What Wyeth says about HRT
Question:
On Fri, 26 Jun 1998, Karen M. d’Unienville wrote: > I too have never seen or been exposed to hormone-related ads.. I was just sitting > here thinking and wondering how I would react if it was the case. Is it much like > the smoking ads that one sees? > Karen M.d’U
You can get a line by line, image by image critique of a Premarin ad on the website: www.oxford.net/~tishy/ It is found in the "Soap Box" section entitled (not surprisingly) "Critique of a Premarin ad." shellyW
Response:
There are still women who post here saying they will take HRT for the heart benefits. True, it’s their decision to make and all of the information has been put in front of them. Somewhere they have gotten the idea that they need these pills to fight heart disease and no one is going to convince them otherwise. fiona – Hide quoted text — Show quoted text -Grey wrote in message <3593A996.B5D23…@pacbell.net>… >Yes, I’ve seen that, but I don’t see it as any different from ads that >try to convince you a certain car will make you seem younger, yogurt >will make you thin, or toilet paper will make you happy. They are >marketing their product. I think we should give women some credit for >being able to make their own decisions, and I don’t think that an >advertisement is going to make women go out and take pills they don’t >need. It shouldn’t, at any rate. As long as they have the FDA warning >on the ad, I think they have the right to try to market their product. >I have the right to say I don’t think I need it.
Response:
On Fri, 26 Jun 1998, Grey wrote: > Yes, I’ve seen that, but I don’t see it as any different from ads that > try to convince you a certain car will make you seem younger, yogurt > will make you thin, or toilet paper will make you happy.
Yogurt and toilet paper does not have the potential to kill or disfigure you. shellyW
Response:
On 26 Jun 1998, Hypoint wrote: > >>fiona wrote: > >> Ahh, so where do you suppose the idea is coming from that every woman who > >> has a hot flash needs and automatic prescription or that women need to be > >on > >> exogenous estrogen for life?
It came from every single MD where on an updated health history, I mentioned I was having hot flashes. Each of them "automatically" whipped out the prescription pad and said exactly the same thing "We’ll take care of that." And each was shocked when I declined. In looking at my written records, one MD said he told me to take HRT at -every- appointment and noted that I had declined …yet this issue was only raised once. I would say from my discussion with other women, my contact with the medical community and listening to stories on asm for several years, that it is very pervasive in the medical industry to -automatically- offer HRT, and lately to impliedly -threaten- women into taking it predicting dire consequences …now that we are "that age." My standard line is that the aging female population they have been observing was the 65% surgical castrate-Premarin taking generation and they in fact have not been observing the menopausal woman. They look at me blankly, when I tell them that. We really should not even be arguing this heart disease-estrogen issue anymore as the new OBGYN textbooks discredit it and it is slowing getting dropped from the FDA warning labels. The controversial studies only appear on the Premarin labels as I recall, and no mention of heart benefits is even suggested on the estradiol (patch) labels. Dead issue. shellyW
Response:
- Hide quoted text — Show quoted text -Grey wrote: >>Hypoint wrote: >> Have you looked at their ads? >> "My estrogen, now and forever." >> USA today, full page spread. >Yes, I’ve seen that, but I don’t see it as any different from ads that >try to convince you a certain car will make you seem younger, yogurt >will make you thin, or toilet paper will make you happy. They are >marketing their product. I think we should give women some credit for >being able to make their own decisions, and I don’t think that an >advertisement is going to make women go out and take pills they don’t >need. It shouldn’t, at any rate. As long as they have the FDA warning >on the ad, I think they have the right to try to market their product. >I have the right to say I don’t think I need it.
And Shelly and I and others have the right to say: Be careful that these ads are not defining your view of menopause. Wendy hypo…@aol.com
Response:
On 26 Jun 1998 14:42:22 GMT, hypo…@aol.com (Hypoint) wrote: >And Shelly and I and others have the right to say: >Be careful that these ads are not defining your view of menopause.
On a similar note, there is an article on the asm website entitled _What is a disease? Be sure it’s not defined by a drug._ http://www.oxford.net/~tishy/disease.html It uses Viagra and Mevacor as specific examples to make the point, but the principle is easily extrapolable to menopause and its manipulation. — <snip> After Prozac or the diet pill Redux came out, says medical historian Dr. David Rothman, doctors and patients alike changed the way they defined depression and obesity: sickness becomes whatever we think the chemical can treat. <major snip> ———
Response:
Hypoint wrote: > Have you looked at their ads? > "My estrogen, now and forever." > USA today, full page spread.
Yes, I’ve seen that, but I don’t see it as any different from ads that try to convince you a certain car will make you seem younger, yogurt will make you thin, or toilet paper will make you happy. They are marketing their product. I think we should give women some credit for being able to make their own decisions, and I don’t think that an advertisement is going to make women go out and take pills they don’t need. It shouldn’t, at any rate. As long as they have the FDA warning on the ad, I think they have the right to try to market their product. I have the right to say I don’t think I need it.
