Women’s bodies not for drug trials

In 1979, my mother died of endometrial cancer, almost certainly caused by the huge doses of estrogen she had taken for a decade at the recommendation of her doctor to hold off the “symptoms” of menopause.

Twenty years later, before I had even reached that milestone myself, my doctor started suggesting that I begin what was then called hormone replacement therapy. I told her I wasn’t interested, but she wouldn’t let up, insisting I was in danger of osteoporosis and a host of other ills if I didn’t sign up for the drugs. I asked her to provide the scientific evidence on which she based that judgment. Within days, I received a letter in the mail telling me that she no longer wished to have me as a patient. I’d been fired.

Now Connie Barton, an Illinois woman who went along with a similar suggestion from her doctor, has won $75 million in punitive damages and $3.75 million in compensatory damages from Pfizer. Barton took the drug Prempro, produced by Wyeth (which was absorbed by Pfizer this year) for five years until she was diagnosed with breast cancer. Her doctor told her the hormones would help prevent dementia and heart disease. She convinced a jury they caused her cancer.

Ever since doctors have figured out how to manipulate hormones, with their power to switch whole bodily systems on and off, it seems they have felt obliged to use that power. Pick your metaphor: Pandora’s box, stolen knowledge from the tree in the Garden. Certainly there have been benefits, the biggest of them perhaps in the form of birth control.

But the twin temptations of profit and control over women also have led to irresponsible — often deadly — misuse of hormonal therapies. Women have gone along, creating generations of guinea pigs whose lives have been damaged by experimental hormonal therapies. Will Barton’s victory (which Pfizer says it will appeal) change any of this?

In the mid-1970s, I gave birth to my first child. My pregnancy lasted longer than the “standard” 40 weeks, and my doctor began lobbying hard to induce labor. A host of dangers lurked, I was told, if the baby went too far overdue. I resisted, and my beautiful baby girl was born three weeks after her due date, plump and healthy. My subsequent three children were all born after drug-free labors and all after pregnancies that lasted at least 42 weeks.

Today, the use of powerful hormones to induce labor is as popular as ever, with doctors warning of dire outcomes once the 40-week deadline passes. All too often the drug (usually Pitocin) causes unnaturally strong and painful contractions. The mother-to-be is then offered more drugs to relieve the pain, resulting in a slowed-down labor, fetal distress and an emergency Caesarean section. A young woman I spoke to recently told me none of her friends had had a normal labor; all had been caught in the induction/Caesarean vortex.

I’m from the Second Wave generation, the women with the well-thumbed copies of “Our Bodies, Ourselves,” the ones who educated ourselves about the workings of our bodies, talked back to our gynecologists and revived the profession of midwifery.

I assumed that my daughters’ generation would give birth differently, just as I assumed mine would be on guard against the arguments that sold HRT drugs to my mother. What happened?

Well, some of us may have had the motivation to read up on the dangers of chemical intervention in our reproductive systems, but in a consumer economy, marketing still rules. Big pharma does a great job of pushing the view of natural female functions as pathology.

Even the critics of broad prescription of hormones to “treat” menopause will say it’s a good idea to relieve discomforts like hot flashes. I’ve been there. Hot flashes aren’t all that much fun, but they’re not exactly life-threatening.

The docs and the drug companies aren’t interested in the simple, the inexpensive and the noninvasive, and too few women question their prescriptions. The ability to manipulate our hormones has become knowledge as dangerous to us as that original revelation in the Garden of Eden. Eve is as vulnerable as ever.

Susanna Rodell lives in Atlanta.

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