The FDA has called for more studies. But in lieu of those, all progesterone and estrogen compounds are now labeled with warnings about the newly discovered dangers of HRT. "Wyeth recommends women stay on these drugs for only the shortest amount of time possible," Seaman writes in her book. "New guidelines are released almost daily by the FDA or pharmaceutical companies themselves."
On the basic research front, investigators are scratching their heads. While previous studies in animals showed substantial cardiovascular protection and other positive effects of estrogen, the WHI results say otherwise for women. According to the November 14, 2003, issue of the journal Science, investigators are hunting down reasons for the apparent discrepancy. However, these attempts are slamming up against a wall. Any study involving estrogen and meno-pause carries taint in the current estrogen milieu, and scientists simply can't get funding.
On the corporate side, meanwhile, drug companies haven't given up. In March, Wyeth released a new version of Prempro, its lowest-dose HRT to date, which follows a similar version introduced last year. "These FDA approvals represent important new options for clinicians and women, and the availability of lower dose products will facilitate better individualization of therapy," says Victoria Kusiak, Wyeth's vice-president of Global Medical Affairs and North American medical director, in a company press release.
Although representatives at Wyeth did not respond to repeated attempts at contact for this story, company press releases include the following statement: "Wyeth Pharmaceuticals' low dose hormone therapies are part of a family of well-studied products. Taken by approximately 5 million women in the United States alone, these products are prescribed more often than any other brand of postmenopausal hormone therapy…Premarin and Prempro should be used at the lowest effective dose and for the shortest duration consistent with a woman's treatment goals and risks."
Despite the professed optimism, many doctors and women remain nonplussed, confused, or downright cynical. Some women are turning toward alternatives such as yoga, diet, and herbal supplements to combat symptoms of perimenopause, as well as postmenopausal ills such as heart disease, osteoporosis, and Alzheimer's disease. But these alternatives bear their own risks, says Seaman. Dietary supplements, for example, don't have to go through the same rigor as drugs and may be worthless or even harmful.
Before despairing, Seaman says to get information. She includes a lengthy appendix in her book that spells out everything from the anatomy of Alzheimer's to the pros and cons of licorice as a menopause symptom reliever.
"Perhaps women will be able to demedicalize menopause–take it back as a natural part of life, not as a disease to be rid of," she says. "It is a great triumph to make it through your childbearing years and get your own life back."
This Oberlin alumna certainly has found hers. She now promotes women's health issues by giving talks, appearing on radio and TV, and teaching young women about the women's health movement and their choices. Following the release of her book last summer, she was a sought-after guest on the morning news shows circuit, and in February she made headlines with a controversial article in O, The Oprah Magazine titled "The Terrifying Truth about Fertility Drugs."
Seaman does have her critics–some very vocal–who challenge her lack of formal medical training and her use of anecdotal evidence in her research. To them, she says simply: "Just look at my track record. My reporting has always been a bit ahead of the curve. I keep in touch with the best sources, and then just as the targets of my investigations are trying to rebut me, new evidence in support of my claims appears."
Case in point: in March, the NIH suddenly halted a seven-year study of estrogen use in women with hysterectomies. For years, estrogen therapy alone had not been proven risky for women without a uterus, but research now suggests an increased risk of stroke.
Moreover, just one month earlier, the FDA recommended that HRT labels now warn of an increased risk of dementia–a link that Seaman has been alleging for years. Also in February, while Seaman waded through reader responses to her O Magazine piece, a New York Times article echoed her findings that fertility treatments are spurring a rise in multiple pregnancies, premature births, and ultimately, U.S. infant mortality rates, which rose in 2002 for the first time in 40 years. "This often happens," she says. "Sometimes the best and most simple response to my critics is ‘wait and see.' They may not be waiting very long."
Despite her baby's rocky start back in 1957, Seaman gave birth to an Oberlin legacy. Noah graduated in 1979, followed in 1983 by Seaman's daughter, Shira. Corfman, who married Oberlin classmate Eunice Luccock '50, also a member of the National Women's Health Network, had three sons who attended Oberlin: Stanley '75, Timothy '79, and Lewis '81. Today more than ever, he says, women must inform themselves about their health. Groups such as the NWHN provide a crucial service.