Response:
Grey made a long and thoughtful posting, to which I’m not entirely doing justice by singling out one paragraph for comment, but time is pressing. She writes: >I have seen the ads and read the critique. My opinion of the ads is >that they look like ads. Whenever you read an advertisement, you should >keep in mind that it is marketing, so of course the company will try to >present itself in the best light possible. I have mixed feelings about >drug companies advertising directly to the consumer…it *is* a source >of information, but I don’t know if it’s one a lot of consumers can >handle, or even care about.
Grey, with respect, I think one of the difficulties is that drug company ads aren’t perceived by ads by many folks. Oh, we know that it’s paid communication, but I suspect that many women think of it more as product information couched in layman’s terms than as the marketing communication — with all the product spin that implies. It’s not in the economic self-interest of the self-described "ethical pharmaceuticals" industry to disabuse the public of that notion, of course, but I do think that some counterweight is required to help consumers recognize the need to read the drug ads with the same "caveat emptor" mentality that they’d bring to, say, the General Foods ad for International Coffee you mention in the next paragraph. While we’re on the subject, it bothers me that an industry that labels itself the ethical pharmaceuticals industry doesn’t have a slightly higher code of ethics for its marketing communications. Regards, vlhb…@aol.com
Response:
On 26 Jun 1998 01:38:02 GMT, vlhb…@aol.com (Vlhb002) wrote: >Right now, it’s a decision each woman has to make with the help of her doctor. >But research is ongoing to find new choices for women who want to stay strong >and vital in the years after menopause. At the Lilly Center for Women’s Health, >we’re monitoring thesituation. For the latest information on postmenopausal >health, call toll-free 1-888-WMN-HLTH. Because there is life after menopause. >—end ad copy– >Regards, >vlhb…@aol.com
Yes, I have seen that one. And it got worse. The latest ad on Evista says: "There’s life after menopause." The letters have become bigger and the sentence is more noticeable. Menopause must be a killer in the U.S. 
Best wishes, Sonja
Response:
Grey wrote: >fiona wrote: >> Ahh, so where do you suppose the idea is coming from that every woman who >> has a hot flash needs and automatic prescription or that women need to be >on >> exogenous estrogen for life? >Well, it’s not coming from the official information Wyeth supplies.
True. It’s coming from the PREMPRO ads. The disconnect between the ad copy the mandated disclosure copy is startling. Regards, vlhb…@aol.com
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- Hide quoted text — Show quoted text ->>fiona wrote: >> Ahh, so where do you suppose the idea is coming from that every woman who >> has a hot flash needs and automatic prescription or that women need to be >on >> exogenous estrogen for life? >Well, it’s not coming from the official information Wyeth supplies. >> Where are all of the future heart benefits and osteo potential benefits >> claims coming from? Apparently not from the drug company! What you have >> read is the information they are required to provide because it is based on >> only the proven safe uses of the product. All of the other uses advocated >> by whomever are ‘offlabel’ and unproven both for long-term safety or >> efficacy. >Exactly. They are required to present this information and it’s a pity >that anyone about to take a medication is not required to read it. The >heart benefit and osteoporosis prevention information is coming from >people who have done research. Whether it is good research and should >be acted upon is still up for grabs. Thus far, research evidence is >inconclusive with regard to estrogen and heart disease. It does seem >that estrogen helps with bone production, but what we don’t know is >whether that is even necessary, why women lose bone after menopause, and >whether the quality of the bone that is produced on HRT is such that it >will prevent fractures. No one knows. The information from Wyeth also >says that the risks of HRT are such that only women who are at risk for >osteoporosis should take HRT for osteoporosis. >Much more adequate research must be done before we can say one way or >the other whether HRT is beneficial or even safe for anything more than >what the manufacturer suggests: Short-term treatment to ease menopausal >discomfort from sudden drops in estrogen, and replacement of estrogen >after surgical menopause.
