Soon after menopause, I thought I had no symptoms that bothered me, my internist suggested I consider hormone replacement therapy. I was leery, not seeing a need to take pills for something I didn’t have. She seemed to understand and suggested a few things I might read. I read them, and through they were mildly supportive, they were no convincing. The next time I saw her, I said I would rather not start HRT. She urged me to reconsider, saying she is taking it.
I had my doubts about taking hormones even though I had been made to feel defensive about my reluctance by a physician & assistant and others. My gynecologist had been urging me to take HRT for some time and I trusted him, so, a few years after I had stopped menstruating, I finally consented, in the mid 1990s. I started menstruating again and it lasted at least a month. I seemed to have PMS; that is, I was enraged much of the time. I started acting out my rage at work and I realized I could lose my promotion possibilities or my job if I didn’t stop taking this stuff.
As a nurse midwife/women’s health provider and as a woman approaching menopause two decades ago I had decisions to make both professionally and personally. I was very concerned about the Big Pharma publicity and pressure on practitioners and women to accept the idea that hormone replacement was the gold standard of care. I knew that many practices and procedures that women are encouraged or forced to undergo, like episiotomy and fetal monitoring, have never been proven to improve outcomes in most cases, but nevertheless adopted widely without adequate study.
In the late 1980s (here in Portland, Oregon), I thought it would be a great idea to teach a class on menopause. A local hospital agreed and I came up with what I thought were non-controversial readings such as the chapter from Our Bodies, Our Selves re: menopause. I also submitted a list of topics including The HRT Controversy: To Take or Not to Take. To my surprise, the head of the Continuing Education committee at the hospital (a male Ob/Gyn) decided to censor my readings.
In September, 1997, I wrote an essay that began: On a recent trip to the United States, I was distressed to find nine of my friends had breast cancer and most of the others were taking some kind of hormone replacement therapy. I spent 20 years in experimental cancer research and have an understanding of the process based, not on clinical research data presented in the media, but on experiments in animals. To convince me to take HRT, my doctor gave me a brochure produced by Wyeth, a pharmaceutical company. I was offended and insulted by the manipulation and misinformation I found there.
Thanks to the Network and other advocacy groups, I was aware early in the 80s of the super-push being made by Wyeth Ayerst and other drug companies to convince ALL women that they should take hormones. They were so slick, convincing us even with their language of “replacement” that we needed estrogen and progesterone. It was so disconcerting to watch physicians shamelessly promoting HRT at Women’s Health Conferences all over the country, often implying that those of us who refused this “treatment” were irresponsible.
At last in the aftermath of the ‘storm’ that was, I am happy to share my personal volunteer experience as a member of the Women’s Health Initiative from 1996-2004. I have two daughters and now have two granddaughters for whom may benefit from our, 48,000 women volunteers. I was a member of the Dietary Study and followed through with two year WHI Extension Study which ended in 2006.