Hormone-replacement therapy “experiment” debunked in NYT Magazine
|
Posted by Paula Kamen September 19th, 2007 |
It wasn’t exactly the most sensational and eye-catching story of the week, and you may have been more likely to turn to the more glitzy one in that September 16 Sunday issue of the “New York Times Magazine”– about anorexic-advocate Rachel Zoe (see Courtney Martin’s post below).
But the chances are that even ardent feminist readers missed the milestone nature of the seemingly dry cover story, “Unhealthy Science,” which Dr. Monica Green of Arizona State University alerted me to on one of my listservs, calling it “a banner day for the field (of women’s health history).”
The in-depth story basically exposes how epidemiological studies (layman’s term: observational studies of large populations used to give public health advice) can have major flaws, mainly relying on too much circumstantial evidence. That is a signficant point to women, mainly because much of this advice has been directed to them, and has had very serious health consequences.
The main example the article gives of this problem is the saga of ever-shifting medical advice over women taking Hormone Replacement Therapy (HRT), which often lacks scentific evidence. As writer Gary Taubes discusses, HRT is significant as “one of the most popular drug treatments in America,” boosted by some questionable epidemiological studies since the 1980s. Taubes estimates that doctors’ prescription of HRT over the longterm to women to try to prevent aging and heart disease, a shaky hypothesis of some epidemiological research, may have led to at least tens of thousands of women dying prematurely of breast cancer or strokes.
The article delves into detail that you may only know if you have taken a class in women’s health, or read something published by a university press, such as Elizabeth Siegel Watkins’ new book, The Estrogen Elixer, or Barbara Seaman’s 2003 The Greatest Experiment Ever Performed on Women: Exploding the Estrogen Myth.
Despite some complex issues, the article lays out the history of the misunderstandings over HRT — and women’s activism against it — as lucidly as possible. It goes into detail about one of the most influential — and problematic — such studies of all time, the Nurses’ Health Study of 1985, which came out of the Harvard Medical School. That Nurses’ study reported that women who took HRT had a third fewer heart attacks than women who never took the drug.
The article then goes into detail about other clinical trials that followed, that began to chip away at this conventional wisdom, starting with the HERS Study in 1998, and then the one by the Women’s Health Initiative in 2002.
As medical advice continues to shift over lucrative products for women’s health — from HRT to those birth control pills that stop periods — such media scrutiny continues to be vital. In the blog on the Our Bodies Ourselves website, Rachel Walden today well sums up what we can learn from the HRT case on the limits of short-term medical research, and how to examine studies, even those gathering much fanfare, critically.
PS: My one criticism of this article is that the HRT angle of the cover story be clearer on the cover. By the generic artwork, it seemed like a very general study about research methods, when actually it was also an in-depth article about HRT. It’s important enough, indeed, to put on the cover of the magazine.
*********************
And speaking of women’s health issues, the fall reading schedule for my forthcoming book, Finding Iris Chang, which deals with bipolar disorder and pregnancy issues, is available at:
http://booktour.com/author/paula_kamen_
I will also be speaking on women and chronic pain at Tufts University Medical School on November 1. More info on that is at paulakamen.com