The History of HRT Part 1 : 1899-1974

A short time ago, I received a call from a woman I’ve known for 25 years. As soon as I heard her voice I knew something was very, very wrong. With a shaky voice, and fighting back tears, she told me she has breast cancer and it was thought to have spread to her lungs.

Anne had been on and off HRT for years looking to help with her menopause symptoms.  She was hoping for a miracle in a pill, regardless of how I tried to help her, she just wasn’t into making lifestyle changes.

She passed away 4 months later at age 66. We will never know if Anne’s cancer was triggered by HRT, but all I know is it didn’t prevent it.

Over the last seventy years, millions of women in the United States were prescribed estrogen, but do any of us know all there is to know about this powerful hormone?

Endometrial cancer is a disease primarily driven by cumulative exposure to estrogen unopposed by progesterone.
Endometrial cancer is a disease primarily driven by cumulative exposure to estrogen unopposed by progesterone.

Barbara Seaman (1935-2008) an author, activist, journalist, the principal founder of the women’s health movement, advocating for women’s health called “the marketing, prescribing and sale of estrogen the greatest experiment ever performed on women. For all these years, they have been used for what doctors and scientist hoped they could do not for what they know the products can do. Medical policy on estrogen has been to “shoot first and apologize later” to prescribe the drug for certain health problems and then see if there is a positive result.”

Many of you may not know the history of HRT, but I think it’s worth knowing how it began and where we are today.

Biochemist Edward Doisy
Biochemist Edward Doisy

 

HRT History: 1899 -1975

In 1899 the Merck Manual featured the first product to treat “climacterica” also known as menopause. The name of the product was Ovarian and it was made from the dried and pulverized ovaries of cows.

In 1929 biochemist Edward Doisy at St Louis University, Missouri, treated menopausal symptoms with hormones that were isolated oestrogens from the urine of pregnant women.

 (Oestrogens are steroid hormones produced artificially for use in oral contraceptives or to treat menopausal and menstrual disorders.)

Canadian firm Ayerst launched a rival oestrogen product called Emmenin in 1934 but later replaced this with conjugated oestrogens obtained from the urine of pregnant horses, marketed as Premarin in 1942.

In 1939, a British biochemist published a formula for a cheap and powerful oral estrogen and within months scores of drug companies were working with the formula.

By the 1960’s doctors were observing that women on hormones developed breast and ovarian cancer by   alarming numbers.

In 1975, two case-control studies published in the same issue of the New England Journal of Medicine demonstrated that women taking oestrogen therapy were, at least, four times more likely to get endometrial cancer than those who had not used oestrogen, and that there was a 14-fold increased risk in women who continued treatment for seven or more years.

1976, a year after the endometrial cancer papers came research showing a link between unopposed estrogens and breast cancer.

 

After 1976 is where things take a turn for the crazy! Part 2 coming Thursday.

 

 

 

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