The Greatest Experiment Ever Performed on Women: Exploding the Estrogen Myth

The Greatest Experiment Ever Performed on Women: Exploding the Estrogen Myth

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by Barbara Seaman

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With the ardent tone of a close friend, Barbara Seaman draws on forty years of journalistic research to expose the "menopause industry" and shows how estrogen therapy often causes more problems—including breast cancer, heart attack, and stroke—than it cures. The Greatest Experiment Ever Performed on Women tracks the well-intentioned discovery of synthetic


With the ardent tone of a close friend, Barbara Seaman draws on forty years of journalistic research to expose the "menopause industry" and shows how estrogen therapy often causes more problems—including breast cancer, heart attack, and stroke—than it cures. The Greatest Experiment Ever Performed on Women tracks the well-intentioned discovery of synthetic estrogen through the unconscionable and misleading promotion of a dangerous drug.

Editorial Reviews

A wake-up call to women about unquestioningly accepting doctors' orders.—Donna Chavez
Susan Love
Barbara Seaman is one heroine of the women's health movement. She pointed out postmenopausal hormones . . . dangerous . . . relentless fighter for women's health.
Gloria Steinem
Barbara Seaman, first prophet of women's health movement and her prophesies are still coming true.
San Francisco Chronicle
A splendid history that exposes how menopause was transformed into a medical problem . . .
The New York Times
Lively and impassioned…[Seaman] certainly makes her point.
Cleveland Plain Dealer
Seaman's story is sometimes astounding.
Publishers Weekly
In June 2002, a large, randomized study of a synthetic estrogen was stopped early because the risks to the postmenopausal women involved were outweighing the benefits, and many women who had been taking estrogen for years were left confused and angry. Seaman, a veteran women's health journalist (The Doctor's Case Against the Pill; Women and the Crisis in Sex Hormones), reminds readers that these findings are just the latest twist in the long and fascinating history of estrogen therapy. In Part I, Seaman offers a somewhat meandering explanation of how the estrogen drug Premarin was developed in the 1930s and then broadly marketed and prescribed to treat menopausal symptoms for the next five decades, despite the known increased risk of endometrial and breast cancer. She describes the historical roles played by different researchers, government officials and activists, and draws parallels to the Senate hearings about the birth control pill that led to prescription drug warnings for patients. In Part II, Seaman reviews the data on estrogen therapy and reveals how it was prematurely promoted to protect against heart disease and Alzheimer's; this section sometimes veers off-topic by delving into, for example, tai chi as an alternative risk reduction measure for osteoporosis. This sprawling book concludes with a chapter on environmental estrogens and an appendix on practical information on menopausal women's treatment options, including other hormone supplements. Seaman passionately and convincingly argues that women have been unnecessarily put at risk by doctors treating menopause as a disease, but a more tightly focused book would have made her case much stronger. (June) Copyright 2003 Reed Business Information.
"Seaman's story is sometimes astounding." (Cleveland Plain Dealer)
Library Journal
When the Women's Health Initiative of the National Institutes of Health stopped one arm of its hormone replacement therapy (HRT) clinical trial last July, it announced that "the balance of risks and benefits for hormone use in healthy postmenopausal women remains uncertain." Seaman, a women's health advocate and author of The Doctor's Case Against the Pill, explains the controversy surrounding the use of prescription hormones for birth control, menopause, and postmenopause. She highlights the history of their development (evidence of their cancer-causing properties was supressed); their extensive marketing, first to doctors and then to patients; and their prevalence in American society throughout the second half of the 20th century. Quite obviously, the author is opposed to the use of long-term prescription hormones; after her aunt died of endometrial cancer in 1959, Seaman was warned by doctors not to take Premarin, and she has spent 40 years researching sex hormones. This book is in direct opposition to older titles like Adam Romoff's Estrogen: How and Why It Can Save Your Life. HRT still remains a confusing and popular topic, and Seaman will add a piece to the puzzle for many readers. Recommended for all libraries, especially public. (Bibliography and notes not seen.)-Elizabeth Williams, Fresno City Coll. Lib., CA Copyright 2003 Reed Business Information.

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Introduction I: Smart Doctors, Foolish Forecasts

I have a doctor friend who so believed in the value of synthetic estrogens that when the National Institutes of Health announced a large clinical trial to compare these pills with sugar pills, she dismissed it as a waste of money. “Obviously, the women on the hormones will be living longer,” she said. “It’s unethical to leave volunteers on the placebos for the full eight and a half years of the trial. At some point they’ll have to stop the study and offer hormones to everyone.”

Her colleagues concurred, but then the opposite came true. On the morning of July 9, 2002, my friend, along with other physicians and the 30 million U.S. patients taking estrogen products, woke up to discover that the world, after all, was flat. A safety-monitoring board had suddenly halted a part of the study involving 16,608 women because those taking hormones had more breast cancer, heart attacks, strokes, pulmonary embolisms, and blood clots than those taking sugar pills. Yes, the volunteers on Prempro also had fewer bone fractures and less colon cancer. But not enough to balance out the risks.

