An example of medical intervention gone wrong?

In the last two months, there have been revelations in the media on the problems of long-term hormone therapy use. A new study that tracked thousands of women for nearly twenty years revealed that women who took estrogen were, on average, 1 1/2 times more likely to develop ovarian cancer. That risk increased dramatically the longer the women took the medicine. Women who took estrogen for 20 years or more were three times more likely to develop ovarian cancer than those who did not take the pills.

Another study was halted around the same time that showed that the pills were doing more harm than good, even causing conditions the medicine was once believed to prevent, including heart disease.

Originally, these hormones were designed to give short-term relief of symptoms of menopause, such as hot flashes and night sweats. However, over time, long-term use of hormones was encouraged to prevent heart disease and osteoporosis. Today, an estimated 8 million women in the United States regularly take estrogen.

However, these new studies are only emphasizing what many people have been saying for years. I have also previously written about hormone replacement therapy (HRT), questioning its efficacy in the treatment of osteoporosis and heart disease, and making the point that the trials supposedly supporting the therapy were highly questionable.

What is most striking about this whole phenomenon is that the apparent scientific evidence that has justified the routine use of HRT for millions of money is highly questionable. However, for the last twenty years at least, doctors have routinely recommended this treatment for women, not questioning or not knowing of any conflicting evidence that may contraindicate it. In many cases, hormones have been given initially for symptoms of menopause and then people are routinely kept on it without their being any clinical evidence to justify it.

It is an example where the relationship between pharmaceutical companies and the scientific community is more collusive than it should be, with physicians being used as distributors for their products. It is now a common criticism that drug companies fund much of the supposed objective research into medicines. It has to make one question the objectivity of researchers. It is also an example of the relentless medicalization of all aspects of life, a tendency to pathologize processes, which are natural and do not need ongoing medical intervention.

Even as this "new" evidence hits the streets, there is now an attempt to make "male menopause" a disease and to prescribe hormones for it, in this case testosterone, the hormone essential for male functioning. An article in the New Yorker magazine of July 29, 2002, by Jerome Groopman is a fascinating exploration of this development. The article explores how a drug company is proposing to market testosterone to middle age men who show symptoms of general malaise, lacking energy and libido. The assumption is that testosterone level may be low requiring a boost. However, there is no scientific data to support what a normal level of testosterone is in middle age men, and no long term trials of the effects of giving men testosterone. Research into normal testosterone levels showed no connection between function and the level of the hormone in the body. Some people just had lower levels than others. The FDA only approved the use of testosterone in specific genetic problems requiring supplementation of testosterone, but once the FDA has given a drug the green light, there is nothing stopping it being marketed for another condition that shows similar symptoms.

This looks like being one more example of the relentless pursuit of drug companies in marketing their product, as if they are selling us laundry powder, with the unfortunate and possible tragic consequence of creating other health problems as a result.

The term "iatrogenic" disease, which means drug induced disease has more meaning today than ever, and the complicity of some of the medical profession in advocating untested products can only make things worse.

All of us have to be willing to take responsibility of our own health, to do our own research, to not believe everything we hear and read. The experts dont always know.