Wyeth and the Multibillion Dollar Menopause Industry

I have written previously (http://www.opednews.com/articles/Marketing-Serotonin-Defici-by-Dr-Stuart-Jeanne-B-100713-513.html) about the ingenious -- and deadly -- strategy by pharmaceutical companies of inventing fictitious illnesses to market highly profitable drugs that allegedly "treat" them. The technical terms for this are "medicalizing" or "disease mongering." Dr Marcia Angell, in her 2004 The Truth About the Drug Companies: How They Deceive Us and What To Do About It, also talks about "generalized anxiety disorder," "erectile dysfunction," "premenstrual dysphoric disorder," and "gastro-esophogeal reflux disorder (heartburn)" as examples of common complaints that drug companies have reinvented as chronic illnesses requiring lifelong treatment (see http://www.cmaj.ca/cgi/content/full/171/12/1451).

Estrogen Deficiency Syndrome

The marketing of so-called "estrogen deficiency syndrome," which is known as "menopause" in English-speaking countries (other cultures have no word for it) and "hormone replacement therapy (HRT)" has been far more lethal, in view of 30 years of research linking it to reproductive cancers. The number of premature deaths linked to HRT is estimated in the millions. In this case the culprit is a single company, Wyeth, which manufactures Premarin (conjugated estrogens extracted from pregnant mare urine) and Prempro, a combination of estrogen and a second female hormone progesterone.

Although the medical community (and Wyeth) have been aware of links between estrogen replacement and breast, uterine and ovarian cancer since the 1970s, the research was effectively concealed from public view -- until the frightening results of the Women's Health Initiative (WHI) study hit the front page in 2002. Between 1993 and 1995, the National Institutes of Health enrolled 161,809 women in the double blind WHI study. In 2002 the NHI shut down the study, originally scheduled to finish in 2005, when it became clear that the women taking HRT were experiencing a 26% increase in breast cancer (with the risk doubling after five years), a 41% increase in strokes and a 29% increase in heart disease (see http://www.theepochtimes.com/n2/content/view/9804/).

Estrogen, a hormone regulating the development and function of the female reproductive system, was first discovered in 1925. In the 1930s, the drug company Wyeth developed a process (viewed as barbaric by animal rights activists) to extract conjugated estrogens from the urine of pregnant mares. They patented their product as the drug Premarin (PREgnantMAresurINe), which first appeared on the market in 1942.

From the beginning Wyeth marketed Premarin, not for temporary relief of menopausal symptoms, but as a lifelong treatment to help all women maintain "healthy" estrogen levels in later life. Obviously this is nonsense, as a "healthy" or natural estrogen level in a post-menopausal woman is virtually zero.

1975: the First Study Linking Premarin with Cancer

The first study linking Premarin with increased uterine cancer appeared in 1975. It was replicated by other researchers in 1977 and 1979. These results were entirely consistent with the discovery of estrogen receptors in the early seventies and the finding that stimulating these receptors caused tumor growth in tissue culture and laboratory animals.

Wyeth responded to these worrisome studies by promoting a small 1980 study that taking progesterone, a second female hormone, reduced the risk of uterine cancer with estrogen replacement. Unfortunately most doctors fell for Wyeth's slick PR campaign (the free pens, watches, clocks, lunches, trips to overseas conferences may have had something to do with it). They somehow overlooked the failure of 1980 study to look at the cancer rates in women who took no hormone replacement or to study the possible role of this combination in inducing other hormone sensitive cancers, like breast and ovarian cancer. In fact, their success in selling doctors on the combination, led Wyeth to launch Prempro in 1995, which combined Premarin with progesterone.

The earliest studies linking Premarin with breast cancer appeared in early 1980. As Nik Ismail points out in "Hormone Replacement Therapy and Gynaecological Cancers," between 1975 and 1995, there were at least fifty studies linking estrogen replacement (also known as HRT) with breast and uterine cancer. Some were cross cultural studies revealing American women had more than ten times the incidence of breast cancer than Asian women, who don't take estrogen replacement (see http://www.gfmer.ch/Books/bookmp/113.htm).

The Multibillion Dollar Wyeth Cover-up

Wyeth responded to the breast cancer studies with a new PR blitz. In addition to flooding doctors' offices with literature claiming studies linking Premarin to cancer were "contradictory," they promoted numerous company-funded studies allegedly showing that estrogen replacement prevents osteoporosis and hip fractures, dementia and heart disease. The spin Wyeth gave doctors was that the effect of reducing cardiovascular disease (heart disease and strokes) -- the most common cause of death in Americans -- outweighed the somewhat lower risk of developing breast cancer. Ultimately the claim that Premarin and Prempro reduce elderly women's risk of cardiovascular disease proved to be false. In fact this was one of the main reasons the WHI study was stopped: the women in the Premarin/Prempro arm of the study were developing significantly more heart attacks, strokes and dementia.

The role of estrogen replacement in reducing osteoporosis was supported by the WHI and other studies. However thus far, no studies have controlled for long term fluoride ingestion or epidemic Vitamin D deficiency in elderly Americans -- which both have a documented role in high US rates of osteoporosis and hip fracture.

The marketing blitz aimed at doctors was accompanied by an even more powerful PR campaign in Harper's Bazaar, the Ladies Home Journal and other women's magazines, appealing to American women's (largely manufactured) terror of aging by emphasizing the value of estrogen replacement in preserving sexual attractiveness by preventing the skin changes and vaginal drying associated with aging.

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.

Wyeth has yet to win a single lawsuit brought by women (or families of deceased women) who developed reproductive cancers as a result of taking Premarin or Prempro. Moreover there are still active information websites for affected women and/or families who have yet to file suit. If you or a loved one has developed breast, uterine or ovarian cancer as a result of taking Premarin or Prempro click here: http://injury-law.freeadvice.com/drug-toxic_chemicals/prempro-lawsuit.htm

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