April 14, 2003
In June 2002, a large, randomized study of a synthetic estrogen was stopped early because the risks to the postmenopausal women involved were outweighing the benefits, and many women who had been taking estrogen for years were left confused and angry. Seaman, a veteran women's health journalist (The Doctor's Case Against the Pill; Women and the Crisis in Sex Hormones), reminds readers that these findings are just the latest twist in the long and fascinating history of estrogen therapy. In Part I, Seaman offers a somewhat meandering explanation of how the estrogen drug Premarin was developed in the 1930s and then broadly marketed and prescribed to treat menopausal symptoms for the next five decades, despite the known increased risk of endometrial and breast cancer. She describes the historical roles played by different researchers, government officials and activists, and draws parallels to the Senate hearings about the birth control pill that led to prescription drug warnings for patients. In Part II, Seaman reviews the data on estrogen therapy and reveals how it was prematurely promoted to protect against heart disease and Alzheimer's; this section sometimes veers off-topic by delving into, for example, tai chi as an alternative risk reduction measure for osteoporosis. This sprawling book concludes with a chapter on environmental estrogens and an appendix on practical information on menopausal women's treatment options, including other hormone supplements. Seaman passionately and convincingly argues that women have been unnecessarily put at risk by doctors treating menopause as a disease, but a more tightly focused book would have made her case much stronger.