Grey, Have you looked at their ads? "My estrogen, now and forever." USA today, full page spread. Wendy hypo…@aol.com
Response:
Of course, one of the worst offenders in making claims for hormones was Lilly, as it created a straw man to knock down just before it released whatchamacallit. Here’s some copy from an ad in October 1997 _Prevention_: –verbatim quote of entire ad— [head] If estrogen is the answer, why are there so many questions? [body copy] There’s no question your body makes less natural estrogen after menpause. 80% less, in fact. And because estrogen does some good things for your body, losing it can mean problems. Like rising cholesterol. Estrogen helps keep your cholesterol low. So after menopause, your cholesterol can rise quickly. Left unchecked, high cholesterol can increase your chances of a heart attack or stroke. Losing estrogen can also mean losing bone. That can lead to osteoporosis. And if you think you drink your milk you’re not at risk, think again. In just the 6 years after menopause, a woman can lose up to one-third of the bone mass in her spine. So what’s the answer? Many doctors prescribe estrogen replacements to help keep bones strong and cholesterol low. But estrogen replacements also raise a lot of questions. Many women don’t like estrogen’s potential side effects, which can include irregular bleeding, spotting, bloating, breast tenderness, and migraines. And many women have serious concerns about a possible link between estrogen replacements and cancer. Right now, it’s a decision each woman has to make with the help of her doctor. But research is ongoing to find new choices for women who want to stay strong and vital in the years after menopause. At the Lilly Center for Women’s Health, we’re monitoring thesituation. For the latest information on postmenopausal health, call toll-free 1-888-WMN-HLTH. Because there is life after menopause. —end ad copy– Regards, vlhb…@aol.com
Response:
Grey wrote:
[snip excerpt of PDR from W/A] >This information goes against the idea that all drug companies are out >to lure women into taking unnecessary drugs. I was impressed by the >statement that over 50% of menopausal women do not need HRT, and by the >statement that HRT should really only be used to relieve severe >discomfort, and that its use should be short-term and evaluated every >six months. I was also impressed by the idea that women should research >HRT on their own.
Hang on to that thought, Grey. I’m going to dig out an older (1996 or 1997) Premarin ad, if I can find one, and we can go over that in light of what W/A is writing in a volume targeted to physicians, although available to consumers. Of course, to be a completely accurate comparison, we should probably compare a 1996/97 ad to the PDR for that year — or possibly not, since lead-times for publishing large volumes tend to be longer than those involved in publishing magazines. My recollection of those ads is that they hinted strongly of bone and/or heart benefit. Moroever, I got the "HRT will protect your heart and bones" speech from one internist and two gynecologists in the 1995-1997 period. Someone is putting out that story somewhere for me to get it so regularly. Now, it’s possible that W/A is modifying its stance on the use of these hormones. It’s also possible that W/A has been misinterpreted. It’s also possible that W/A has now convinced a large segment of the medical profession and the general public of the efficacy of these drugs and is backpedaling with caveats to protect against potential future litigation, knowing that the market is already pre-sold. I offer these possibilities as a menu of possibilities, proffering no one over the other at this point. Regards, vlhb…@aol.com
Response:
Here’s part of the Wyeth ad for Premarin, which appears on pp 85-88 of the October 1997 issue of _Prevention_. [In the late 1970s, a full page ad in Prevention cost more than $8,000. I leave it to your imagination what four pages costs in 1997.] [head] Menopause… a time to look ahead [subhead] If you’re in menopause, you could be developing osteoporosis. Relieving your menopausal symptoms can help you feel better and protect your future against osteoporosis. Ask your doctor about PREMPRO. <text> If you’re in menopause, changes are occurring within your body. Changes that not only affect you now but that could significantly affect your future. The hot flashes, night sweats, and vaginal dryness you might be experiencing are a result of your body producing less and less estrogen. Hormone replacement therapy with PREMPRO can relieve those symptoms and help you feel better. <copy head> You may be losing bone mass…right now <text> Menopause also marks the time in your life when, because of estrogen loss, you begin losing bone mass more quickly. In fact, half the bone mass a woman loses is lost in the first 3 to 6 years after menopause begins. For some women, bone loss can lead to osteoporosis, a serious disease affecting one out of every four women over 50. Ask your doctor about risk factors for osteoporosis to help determine if you’re at risk. While calcium, diet, and exercise are important to help maintain bone strngth, they may not be enough to help prevent osteoporosis. For this reason, many doctors prescribe PREMPRO for women who have not had a hysterectomy. <copy head> PREMPRO is low-does hormone replacement therapy, or HRT, and it is the only estrogen-progestin combination available in a single tablet. <text> PREMPRO combines the estrogens in PREMARIN (R) (conjugated estrogens tablet, USP), the estrogen taken by more than 8,000,000 American women, with a progestin…in one convenient tablet. While some women taking PREMPRO may experience menstrual-like bleeding, research has shown that many women who use PREMPRO stop bleeding within one year of use. Women taking PREMPRO may experience an increase in their high-density lipoproteins (HDLs), generally known as "good" cholesterol, although this effect is less than when taking PREMARIN alone. PREMPRO also decreases low-density lipoproteins (LDLs), generall known as "bad" cholesterol. This effect is comparable to Premarin alone. Be sure to talk to yourdoctor about your cholesterol profile. <copy head> Side effects of hormones should be considered. <text snipped for brevity…two paragraphs of copy on progestin decreasing risk of uterine cancer brought about by use of estrogen, progestins’ possible unfavorable effects on blood sugar, which may worsen a diabetic condition, etc.