Hormone Therapy’s Moving Target
For nearly 100 years, different opinions on hormone replacement
therapy have caused its use to ebb and flow.
by Anita Slomski // Spring 2009
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EARLY 1900s: Women drink solutions of animal ovaries or eat fresh sow or cow ovaries to treat menopause symptoms and a host of diseases thought to stem from ovarian failure.
(THE GRANGER COLLECTION)
MID-1930s: Drug companies produce estrogen injections and pills from animal placentas and fetal fluids to relieve symptoms of natural and surgical menopause.
1941-1942: Canadian firm Ayerst, McKenna and Harrison introduces Premarin, a combination of estrogens produced from the urine of pregnant mares, the most potent form of the hormone yet developed. (COURTESY OF SCHERING-PLOUGH)
1941-1942: Canadian firm Ayerst, McKenna and Harrison introduces Premarin, a combination of estrogens produced from the urine of pregnant mares, the most potent form of the hormone yet developed. (COURTESY OF SCHERING-PLOUGH)
1951: After six years of prescribing estrogen to institutionalized elderly patients, sex researcher William Masters recommends hormone therapy to rejuvenate “mental and physical function.”
1953: Mayo Clinic scientists posit that estrogen is cardioprotective after performing autopsies and finding that women who had their ovaries removed suffered more advanced atherosclerosis than women with ovaries.
THROUGH 1950S: Concerned by animal studies suggesting estrogen is carcinogenic and that it somehow abets preexisting tumors, physicians begin prescribing estrogen primarily for short-term relief of menopausal symptoms. (THE GRANGER COLLECTION)
1953: Mayo Clinic scientists posit that estrogen is cardioprotective after performing autopsies and finding that women who had their ovaries removed suffered more advanced atherosclerosis than women with ovaries.
THROUGH 1950S: Concerned by animal studies suggesting estrogen is carcinogenic and that it somehow abets preexisting tumors, physicians begin prescribing estrogen primarily for short-term relief of menopausal symptoms. (THE GRANGER COLLECTION)
1966: Gynecologist Robert Wilson writes Feminine Forever and promotes estrogen use through a drug-
company-sponsored foundation.
1975: Studies show a link between estrogen and endometrial cancer. (Courtesy of Pocket Books)
1975: Studies show a link between estrogen and endometrial cancer. (Courtesy of Pocket Books)
1979: Ten-year study finds estrogen taken within three years of the onset of menopause reverses bone loss.
(PETE SALOUTOS/CORBIS)
1984: NIH and FDA sanction estrogen as the most effective drug to prevent osteoporosis.
1985: Nurses’ Health Study concludes estrogen users have lower risk of heart disease... but the Framingham Heart Study finds the opposite.
(WENDY HOPE/STOCKBYTE/GETTY IMAGES)
1991: More than 20 small studies estimate that hormone therapy halves heart disease risk in women who have reached menopause.
1992: The American College of Physicians recommends hormone therapy to all women to prevent heart disease and osteoporosis.
1994: First large-scale randomized controlled clinical trial of combined hormone therapy shows better cholesterol scores for women taking the drug than for women on a placebo.
1998: The four-year Heart and Estrogen/Progestin Replacement Study finds hormone therapy does not reduce heart attacks in women who already have heart disease. (THE MEDICAL FILE/PETER ARNOLD INC.)
1992: The American College of Physicians recommends hormone therapy to all women to prevent heart disease and osteoporosis.
1994: First large-scale randomized controlled clinical trial of combined hormone therapy shows better cholesterol scores for women taking the drug than for women on a placebo.
1998: The four-year Heart and Estrogen/Progestin Replacement Study finds hormone therapy does not reduce heart attacks in women who already have heart disease. (THE MEDICAL FILE/PETER ARNOLD INC.)
2002: The estrogen-plus-progestin arm of the 27,000-subject Women’s Health Initiative study is halted three years early when it substantiates increased risk of breast cancer, heart attacks, strokes and blood clots.
2004: The Premarin arm of the WHI study is ended a year ahead of schedule because estrogen alone offered no cardioprotective benefit but increased the risk of blood clots and stroke. (SCOTT CAMAZINE/PHOTOTAKE)
2004: The Premarin arm of the WHI study is ended a year ahead of schedule because estrogen alone offered no cardioprotective benefit but increased the risk of blood clots and stroke. (SCOTT CAMAZINE/PHOTOTAKE)
2005-PRESENT: Hormone therapy is recommended only for relief of severe menopausal symptoms and for the shortest time possible.
( PAUL BURNS/DIGITAL VISION/GETTY IMAGES)
