Addendum: See Merrill Goozner’s story, “The Trouble with Trump’s Pick to Run the FDA.”(https://washingtonmonthly.com/2024/12/04/the-trouble-with-trumps-pick-to-run-the-fda/) He includes a deep discussion of Dr. Marty Makary’s opinions on hormone therapy for menopause, on the Women’s Health Initiative Study, on a newer study that also found elevated risk, on his “broad claims for the health benefits of HRT, including delaying the onset of Alzheimer’s disease preventing cardiovascular disease and heart attacks and reducing colon cancer risk.” Goozner then explains that Makary’s claims for these benefits are an example of taking sides “on controversial issues based on studies that are far from conclusive.”
My colleague Avrum Bluming, MD, an oncologist, and I, Carol Tavris, a social psychologist, are authors of "Estrogen Matters," which tells the story of the Women's Health Initiative,which scared women off hormone therapy in menopause in 2002. Prescriptions plummeted from 44% to about 5%. We have NO conflicts of interest on the hormone question. Neither of us have taken a dime from Big Pharma or Little Pharma, and I sailed through menopause without a symptom and never took estrogen. We completely agree with Gary and others who have debunked the nonsense and nonhormonal therapies that now pervade the menopause market. But the story of the WHI is itself a scandal. Its leading investigator, a cardiologist, published a paper in the 1990s saying it was time to "stop the HRT bandwagon," and the WHI did: HRT causes dementia! breast cancer! Stroke! Deaths from "all causes"! Unfortunately, most women and most physicians are unaware that the WHI has walked back almost all of these scares. Now they acknowledge that HRT is the best, safest, most effective treatment for menopausal vasomotor symptoms -- which last an average of 7 years for most women and 10 years for Black women. Of course these symptoms may be merely troublesome for some women but they can be debilitating for many more (sleeplessness and heart palpitations are not trivial). They report that it is the best and safest treatment for vaginal dryness and menopausal UTIs. It reduces the risk of heart disease --the leading killer of women -- by up to 50%. It is the ONLY thing that prevents osteoporosis in later years, because it keeps the internal tensile strength of the bone flexible (calcium is deposited externally and does nothing). Estrogen alone (for women who have had hysterectomies) actually REDUCES the risk of breast cancer by some 23% and also of deaths from breast cancer. Far from causing "deaths from all causes" HRT extends women's lives by 3-4 years! Why isn't this headline news? Oh yes, it causes breast cancer: the original scare. In fact, it does not. That was a statistically nonsignificant finding and vanished when the researchers controlled for primary risk factors.
The WHI has been on a campaign from the get-go to scare women off estrogen; we don't know why. (They needed a sensational result to warrant the $1 billion it cost? Conflict of interest with statins?) From the outset, only 3 of the 40 principal investigators even read the first dire report that was published in JAMA. When they did not find a scary result, they resorted to data mining (retrospective substratification) to try to find one. How did they show that HRT doesn't even help quality of life, a 2003 NYT headline? By eliminating the women who had symptoms from analysis: So the women who had no symptoms reported that HRT did not help the symptoms they didn't have. (The 13% who did have major symptoms said, in effect, you bet it helped.) How did they show that HRT increases the risk of dementia? By eliminating women who had no cognitive impairment at the outset. And this was not a healthy sample of women in menopause to begin with: average age 63.
Avrum is a meticulous, ethical scientist as well as clinical practitioner who has been willing to challenge the paradigm that estrogen is carcinogenic. what he has learned is stunning and of immense importance to the health of women. Let's try to separate the marketing of menopause that indeed confuses women, from the medical findings that can prolong their quality of life in menopause, their health, and their lives. When I was 50, I, a lifelong feminist, pooh-poohed hormone therapy. The evidence changed my mind.
It's striking how quick Gunter is to criticize those peddling supplements while embracing the FDA's approved hormone therapy as if the FDA were completely trustworthy. Yes, a lot of profits are being made off supplements. But a lot of profits are being made off pharma products as well. Seems like a double standard.
I think that in order to sell the steak you have to sell the sizzle, and the celebrities, the influencers, the talking heads and others are, in one way or another, capitalizing on the buzz. The REAL capitalists, the drug companies, are going to bank on all the buzz. Astellas, the Pharma company producing the new drug Veozah is, hoping to see their new drug added to formularies—so the real target is governments and payers.
I have also been looking closely at a wide swath of menopause mongering on major media outlets in Canada recently and wondered: Why this and why now? Only one small thing not mentioned in your analysis is the fact that this new, very expensive treatment for hot flashes (marketed as 100% hormone free!) has just been approved this year. I've been around long enough to remember the same sort of "buzz" around the newest and latest osteoporosis drugs, the new drugs for female sexual dysfunction, and the just launched drugs for 'heavy' periods. Same sort of thing....