> <copy head> Help protect your future against osteoporosis. Speak to your doctor about the long-term effects of menopause, such as osteoporosis. <text> Today, more women than ever are taking an active role in their own health care. Why not help protect your future against osteoporosis? Speak to your doctor or health care provider. Ask about PREMPRO, the low-dose HRT proven to relieve symptoms of menopause and to help prevent osteoporosis. You’ll feel better. <copy head> Please be sure to read the important information on the following page. —end quoted portion of four-page spread– The following two pages appear to be 5 pt or 6 pt Helvetica light condensed, set solid. I found this interesting paragraph tucked in as "other information" toward the end of the fine print: "Some research has shown that estrogens taken without progestins may protect women against developing heart disease. However, this is not certain. The protection shown may have been caused by the characteristics of the estrogen-treated women and not by the estrogen treatment itself. In general, treated women were slimmer, more physically active, and were less likel to have diabetes than the untreated women. These characterisctics are known to protect against heart disease." I think I’m ready to go back and read the web site critique. I wonder if it’s the same ad? [Grey, you're insulated against these ads in England, aren't you? Possibly this may help explain some of the anger from those of us here in the U.S. who live with this barrage of expensive advertising directed at us.] Regards, vlhb…@aol.com
Response:
Vlhb002 wrote:
<snip> > Hang on to that thought, Grey. I’m going to dig out an older (1996 or 1997) > Premarin ad, if I can find one, and we can go over that in light of what W/A is > writing in a volume targeted to physicians, although available to consumers. Of > course, to be a completely accurate comparison, we should probably compare a > 1996/97 ad to the PDR for that year — or possibly not, since lead-times for > publishing large volumes tend to be longer than those involved in publishing > magazines.
This could be useful, although, to be accurate, we should also look at the available research at that time. If available studies showed heart and bone benefits, then the drug company was not that far off. I think we also have to look at culture. People today are much more likely to question authority than they were back when Premarin was first introduced. My understanding from several sources (and Wyeth includes a similar history in its PDR information) was that when Premarin first came out, it passed its trials and was effective for relief of menopausal symptoms. Then they found out about the increased cancer risk. Then they started testing with progesterone supplements. Then they started using those. After that, they found out the heart stuff wasn’t really such hot stuff. Now, there are questions about the bone issues and even more questions about long-term use of HRT. Unfortunately, people who need treatment get caught between medical need and the best technology available. Look at Prednisone. It has horrific side effects and is just a beastly thing to have to take. Before anti-rejection drugs came out, though, transplant patients were kind of stuck. And, it will save your life if you have a severe allergic reaction or a severe asthma attack. I hate Prednisone…but it kept me off a respirator once. We talk about "snake oil," but there was a time when that was the cutting edge in medical technology. They used to put people with syphilis in mercury vapor chambers…it was all they had at the time. > Now, it’s possible that W/A is modifying its stance on the use of these > hormones. It’s also possible that W/A has been misinterpreted. It’s also > possible that W/A has now convinced a large segment of the medical profession > and the general public of the efficacy of these drugs and is backpedaling with > caveats to protect against potential future litigation, knowing that the market > is already pre-sold. I offer these possibilities as a menu of possibilities, > proffering no one over the other at this point.
Any one or all three could be happening at the same time.
Response:
fiona wrote: > Ahh, so where do you suppose the idea is coming from that every woman who > has a hot flash needs and automatic prescription or that women need to be on > exogenous estrogen for life?
Well, it’s not coming from the official information Wyeth supplies. > Where are all of the future heart benefits and osteo potential benefits > claims coming from? Apparently not from the drug company! What you have > read is the information they are required to provide because it is based on > only the proven safe uses of the product. All of the other uses advocated > by whomever are ‘offlabel’ and unproven both for long-term safety or > efficacy.
Exactly. They are required to present this information and it’s a pity that anyone about to take a medication is not required to read it. The heart benefit and osteoporosis prevention information is coming from people who have done research. Whether it is good research and should be acted upon is still up for grabs. Thus far, research evidence is inconclusive with regard to estrogen and heart disease. It does seem that estrogen helps with bone production, but what we don’t know is whether that is even necessary, why women lose bone after menopause, and whether the quality of the bone that is produced on HRT is such that it will prevent fractures. No one knows. The information from Wyeth also says that the risks of HRT are such that only women who are at risk for osteoporosis should take HRT for osteoporosis. Much more adequate research must be done before we can say one way or the other whether HRT is beneficial or even safe for anything more than what the manufacturer suggests: Short-term treatment to ease menopausal discomfort from sudden drops in estrogen, and replacement of estrogen after surgical menopause.
