Menopause: Made in the USA
Historically 80% of Premarin and Prempro sales have occurred in the US . Even in the US , the cessation of menstruation is a non-event in 75% of women, producing no physical symptoms whatsoever. In fact, most languages and cultures have no word for menopause. In Chinese medicine, so-called menopausal symptoms are considered a manifestation of an underlying "imbalance" and disappear within a few days of herbal treatment. Even untreated, the hot flashes, night sweats, mood swings and insomnia some women experience rarely last longer than a few months. In fact, many women report an overall improvement in their health and well-being when they stop having periods.
There are interesting cross cultural studies of the "menopause" phenomenon. Non-western cultures typically view the cessation of monthly cycles as a milestone signaling transition to the role of community elder. The Filipino women Berger and Wenzel studied in Women, Body and Society: Cross-cultural Differences in Menopause (http://www.ldb.org/menopaus.htm) were extremely pleased with their freedom from the inconvenience of menstruation. They saw it as an initiation into the joys of old age -- better sex (contrary to popular misconception, estrogens suppress sex drive, which in women is regulated by the hormones testosterone and oxytocin) and improved mood and energy. However most of all they appreciated the new love and respect they enjoyed, as an elder, outside the family. I see this attitude here in New Zealand in the Maori culture, where senior women receive the title of "kuia" or "whaia" both designating immense esteem, prestige, and influence over community affairs.
As Berger and Wenzel's and other cross cultural studies note, attitudes in the US and other English speaking countries are heavily influenced by a multibillion dollar PR industry that bombards women with messages glorifying youth, thinness and sexual attractiveness -- and engendering frank terror of gray hair, facial wrinkles, weight gain and cellulite. Aggressive marketing preys very effectively on the insecurities these messages create to sell billions of dollars of wrinkle removing creams and lotions, age concealing make-up, hair coloring, botox, diet products and programs and plastic surgery.
Six Decades of False and Misleading Marketing
As revealed in internal documents uncovered in a few of the 5000+ lawsuits filed against Wyeth since 2002, the drug company's culpability goes far beyond neglecting to inform menopausal women of cancer risks. They paint a very ugly picture of an aggressive public relations campaign to convince women and their doctors that estrogen replacement was the secret to eternal youth -- by preventing age-related skin changes.
It was a win-win campaign. As a result of decades of marketing about the horrors of aging, post menopausal women were terrified of losing their sexual attractiveness if they didn't take estrogen. And because women's health "experts" were recommending it in medical journals, doctors were more than happy to overlook increasing evidence that it caused cancer.
The result of Wyeth's public relations effort
was to make Premarin was the most commonly prescribed drug in the US in 1992. Yet by the mid-nineties, even the mainstream
media was starting to take note of the preponderance of studies linking
estrogen replacement to cancer. In 1995 this resulted in a Time magazine article
(Wallis, C. "A Risky Elixir of Youth" Time. (26), 46-56, 1995),
followed by a Tom Brokaw feature on NBC's nightly news.
The NIH Shuts Down the WHI
Seventy percent of American women taking estrogen replacement in 2002 stopped when the National Institute of Health shut down the WHI study. This resulted in a 7% decrease in the first year alone of new breast cancer cases -- a total of 14,000 women spared the agony of a potentially fatal breast cancer diagnosis (see
http://www.theepochtimes.com/n2/content/view/9804/ ). The study findings have also resulted in 5000+ cancer lawsuits against Wyeth for misrepresenting earlier cancer research to doctors -- and their failure to inform women of the significant cancer risks associated with HRT.Wyeth's response to all the negative publicity was to initiate a massive PR campaign discrediting the WHI study. They started with a letter to 500,000 doctors attacking the study, complaining that the women in the Premarin arm had other reasons for developing cancer -- they were too old, too menopausal or weren't checked for pre-existing heart disease (I find this ironic -- in 2002 Wyeth was still aggressively promoting Premarin as a way to prevent heart disease). This was followed by articles attacking the study in various medical journals -- articles published under the names of doctors specializing in women's health which were actually ghost written by the company (see http://www.theepochtimes.com/n2/content/view/9804/ ).
Many of the doctors were affiliated with the notorious Council on Hormone Education at University of Wisconsin (where 44 of the 64 doctors have financial ties to Wyeth) Wyeth founded in response to the 2002 WHI study. In 2006 the Council even began offering a continuing medical education course for doctors called "Quality of Life, Menopausal Changes and Hormonal Therapy" -- heavily promoting estrogen replacement.
Filing Suit: the Only Consumer Protection Against Big Pharma
Wyeth's massive campaign to discredit the 2002 WHI study, at the expense of tens of thousands who would start or continue estrogen replacement as a result of these misguided efforts, has clearly harmed their defense in the dozens or so of the 5000+ lawsuits that have made it through the courts.
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