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TIMELINE //

Hormone Therapy’s Moving Target

For nearly 100 years, different opinions on hormone replacement
therapy have caused its use to ebb and flow.

by Anita Slomski // Spring 2009
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cow

THE GRANGER COLLECTION

EARLY 1900s

Women drink solutions of animal ovaries or eat fresh sow or cow ovaries to treat menopause symptoms and a host of diseases thought to stem from ovarian failure.

estrogen

COURTESY OF SCHERING-PLOUGH

MID-1930s

Drug companies produce estrogen injections and pills from animal placentas and fetal fluids to relieve symptoms of natural and surgical menopause.

1941-1942

Canadian firm Ayerst, McKenna and Harrison introduces Premarin, a combination of estrogens produced from the urine of pregnant mares, the most potent form of the hormone yet developed.

William Masters

THE GRANGER COLLECTION

1951

After six years of prescribing estrogen to institutionalized elderly patients, sex researcher William Masters recommends hormone therapy to rejuvenate “mental and physical function.”

1953

Mayo Clinic scientists posit that estrogen is cardioprotective after performing autopsies and finding that women who had their ovaries removed suffered more advanced atherosclerosis than women with ovaries.

THROUGH 1950s

Concerned by animal studies suggesting estrogen is carcinogenic and that it somehow abets preexisting tumors, physicians begin prescribing estrogen primarily for short-term relief of menopausal symptoms.

Robert Wilson, Feminine Forever

Courtesy of Pocket Books

1966

Gynecologist Robert Wilson writes Feminine Forever and promotes estrogen use through a drug-company-sponsored foundation.

1975

Studies show a link between estrogen and endometrial cancer.

 osteoporosis

PETE SALOUTOS/CORBIS

1979

Ten-year study finds estrogen taken within three years of the onset of menopause reverses bone loss.

FOOD AND DRUG ADMINISTRATION

1984

NIH and FDA sanction estrogen as the most effective drug to prevent osteoporosis.

Nurses Health Study, 1985

WENDY HOPE/STOCKBYTE/GETTY IMAGES

1985

Nurses’ Health Study concludes estrogen users have lower risk of heart disease... but the Framingham Heart Study finds the opposite.

heart

THE MEDICAL FILE/PETER ARNOLD INC.

1991

More than 20 small studies estimate that hormone therapy halves heart disease risk in women who have reached menopause.

1992

The American College of Physicians recommends hormone therapy to all women to prevent heart disease and osteoporosis.

1994

First large-scale randomized controlled clinical trial of combined hormone therapy shows better cholesterol scores for women taking the drug than for women on a placebo..

1998

The four-year Heart and Estrogen/Progestin Replacement Study finds hormone therapy does not reduce heart attacks in women who already have heart disease.

breast cancer cell

SCOTT CAMAZINE/PHOTOTAKE

2002

The estrogen-plus-progestin arm of the 27,000-subject Women’s Health Initiative study is halted three years early when it substantiates increased risk of breast cancer, heart attacks, strokes and blood clots.

2004

The Premarin arm of the WHI study is ended a year ahead of schedule because estrogen alone offered no cardioprotective benefit but increased the risk of blood clots and stroke.

menopause symptoms

PAUL BURNS/DIGITAL VISION/GETTY IMAGES

2005-PRESENT

Hormone therapy is recommended only for relief of severe menopausal symptoms and for the shortest time possible.

Stat-arrow-green

Yes. No. Maybe.

hormone replacement therapy

Hormone therapy after menopause may prevent heart attacks and cancer—or cause them. New research could show who benefits.

The Cancer Question

There’s little doubt that hormone therapy affects a woman’s risk of malignancies. But that’s where the clarity ends.

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