Response:
> >From: shelly <she…@rain.org> <snip> > > There is no FDA approval for Provera to be used in this capacity. > >HRT is an unauthorized combination of drugs according to the FDA. Provera > >has only a few limited FDA uses, and life long use as an HRT combination > >is not one of them.
From AneeBear: > So? It works for me. Its my choice, my decision. But thanks for the textbook > information. I appreciate it. 
)
<snip> Many people are confused about what FDA approval means. When a pharmaceutical company applies for FDA approval, it must submit a purpose for the drug and the drug must have been tested for safety. Although the FDA grants approval under that application, after a drug is approved physicians may prescribe it as they see fit. There is no such thing as "unauthorized" prescribing, although the FDA does monitor prescription patterns for narcotics. A non-meno related example is medication such as Tegretol. It has been approved for use in seizure disorders. However, it has also been discovered through research that Tegretol helps control aggression, mood swings, and is useful in difficult depressions that don’t respond to the usual depression medications, as well as in treating bipolar disorder. None of these uses is the one that the medication was originally approved for, but that doesn’t keep physicians from prescribing it for these problems. Another example is Rogaine, originally approved as a hypertension medication. It was later used for one of its side effects–it grows hair in some people. Once a medicaton is approved, research often determines how it will be used. Some pharmacological trivia…this process is how we got antidepressants. It was discovered that some medications used to treat lung ailments (and approved for that only) helped some patients’ depression. Doctors started prescribing them for lung ailments. This later led to study to find drugs that were in and of themselves antidepressants.
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droz…@direct.ca wrote:
<snip> >I think you will notice that the piece you read also says a > heart benefit is not yet proven?
Yes, I think I noted that. The studies that show a heart benefit are methodologically flawed…I think one didn’t have an adequate control group and some didn’t have enough subjects to get a statistically significant result. > I live in Canada and we do not allow drug advertising either, but I do > read American magazines and see the ad copy for these drugs the > required tiny, tiny print with the ads provides the similiar factual > information found in the PDR. The ad itself does not outright > contradict the facts, but it does give the warm fuzzy impression that > HRT is good for you. Have you read the print copy in some of these > ads? > If not take a look at a critque of a premarin ad on tishy’s webpage.
<snip> I have seen the ads and read the critique. My opinion of the ads is that they look like ads. Whenever you read an advertisement, you should keep in mind that it is marketing, so of course the company will try to present itself in the best light possible. I have mixed feelings about drug companies advertising directly to the consumer…it *is* a source of information, but I don’t know if it’s one a lot of consumers can handle, or even care about. As a comparison, General Foods International Coffee is advertised in some of the same magazines. The advertisement depicts a relaxing time with the product. However, the product, coffee, is a stimulant. The regular ones are high in fat and useless calories, and coffee has been implicated in fibrocystic breast disease. The low-calorie ones have the added bonus of aspartame, which has been implicated in all sorts of medical problems. Coffee companies don’t have to have a product warning, either. Their ad presents their product in the best light possible; it’s up to the consumer to be informed. I’m not under a magic spell when I look at one of these ads…I know it’s an ad, so it should be taken with a grain of salt. Of course, anyone spending money on an advertisement in a major magazine is hoping you will use their product. > Here is some sample text to compare to the PDR. "Three years ago my > doctor and I agreed that taking PREMARIN was right for me. I’ve been > taking it ever since, with my doctor’s approval. I feel wonderful > …my menopausal symptoms are gone and I know I am helping to prevent > osteoporosis and protect my future. Taking PREMARIN is part of my > daily future." > So really the drug companies are hoping that doctors and other > professionals will < lure women into taking unnecessary drugs>
I think they are just marketing their product the best way they can. The ad copy is not misleading; Premarin has been shown to relieve menopausal symptoms and it does prevent osteoporosis. We just don’t know if osteoporosis prevented with estrogen will prevent fractures. All advertisers make exaggerated claims…look at an ad for a health club sometime. I don’t have *any* misconceptions that I’m going to look like the people in those ads no matter how hard I work out. But, having the Pillsbury doughboy and the Michelin man promoting your health club won’t get you too many memberships. And, speaking of Michelin…does anyone *really* believe that their tires are any safer than any other company’s tires? There’s a road standard for tires and they all have to meet it. > As a result W/A gave a sizeable grant to the AHA last year to educate > women about heart disease. > In Canada Lilly contributed to an educational advertisment <about > menopause> allowed because no products were mentioned.This came out > just before raloxifene was approved.