My friend initially heard the startling results on Good Morning America, where Dr. Tim Johnson described this “somewhat surprising outcome.” He predicted that most women then taking hormone pills would stop “after talking to their physicians today,” failing to anticipate that many doctors would take their telephones off the hook. My friend switched the channel to CNN, where Paula Zahn repeatedly exclaimed: “I tell you— women gotta go insane today.” Channel surfing, my friend caught up with the “usual suspects,” certain doctors familiar to TV viewers whose spin skills had been developed by public-relations coaches at agencies that handle pharmaceutical accounts. It was then that my friend got it. These physicians were appearing on stations where paid ads suggested that if only we took estrogen we could look like Lauren Hutton and sing like Patti LaBelle.

That night my friend called me to apologize for having objected to the title I planned for this book. She had called it “over the top and ridiculous,” but now she said she could almost agree.


While the Prempro arm of the Women’s Health Initiative, which lasted 5.2 years and included 16,608 women, was a major test, it is only a small part of what I consider to be The Greatest Experiment Ever Performed on Women. The experiment began in England in 1938, and it has continued for sixty-five years. A British biochemist, desperate to prevent Nazi Germany from cornering the world market on synthetic sex hormones, published his formula for cheap and powerful oral estrogen. Within months, thousands of doctors and scores of drug companies around the world were working with this formula.

That opened the Greatest Experiment. Products made from chemicals that mimicked the feminizing effects of a woman’s natural secretions were marketed fresh out of the lab. They were prescribed and sold for a host of concerns—to slow and prevent aging, to stop hot flashes, to avoid pregnancy or miscarriage, and as a morning-after contraceptive.

I call the marketing, prescribing, and sale of these drugs an experiment because, for all these years, they have been used, in the main, for what doctors and scientists hope or believe they can do, not for what they know the products can do. Medical policy on estrogens has been to “shoot first and apologize later”—to prescribe the drugs for a certain health problem and then see if there is a positive result. Over the years, hundreds of millions, possibly billions of women, have been lab animals in this unofficial trial. They were not volunteers. They were given no consent forms. And they were put at serious, often devastating risk.

The risks of these drugs have been known and documented from the start.  The British doctor who published his estrogen formula in 1938 spent many years thereafter warning the world that these drugs, although containing great promise, put women at serious peril for endometrial and breast cancer. Since the halting of the Prempro trial in July, despite the ignorance or hypocrisy of many doctors who said “Who knew?,” there is nothing surprising in the recent findings. We have known since day one that these drugs posed threats. And since then science has added to, not subtracted from, the list of estrogen’s problems.

If doctors and scientists have known these dirty secrets for so long, why is the bad press so recent? That is an essential question right now, and this book seeks to present the answer. Part of the answer lies in the vigorous efforts by drug companies to protect an invaluable market.  These efforts have included underwriting studies and subsidizing doctors, participating in medical-school curriculums, advertising heavily in medical journals, and seeing that continuing medical education is directed by doctors on the drug industry’s payroll. They have also entailed one of the most elaborate promotion and advertising campaigns in the history of the media not only in America but worldwide.

This is not the first time estrogen sales have felt the cold wind of consumer anger. In 1975, the magnitude of estrogen-related endometrial cancer was established; drug sales sank by half in subsequent years. In that instance, as in every other that has cast suspicion on estrogen, the drug companies managed to revitalize sales through new claims, which is why I say that only through learning how these companies buy and influence medical opinion can women protect themselves from any new spin, any new claim that will inevitably emerge about these drugs and countless others.

Estrogen products won’t go away, and they shouldn’t. One can only wish, as I do, that they will be used now with caution, based on evidence and facts, not illusion. My aim is to consider whether hormone supplements are necessary and for whom. Specifically, I hope this book will help women navigate the estrogen issue and keep anything similar from happening again. But the larger hope is that we can make informed decisions about other drugs as well.

On the sixty-fifth birthday of the Greatest Experiment, I recall a poem by William Butler Yeats entitled “The Corning of Wisdom with Time”: 

Though leaves are many, the root is one;

Through all the lying days of my youth

I swayed my leaves and flowers in the sun

Now I may wither into the truth. 

Let us hope.

Meet the Author

One of the nation’s most tireless health advocates, BARBARA SEAMAN (1935-2008) co-founded the National Women’s Health Network and pioneered a new style of health reporting that focused on patients’ rights. Her groundbreaking investigative book, The Doctor’s Case Against the Pill (1969), prompted Senate hearings in the 1970s that led to a warning label on oral contraceptives and the drastic lowering of estrogen doses due to dangerous health effects. Dedicated to reaching a wide audience, Seaman wrote columns for Brides Magazine, Ladies’ Home Journal, and Ms., inspiring women around the world to take control of their own health. Seaman was a founding advisory board member of and key advisor to Seven Stories Press.

From the Trade Paperback edition.

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