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The Greatest Experiment Ever Performed On Women: Exploding the Estrogen Myth    by Barbara Seaman order for
Greatest Experiment Ever Performed On Women
by Barbara Seaman
Order:  USA  Can
Hyperion, 2003 (2003)
Hardcover, Audio

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* * *   Reviewed by Hilary Williamson

Barbara Seaman, author of The Greatest Experiment Ever Performed On Women and cofounder of the National Women's Health Network, has been questioning estrogen medication since the 60s. Her book begins with a totally fascinating historical perspective, which includes a British doctor, Sir Charlie Dodds, who let the estrogen genie out of the bottle (in the form of DES) in 1938 to foil Hitler, and subsequently had frequent cause to regret that decision. Apparently Dodds himself was conservative about the use of estrogen saying 'we still have to proceed with caution on any long-term hormonal treatment of the human female.'

Seaman uses the term experiment in her title because, in her words, the drugs 'have been used, in the main, for what doctors and scientists hope or believe they can do, not for what they know the products can do.' She tells us that between 1941 and 1971, more than four million pregnant women in the United States 'were treated with nonsteroidal synthetic estrogen' to ensure healthy babies! Then came Premarin, which 'soon was to estrogen as Kleenex was to disposable hanky.' She presents the players, from well-intentioned doctors like Dodds, Robert Greenblatt and Fuller Allbright to skilled marketers who pushed 'feminine forever', and dedicated health activists like reporter Madeline Gray. She warns us about 'off-label prescriptions' and substandard processing plants.

It's a depressing story, especially when I remember my own awareness of the issues and concerns about the birth control pill in the 70s, which somehow faded into acceptance of the prevailing point of view on HRT in the 80s and 90s, as life became busier and children's health seemed more important than my own. Indeed Seaman talks of 'similarities between the Pill panic of 1970 and the Prempro panic of 2002', with a rather cynical (but unfortunately believable) view of outcomes. She tells us of the 'triumph of suggestion over science' in prescription of estrogen as a heart disease preventative, and addresses the topic of osteoporosis, which is under 'a long overdue reevaluation'.

Alzheimer's receives attention under a subtitle 'Science by Press Release', with the comment that the connection 'between estrogen and cognitive function ... has been largely undefined and overstated.' And then there is the issue of environmental estrogen - 'agricultural contamination of water and soil' and hormones in livestock (given the validity of the author's previous warnings, I hope more attention will be paid to this one!) The EU banned the import of hormone-treated meat in 1988, but we're still eating it in North America. An Appendix covers menopausal treatment options in fairly technical detail and with an apt comparison of the experience to the 'Journey to Oz'. There is a solid documentation of sources (over 40 pages of notes) at the back.

While The Greatest Experiment Ever Performed On Women is a must read for women concerned about managing their health, it's also an important study of the societal impact of underlying influences on the health system - in particular the momentum of corporate marketing by big drug companies and the foolish desire that we, as patients, have for a magic pill to solve health problems with minimal effort on our own part. After reading this book, I also wonder if more women doctors did research, that perhaps it might avoid the blinkered perspective that feminine forever should take precedence over our long-term health.

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