Where I work, we were awarded a grant from Toyota. We bought a fleet of Chevrolets, however. I have a Domino’s Pizza sticker on my refrigerator, but when I want pizza, I usually call someplace else. I have a Zoloft pen, but I really think Prozac is a better antidepressant. I have a Motorola notepad…but I have another company’s beeper and cell phone. All companies make donations and do things to promote themselves. The choice to use them is up to the consumer. Is it influence? Sure it is. That’s why it’s important to keep informed. As my mother used to say, "If everyone else went and jumped off a cliff, and said you should do it, would you do it, too?" > The Society of Obstetricians and Gynecologistis of Canada are going to > produce a brochure <Hormone Replacement Therapy: An Update> to be > released this coming October. I have no idea if any drug company is > contributing to the cost, I just have my suspicions and will check > when it becomes available. > [The information about the brochure is from a local newspaper > interview with Dr. John Collins who was speaking for the society. He > stated that [quote from the article] "85 to 90 % of women eligible > for hormone therapy avoid it. The society hopes that its new > information, which will be available in brochure form by October, will > change their minds.]
This is true, though. 85% of women prescribed HRT don’t take it. Very few women continue with HRT after the first year. I think the definitive term here is, "eligible." Apparently, the definition of that varies widely from anyone with a case of the blues to cancer patients who have prematurely had their gonads removed. I hope this brochure will actually be something useful and unbiased that women can use to make an informed choice about HRT. > I don’t think the drug companies are out to mislead Grey, but they do > have an understandable bias. And we need to be wary of our information > sources about menopause or HRT.
Yes, this is true. You know, I brought the PDR information home and updated my SO, who observed, "Well, I think anyone who takes a medicine without looking up the product information is an idiot. I never take anything without looking it up in the PDR." He tends to be a bit more blunt than I. A few years ago, I was prescribed Naprosyn for a very bad knee. I was scheduled for arthroscopy but the Naprosyn was supposed to control swelling and pain until the surgery. I read the product information, and the side effects included damage to the stomach and kidneys. The product did not really relieve my pain and I didn’t notice any reduction in swelling. I decided that the benefits were not worth the risks and stopped taking it. I told my doctor that, too, next time I saw him. This is consumer choice and consumer power. Ironically, after doing quite a bit of research on HRT recently, including searching Medline for osteoporosis and heart disease studies, and reading a variety of viewpoints on HRT and alternatives from Wiccan rituals to acupuncture, I decided it’s not for me, at least at this time. My biggest influence in this decision was the product information. I don’t have enough difficulty to justify the risks, even if it does prevent heart disease I’m not in a risk group for that, and I have strong bones and I also make sure to get enough calcium and weight-bearing exercise, which have been shown to be effective in preventing osteoporosis. If I have a really difficult time, I can take an herbal remedy that works for me.
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- Hide quoted text — Show quoted text ->From: shelly <she…@rain.org> >Date: Thu, Jun 25, 1998 15:49 EDT >On 25 Jun 1998, Anee Bear wrote: >> >From: Grey <Astra…@pacbell.net> >> >Date: Thu, Jun 25, 1998 01:08 EDT >> >The information goes on to say that estrogen should be balanced with >> >progesterone for women with uteri, and that HRT does not work to relieve >> >anxiety or to keep skin looking young. >> Hey, that’s what I am doing. Provera and Climara. ) Hmmm…. >> Anee:) > Because the Climera causes the uterine cancer, so you have to >layer another drug on top of the estrogen to hopefully counteract this >cancerous stimulation. But the drug insert says there needs to be further >research on this as it is no guarantee. Take one drug known now to cause >cancer in the uterus, and then have to add another drug on top of it to >try and stop it. > There is no FDA approval for Provera to be used in this capacity. >HRT is an unauthorized combination of drugs according to the FDA. Provera >has only a few limited FDA uses, and life long use as an HRT combination >is not one of them. >shellyW
So? It works for me. Its my choice, my decision. But thanks for the textbook information. I appreciate it. ) By the way, is this a hobby of yours? I mean researching HRT and menopause. Just curious. It occured to me that you must have a really large library of textbooks, the way you recite them. Do you have them memorized? Sorry, guess I am being obnoxious again, aren’t I? 
Anee:) "Sex is no one’s business except the three people involved."
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On Wed, 24 Jun 1998, Grey wrote: > I wanted to see for myself if drug companies purposely mislead women > about the benefits and effects of HRT. I was interested in finding out > if drug companies really do advocate women taking unsafe amounts of > unnecessary hormones just to make money.