Too bad the drug has this pesky FDA warning on Liver injury
Addendum: See Merrill Goozner’s story, “The Trouble with Trump’s Pick to Run the FDA.”(https://washingtonmonthly.com/2024/12/04/the-trouble-with-trumps-pick-to-run-the-fda/) He includes a deep discussion of Dr. Marty Makary’s opinions on hormone therapy for menopause, on the Women’s Health Initiative Study, on a newer study that also found elevated risk, on his “broad claims for the health benefits of HRT, including delaying the onset of Alzheimer’s disease preventing cardiovascular disease and heart attacks and reducing colon cancer risk.” Goozner then explains that Makary’s claims for these benefits are an example of taking sides “on controversial issues based on studies that are far from conclusive.”
My colleague Avrum Bluming, MD, an oncologist, and I, Carol Tavris, a social psychologist, are authors of "Estrogen Matters," which tells the story of the Women's Health Initiative,which scared women off hormone therapy in menopause in 2002. Prescriptions plummeted from 44% to about 5%. We have NO conflicts of interest on the hormone question. Neither of us have taken a dime from Big Pharma or Little Pharma, and I sailed through menopause without a symptom and never took estrogen. We completely agree with Gary and others who have debunked the nonsense and nonhormonal therapies that now pervade the menopause market. But the story of the WHI is itself a scandal. Its leading investigator, a cardiologist, published a paper in the 1990s saying it was time to "stop the HRT bandwagon," and the WHI did: HRT causes dementia! breast cancer! Stroke! Deaths from "all causes"! Unfortunately, most women and most physicians are unaware that the WHI has walked back almost all of these scares. Now they acknowledge that HRT is the best, safest, most effective treatment for menopausal vasomotor symptoms -- which last an average of 7 years for most women and 10 years for Black women. Of course these symptoms may be merely troublesome for some women but they can be debilitating for many more (sleeplessness and heart palpitations are not trivial). They report that it is the best and safest treatment for vaginal dryness and menopausal UTIs. It reduces the risk of heart disease --the leading killer of women -- by up to 50%. It is the ONLY thing that prevents osteoporosis in later years, because it keeps the internal tensile strength of the bone flexible (calcium is deposited externally and does nothing). Estrogen alone (for women who have had hysterectomies) actually REDUCES the risk of breast cancer by some 23% and also of deaths from breast cancer. Far from causing "deaths from all causes" HRT extends women's lives by 3-4 years! Why isn't this headline news? Oh yes, it causes breast cancer: the original scare. In fact, it does not. That was a statistically nonsignificant finding and vanished when the researchers controlled for primary risk factors.
The WHI has been on a campaign from the get-go to scare women off estrogen; we don't know why. (They needed a sensational result to warrant the $1 billion it cost? Conflict of interest with statins?) From the outset, only 3 of the 40 principal investigators even read the first dire report that was published in JAMA. When they did not find a scary result, they resorted to data mining (retrospective substratification) to try to find one. How did they show that HRT doesn't even help quality of life, a 2003 NYT headline? By eliminating the women who had symptoms from analysis: So the women who had no symptoms reported that HRT did not help the symptoms they didn't have. (The 13% who did have major symptoms said, in effect, you bet it helped.) How did they show that HRT increases the risk of dementia? By eliminating women who had no cognitive impairment at the outset. And this was not a healthy sample of women in menopause to begin with: average age 63.
Avrum is a meticulous, ethical scientist as well as clinical practitioner who has been willing to challenge the paradigm that estrogen is carcinogenic. what he has learned is stunning and of immense importance to the health of women. Let's try to separate the marketing of menopause that indeed confuses women, from the medical findings that can prolong their quality of life in menopause, their health, and their lives. When I was 50, I, a lifelong feminist, pooh-poohed hormone therapy. The evidence changed my mind.
It's striking how quick Gunter is to criticize those peddling supplements while embracing the FDA's approved hormone therapy as if the FDA were completely trustworthy. Yes, a lot of profits are being made off supplements. But a lot of profits are being made off pharma products as well. Seems like a double standard.
Gary, good job on the post.
I think that in order to sell the steak you have to sell the sizzle, and the celebrities, the influencers, the talking heads and others are, in one way or another, capitalizing on the buzz. The REAL capitalists, the drug companies, are going to bank on all the buzz. Astellas, the Pharma company producing the new drug Veozah is, hoping to see their new drug added to formularies—so the real target is governments and payers.
https://www.youtube.com/watch?v=e-H2BF0GZik
I have also been looking closely at a wide swath of menopause mongering on major media outlets in Canada recently and wondered: Why this and why now? Only one small thing not mentioned in your analysis is the fact that this new, very expensive treatment for hot flashes (marketed as 100% hormone free!) has just been approved this year. I've been around long enough to remember the same sort of "buzz" around the newest and latest osteoporosis drugs, the new drugs for female sexual dysfunction, and the just launched drugs for 'heavy' periods. Same sort of thing....
Too bad the drug has this pesky FDA warning on Liver injury
https://www.fda.gov/drugs/drug-safety-and-availability/fda-adds-warning-about-rare-occurrence-serious-liver-injury-use-veozah-fezolinetant-hot-flashes-due