n2/content/view/9804/).

5000+ Lawsuits Against Wyeth

Seventy percent of American women taking estrogen replacement in 2002 stopped when the NHI shut the WHI study down. This resulted in a 7% decrease in the first year alone of new breast cancer cases – a total of 14,000 women spared the agony of a potentially fatal breast cancer diagnosis (see http://www.theepochtimes.com/n2/content/view/9804/). The study findings have also resulted in 5000+ cancer lawsuits against Wyeth for misrepresenting earlier cancer research to doctors – and their failure to inform women of the significant cancer risks associated with HRT.

Marketing Eternal Youth

As revealed in internal documents uncovered in some of the initial lawsuits, Wyeth’s culpability goes far beyond neglecting to inform menopausal women of cancer risks. In fact they paint a very ugly picture of an aggressive public relations campaign to convince women and their doctors that estrogen replacement was the secret to eternal youth – by preventing age-related skin changes.

It was a win-win campaign. As a result of decades of marketing about the horrors of aging, which still sells billions of dollars of hair coloring, wrinkle removing creams, botox, diet products and plans, and plastic surgery,  post menopausal women were terrified of losing their sexual attractiveness if they didn’t take estrogen. And because women’s health “experts” were recommending it in medical journals, doctors were more than happy to overlook increasing evidence that it caused cancer.

Ads linking Premarin with youth and sexual attractiveness

To be continued, with a discussion of the uniquely American concept of “menopause.”