We noticed this same thing when comparing their drug advertisement imagery and the official FDA approved information about the product they are also required to state. For a thorough analysis of the mixed messages they are sending women, please read the "Critique of a Premarin Ad" found on the website for this newsgroup. Since you do not live in a country where public drug ads are allowed, you will have to use your imagination to see the imagery described in the critique. But anyone living in the US has seen plenty of these ads by now in the popular magazines. In "The Menopause Industry" by New Zealand journalist Sandra Coney, are copies of actual drug company ads for medical journals showing the visual evolution of the "menopausal woman" over the past several years. As they say, in advertising, a picture is worth a thousand words. Glad you got to read the words, and thank you for printing them, but I hope also you get a chance now to see their very conflicting "pictures" and their contradictory ad copy. shellyW
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On 25 Jun 1998, Anee Bear wrote: > >From: Grey <Astra…@pacbell.net> > >Date: Thu, Jun 25, 1998 01:08 EDT > >The information goes on to say that estrogen should be balanced with > >progesterone for women with uteri, and that HRT does not work to relieve > >anxiety or to keep skin looking young. > Hey, that’s what I am doing. Provera and Climara. ) Hmmm…. > Anee:)
Because the Climera causes the uterine cancer, so you have to layer another drug on top of the estrogen to hopefully counteract this cancerous stimulation. But the drug insert says there needs to be further research on this as it is no guarantee. Take one drug known now to cause cancer in the uterus, and then have to add another drug on top of it to try and stop it. There is no FDA approval for Provera to be used in this capacity. HRT is an unauthorized combination of drugs according to the FDA. Provera has only a few limited FDA uses, and life long use as an HRT combination is not one of them. shellyW
Response:
I wanted to see for myself if drug companies purposely mislead women about the benefits and effects of HRT. I was interested in finding out if drug companies really do advocate women taking unsafe amounts of unnecessary hormones just to make money. Here is the information on Premarin provided by Wyeth-Ayerst Laboratories (makers of Premarin, Prempro, etc.) to the Physicians’ Desk Reference for 1998. This quote is excerpted from the information for Premarin. I found it quite surprising; you may as well. This quote is from page 3110, from the section, "Information for the Patient–Estrogens in the Menopause." Remember, this is a pharmaceutical company talking: "In the natural course of their lives, all women eventually experience a decrease in estrogen production. This usually occurs between the ages of 45 and 55, but may occur earlier or later. Sometimes the ovaries may need to be removed before natural menopause by an operation, producing a ’surgical menopause.’ When the amount of estrogen in the blood begins to decrease, many women may develop typical symptoms: feelings of warmth in the face, neck, and chest, or sudden intense episodes of heat and sweating throughout the body (called, "hot flashes" or "hot flushes"). These symptoms are sometimes very uncomfortable. Some women may also develop changes in the vagina (called, ‘atrophic vaginitis) that cause discomfort, especially during and after intercourse. Estrogens can be prescribed to treat these symptoms of the menopause. It is estimated that considerably more than half of all women undergoing menopause will have only mild symptoms or no symptoms at all, and, therefore, do not need estrogens. Other women may need estrogens for a few months, while their bodies adjust to lower estrogen levels. Sometimes the need will be for periods longer than six months. In an attempt to avoid overstimulation of the uterus (womb), extrogens are usually given cyclically furing each month of use, such as three weeks of pills followed by one week without pills." The information goes on to say that estrogen should be balanced with progesterone for women with uteri, and that HRT does not work to relieve anxiety or to keep skin looking young. Six-month re-evaluations are suggested, with the idea that HRT be short term treatment for discomfort. It also advises patients to seek information from other sources and states that this information is not complete. There are also lengthy sections dealing with contraindications and risks. This information goes against the idea that all drug companies are out to lure women into taking unnecessary drugs. I was impressed by the statement that over 50% of menopausal women do not need HRT, and by the statement that HRT should really only be used to relieve severe discomfort, and that its use should be short-term and evaluated every six months. I was also impressed by the idea that women should research HRT on their own.
Response:
Ahh, so where do you suppose the idea is coming from that every woman who has a hot flash needs and automatic prescription or that women need to be on exogenous estrogen for life? Where are all of the future heart benefits and osteo potential benefits claims coming from? Apparently not from the drug company! What you have read is the information they are required to provide because it is based on only the proven safe uses of the product. All of the other uses advocated by whomever are ‘offlabel’ and unproven both for long-term safety or efficacy. fiona Grey wrote in message <3591DB5B.AAF5B…@pacbell.net>…
<<snip>> – Hide quoted text — Show quoted text ->This information goes against the idea that all drug companies are out >to lure women into taking unnecessary drugs. I was impressed by the >statement that over 50% of menopausal women do not need HRT, and by the >statement that HRT should really only be used to relieve severe >discomfort, and that its use should be short-term and evaluated every >six months. I was also impressed by the idea that women should research >HRT on their own.
Response:
>From: Grey <Astra…@pacbell.net> >Date: Thu, Jun 25, 1998 01:08 EDT >The information goes on to say that estrogen should be balanced with >progesterone for women with uteri, and that HRT does not work to relieve >anxiety or to keep skin looking young.
Hey, that’s what I am doing. Provera and Climara. ) Hmmm…. Anee:) "Sex is no one’s business except the three people involved."
