The Evolution of Hormone Therapy

Contemporary medical articles often report that prior to the 1960s, menopausal women had few options when it came to effectively dealing with the symptoms they experienced during “the change.” Hot flashes, night sweats, mood swings, and irritability were just a natural part of life and must be endured.

However, history reveals that many different cultures may have sought menopausal relief from sources before the advent of modern-day hormone therapy (HT). For example, some Native Americans used black cohosh to treat menopause symptoms. Others created herbal remedies that included alfalfa, chasteberry, dong quia, maca, oak, sage, red clover, star anise and sweet grass.

What Exactly Were They Treating?

Historical journals indicate that in the mid-1800s in England, physicians prescribed a wide range of remedies to cure what ailed menopausal women:

• Pre-meal mixtures of carbonated soda
• Large belladonna (aka, deadly nightshade) plasters placed at the pit of the stomach
• Vaginal injections with a solution of acetate of lead
• Prescriptions for opium and cannabis 

In Victorian England, it was believed that menopausal women should be shut away by themselves. In some instances, these women were diagnosed with “climacteric insanity” and committed to asylums.

In many of these cases, the cure seems worse than the disease.

It Gets Worse

As time passed and women continued to suffer with their symptoms, drug companies stepped in to offer relief. In the 1890s, Merck concocted a blend of shriveled and pulverized cow ovaries combined with a flavored powder and called it Ovariin. Others believed that “testicular juice” was the balm needed.

By the 1930s, new solutions appeared. The first hormone replacement therapy (HRT) to make it to drugstore shelves was a product called “Emminen” comprised of the urine of pregnant women. In a sense, it was actually a bioidentical hormone, but unfortunately, was too expensive to manufacture. A cheaper alternative evolved in 1941 called Premarin, which was harvested from pregnant mares’ urine and eventually became one of the most widely prescribed drugs in the United States.

A highly sexist and successful ad campaign encouraged husbands to “Keep her on Premarin,” purportedly to “make her pleasant to live with once again.”

Some Progress, or No Progress at All?

Released in 1966, the book “Feminine Forever” by Robert Wilson, MD, told women that menopause was preventable if they took estrogen. As a result, synthetic estrogen therapies gained in popularity. However, after it was determined that this form of estrogen promoted the growth of the uterine lining and increased the risk of cancer, pharmaceutical companies added progestin to the synthetic formula, creating a new medication called Prempro. While the drug did help ease women’s symptoms, there was little known about its long-term effects.

In 2002, the results of a study performed by the Women’s Health Initiative (WHI) revealed that the combination of non-bioidentical (synthetic) hormones found in Prempro could actually increase a woman’s risk for breast cancer, heart attack, and stroke.

It seemed that progress with Prempro was no progress at all.

A Turn Toward the Better

In 2004, investigators of the WHI study published further analysis of the original study, finding that some of the risks reported in 2002 may have been over-estimated. In fact, the new findings suggested that for women between 50-59 years of age, there tended to be lower risk of heart disease and stroke with the use of HT.

By 2005, the news of bioidentical hormone replacement therapies had spread. Bioidenticals are not human in origin, but identical in organic structure and function to human hormones. Generally, they are extracted from plants such as soybeans and wild yams. Bioidentical hormones are designed to replicate the same chemical structure present and naturally occurring in a woman’s body.

Because these hormones are derived naturally, designed to match a woman’s individual hormonal needs, and can be easily metabolized, they are preferable to synthetic hormones.

Is Hormone Therapy for You?

Given a choice of solutions, most women would opt for what’s available to them today as opposed to options like vaginal injections and opium prescriptions of yesteryear. 
Still, it’s an important decision for every woman to make in collaboration with a medical advisor. The impact of menopause and its myriad symptoms cannot be minimized. For many women, it’s negative effect on the quality of their lives and their relationships is unquestionable. Each woman must examine the facts, review the research, consult with experts, and make the decision that is best for her.

For many women, HT has proven beneficial, with many women reporting:

• Reduced menopause symptoms
• Lessened early menopause symptoms after hysterectomy
• Increased energy
• Clearer thinking
• Improved vaginal health
• Decreased bone loss
• Improved libido

Of course, no medical procedure or medication is without side effects or risk. Women considering HT should have a frank and forthcoming discussion of all benefits and risks with a medical professional.