The Greatest Experiment Ever Performed on Women
By Barbara Seaman, Schwartz, 331pp, $27.95
THE pill was invented in the 1960s, right? True, but it was in 1938 that a British biochemist made public his formula for cheap, powerful synthetic oral oestrogen, thus foiling a bid by Nazi Germany to patent a steroidal version. That move, according to Barbara Seaman, long-time US health journalist and co-founder of the National Women's Health Network, kicked off the great experiment of her title. From then on, female hormones "were marketed fresh out of the lab" for all sorts of conditions in a shoot first, ask questions later stampede.
Seaman says the risks were always known, all the inventors warned of them and the list has merely been added to over 65 years. Her book aims to reveal the nexus of interest behind this state of affairs and to "help women navigate the [oestrogen] issue".
The first hormone pill prescribed for "climacteric" symptoms went on the market in 1899. It was called Ovariin and made from pulverised dried cow ovaries. Then, in the 1920s, Edgar Allen established the existence of the hormone oestrogen and charted its effects in the monthly cycle of mice. Allen moved on to study oestrogen's connection to female human cancers and in 1941 published research to show that the hormone was directly involved in cervical carcinomas.
At the same moment, Premarin, made from pregnant mare's urine (hence the name), went on the market for women's troubles, set to become one of the most profitable and long-lived drugs in history, rubber-stamped by the US Food and Drug Administration — "a most shameful day in the agency's history".
Synthetic oestrogen went on to be prescribed, until 1971, to 4 million pregnant US women to prevent miscarriages and ensure healthy babies.
Seaman is intrigued by the lives of the main players in the oestrogen story. In the first section, How Did All This Happen?, she names and situates them all, taking us back to the family-based beginnings of certain large drug companies, offering a blow-by-blow account of the race to boil down from seasonal urine or synthesise female sex hormones, bringing to life scientists in their labs in Nazi Germany, prewar Britain or Canada.
Detailed pen-portraits of doctors, researchers, administrators and patients crowd the pages, a journalist's focus on colourful personalities that, while interesting, is rather distracting. Seaman wants to pin the blame or the medals on the appropriate chests, but it's easy to lose the thread as she stops for yet another character sketch.
For the author, on the women's health frontline for 40 years, the people are inseparable from their discoveries and practices — and she's met most of them. "Greenblatt [head of the first department of endocrinology] was not a tyrant, but I did have a serious bone to pick with him" is a typically brisk lead-in to an interview from her files. (Greenblatt figured out the combination of hormones that would stop ovulation, eventually used in the birth control pill). Female hormones for menopause symptoms, for osteoporosis, for heart disease, to delay ageing, to stop depression — drug companies, doctors and promotional experts have plugged oestrogen as a women's panacea for decades but in the past few years alarm bells have been ringing and are being heard. Seaman has at her fingertips all the misleading information purveyed by the media, the slewed studies funded by the pharmaceuticals industry and the manner in which serious studies were "extended and ballyhooed beyond what was justified".
Seaman was involved in getting a health-risks pamphlet included with the early birth control pill (something the American Medical Association opposed and watered down). She devotes chapters of this book to that campaign and others run by women alarmed that prescribing of hormones continued to outpace research. There are horror stories of tainted Wyeth preparations (shades of Pan Pharmaceuticals), the standover tactics of Big Pharma (the pharmaceuticals conglomerates), manipulation of all kinds.
The bright side is the Women's Health Initiative ultimately funded by the US Congress and the many individual stories of medically mistreated women who become fighters.
The second half of Seaman's book attempts to outline the state of research about oestrogen, exposing myths, listing pages of side effects, clearing up confusion, holding out cautious hope. It focuses mostly on the American scene that Seaman knows best, but includes quite a bit of research from international studies.
You might easily decide to buy this book simply to keep the second half handy for reference; it pulls together mountains of research in comprehensible form and concludes the evidence still isn't there for oestrogen's multiple putative health benefits, especially not long term.
Seaman's penultimate chapter, Swimming in the Sea of Estrogens, however, makes the whole question seem academic. We're all ingesting female hormones at a staggering rate, from hormone-treated food and hormone-tainted water. Don't bother requesting hormone replacement therapy; it's happening to you whether you like it or not.
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