Response:
On Wed, 24 Jun 1998 22:08:43 -0700, Grey <Astra…@pacbell.net> wrote:
<full snipped quote copied at end> >This information goes against the idea that all drug companies are out >to lure women into taking unnecessary drugs. I was impressed by the >statement that over 50% of menopausal women do not need HRT, and by the >statement that HRT should really only be used to relieve severe >discomfort, and that its use should be short-term and evaluated every >six months. I was also impressed by the idea that women should research >HRT on their own.
Good question Grey. (We’ve discussed this information before and this is why some on asm keep saying read the drug insert over and over again. I think you will notice that the piece you read also says a heart benefit is not yet proven? I live in Canada and we do not allow drug advertising either, but I do read American magazines and see the ad copy for these drugs the required tiny, tiny print with the ads provides the similiar factual information found in the PDR. The ad itself does not outright contradict the facts, but it does give the warm fuzzy impression that HRT is good for you. Have you read the print copy in some of these ads? If not take a look at a critque of a premarin ad on tishy’s webpage. http://www.oxford.net/~tishy/premarinad.html Here is some sample text to compare to the PDR. "Three years ago my doctor and I agreed that taking PREMARIN was right for me. I’ve been taking it ever since, with my doctor’s approval. I feel wonderful …my menopausal symptoms are gone and I know I am helping to prevent osteoporosis and protect my future. Taking PREMARIN is part of my daily future." So really the drug companies are hoping that doctors and other professionals will < lure women into taking unnecessary drugs> As a result W/A gave a sizeable grant to the AHA last year to educate women about heart disease. In Canada Lilly contributed to an educational advertisment <about menopause> allowed because no products were mentioned.This came out just before raloxifene was approved. The Society of Obstetricians and Gynecologistis of Canada are going to produce a brochure <Hormone Replacement Therapy: An Update> to be released this coming October. I have no idea if any drug company is contributing to the cost, I just have my suspicions and will check when it becomes available. [The information about the brochure is from a local newspaper interview with Dr. John Collins who was speaking for the society. He stated that [quote from the article] "85 to 90 % of women eligible for hormone therapy avoid it. The society hopes that its new information, which will be available in brochure form by October, will change their minds.] I don’t think the drug companies are out to mislead Grey, but they do have an understandable bias. And we need to be wary of our information sources about menopause or HRT. Thank you for copying this out again for us to see. Kathryn droz…@direct.ca – Hide quoted text — Show quoted text ->I wanted to see for myself if drug companies purposely mislead women >about the benefits and effects of HRT. I was interested in finding out >if drug companies really do advocate women taking unsafe amounts of >unnecessary hormones just to make money. >Here is the information on Premarin provided by Wyeth-Ayerst >Laboratories (makers of Premarin, Prempro, etc.) to the Physicians’ Desk >Reference for 1998. This quote is excerpted from the information for >Premarin. I found it quite surprising; you may as well. >This quote is from page 3110, from the section, "Information for the >Patient–Estrogens in the Menopause." Remember, this is a >pharmaceutical company talking: >"In the natural course of their lives, all women eventually experience a >decrease in estrogen production. This usually occurs between the ages >of 45 and 55, but may occur earlier or later. Sometimes the ovaries may >need to be removed before natural menopause by an operation, producing >a ’surgical menopause.’ >When the amount of estrogen in the blood begins to decrease, many women >may develop typical symptoms: feelings of warmth in the face, neck, and >chest, or sudden intense episodes of heat and sweating throughout the >body (called, "hot flashes" or "hot flushes"). These symptoms are >sometimes very uncomfortable. Some women may also develop changes in >the vagina (called, ‘atrophic vaginitis) that cause discomfort, >especially during and after intercourse. Estrogens can be prescribed to >treat these symptoms of the menopause. It is estimated that >considerably more than half of all women undergoing menopause will have >only mild symptoms or no symptoms at all, and, therefore, do not need >estrogens. Other women may need estrogens for a few months, while their >bodies adjust to lower estrogen levels. Sometimes the need will be for >periods longer than six months. In an attempt to avoid overstimulation >of the uterus (womb), extrogens are usually given cyclically furing each >month of use, such as three weeks of pills followed by one week without >pills." >The information goes on to say that estrogen should be balanced with >progesterone for women with uteri, and that HRT does not work to relieve >anxiety or to keep skin looking young. Six-month re-evaluations are >suggested, with the idea that HRT be short term treatment for >discomfort. It also advises patients to seek information from other >sources and states that this information is not complete. There are also >lengthy sections dealing with contraindications and risks. >This information goes against the idea that all drug companies are out >to lure women into taking unnecessary drugs. I was impressed by the >statement that over 50% of menopausal women do not need HRT, and by the >statement that HRT should really only be used to relieve severe >discomfort, and that its use should be short-term and evaluated every >six months. I was also impressed by the idea that women should research >HRT on their own.
Response:
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