I want to learn more about why older feminists were against hormone replacement therapy for menopause; can anyone point me in the right direction?

submitted by MaleFriedanFan from self.GenderCritical

Maybe an oddly specific request. I was reading one of Betty Friedan's less popular books, "The Fountain of Age", and while I can understand why it is less popular, one thing that I found really interesting was her description of the resistance against hormone replacement therapy for menopause among older feminists when the book was written.

They felt (if I am understanding correctly) that even though HRT was argued to be scientific, that it was using the same sort of commercial-based fear tactics that inspired older women to get face-lifts or breast implants, based on the old idea that they had fought so hard against in earlier years, that a woman was no more than the sum of her femininity. They felt that there were alternate solutions to the problems that HRT claimed to solve that deserved consideration.

I feel like if I can understand this old fight better, it will give me a better understanding over the present-day hormone fights involving trans identity, but I don't really know where to look.

Does anyone have any advice?

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[–]MarkTwainiac 13 insightful - 1 fun13 insightful - 0 fun14 insightful - 1 fun -  (2 children)

What was Friedan's position on HRT? I didn't read that book.

And can you be clearer by what you mean as "older feminists when the book was written"? Her book was published in 1993, so what are the birth dates/decades (generally speaking) of the women she supposedly was referring to at that time? (Friedan herself was born in 1921, so would have been 72 then. Was she speaking of women her own age, or older - or a range of ages?)

Far more influential at the time, IIRC, was Gail Sheehy's "The Silent Passage," a big best-seller in 1992. I recall Sheehy being a proponent of Big Pharma-produced HRT and doing everything else one can to stay young, slim and conventionally sexy-looking. But I might be misremembering.

Also probably more influential, and reflective of of counter-culture ideas in the 1980s and 90s, were books like Christiane Northrup's "Women's Bodies, Women's Wisdom," published in 1994. Northrup was one of the advocates of "bio-identical" and plant-based hormones and a generally more natural approach to aging.

Some of the many reasons a lot of women were so turned off to Big Pharma-produced HRT included horror over how it was made, the lack of research and evidence about dosing, and the history of the medical profession's routine pooh-poohing of women's complaints about both our health problems and the various accepted "remedies" we were given for them.

Today, people seem much more willing to trust Big Pharma and to put faith in drug interventions and "magic pills," particularly hormones, than in previous generations. In the 60s, 70s and 80s, there was a lot of recreational drug use, but skepticism about Big Pharma. And psychopharmacologists were few and far between. Back then, talk therapy and behavior change were seen as the cure for psychic distress, not taking drugs.

That seems to have changed around the time Prozac (first introduced 1989/90) and the other SSRIs, benzos, ADHD drugs and Ambien all came on the market, along with other so-called "miracle drugs" that have turned out to have terrible effects, such as proton pump inhibitors for GI distress, statins, and the quinolone class of antibiotics. Suddenly, shrinks who in the past would do psychoanalysis or CBT and spend their careers listening to patients for a 50-minute hour at a time were seeing patients in 15 minute intervals and furiously writing scrips - ka ching! And as the idea took hold that mental illnesses like depression and anxiety were merely a matter of the wrong brain chemistry, suddenly psychopharmacology was the hot new field. Lots of books have been written about this.

What finally turned the tide and helped make seemingly all of society fall for Big Pharma snake oil, especially in the US, were the AIDS cocktails that worked, and then PrEP. And of course Oxycontin and the opioids.

Many women of my generation (Boomer) had very bad experiences with the first generation of hormonal BC pills, which in their initial incarnation and formulation were much stronger than today. What's more, in the 60s, 70s and 80s the scandals of Thalidomide, DES, "diet pills" like dexedrine, Valium, Qualuudes were still pretty fresh in people's minds - these were things most people could remember, not ancient history they/we only read about. In fact, many were unfolding back then - happening as we watched. If I recall correctly, the Halcion scandal was circa 1992.

Also, women of older generations fought against the medical establishment to make labor and childbirth more woman-centered and woman-directed. Many championed natural childbirth in which all drugs and interventions like episiotomies were eschewed. The 60s and 70s were also a time when health foods became a thing, yet lots of people smoked cigs and dope and did recreational drugs. So there was a lot of ambivalence and a lot of hewing to contradictory beliefs back then, just as today.

But what really changed things, and fast, regarding HRT for menopause was the massive longterm study whose results were published in 2002 that showed the health risks of Big Pharma HRT for women. Overnight, no responsible ob-gyn, GP or endocrinologist would prescribe the stuff for menopause any more.

Even today, HRT for menopause is prescribed in very low doses for very brief periods. Which has screwed a lot of women who entered menopause around that time and since then, and has also screwed women who had to have their ovaries removed for health reasons prior to menopause.

I personally would like to take estrogen now coz of some genuine health problems like frequent UTIs and pelvic pain due to vaginal atrophy. So would a number of my friends. But most physicians won't prescribe it for ordinary women with such issues due to being past menopause any more.

If I were a man who claimed to be a woman, however, I could easily get estrogen - and in high doses too. Just as I could if I went to a trans-affirmative doctor and said my issues were from taking exogenous testosterone for years like Buck Angel. Which is one of the many reasons I am so fucking pissed off at this stage of my life!

This article from 2009 offers some background about what women used to be told about HRT that might explain why so much skepticism towards it developed:

https://www.nytimes.com/2009/12/13/business/13drug.html

[–]BrendaFricker 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (0 children)

Thank you for this in-depth comment, very interesting!

[–]MaleFriedanFan[S] 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (0 children)

Sorry for the delay, I took a short internet break. I wouldn't feel comfortable speaking for Betty Friedan, so I can only point back to her own words.

Older feminists were those who the process was being marketed to; those who had experienced menopause.

Thank you for the suggestions and context -- I really appreciate the advice.

[–]BEB 9 insightful - 1 fun9 insightful - 0 fun10 insightful - 1 fun -  (0 children)

Don't know about Friedan, but for many women now it seems to be the health risks involved in HRT. Although I have a friend whose doctor claimed that the benefits for her outweighed the risks. No idea why.

[–]our_team_is_winning 8 insightful - 1 fun8 insightful - 0 fun9 insightful - 1 fun -  (0 children)

My mother's (female) doctor some years ago told her I would NEVER put you on Pregnant Mare Urine (Premarin had such an innocent sounding name) but then said the new ones were better. My mother has terrible hot flashes and tried the black cohosh and that sort of natural route -- no help at all. The cancer risk is scary.

Having said that, I have a friend in her 40s who had to have a hysterectomy due to cancer, and she has to wear a hormone patch now. Not sure how that will interact with her history of cancer.

The whole reason my mom considered it was that she is just dripping wet most of the time with hot flashes and this has gone on for decades now (she had to have a hysterectomy early 40s for massive fibroids but she kept her ovaries.)

(edit) PS: Neither my mother nor my friend are what I would call feminists -- I was just saying for my mom it wasn't about being "feminine" but about suffering daily dripping wet with hot flashes, but then she still didn't get the hormones for fear of cancer.

[–]GConly 7 insightful - 1 fun7 insightful - 0 fun8 insightful - 1 fun -  (0 children)

I think it's something to do with conforming to patriarchal beauty standards (which require youth).

Most of the research suggesting HRT caused issues were looking at non bio identical hormones taken orally. Premarin was not the same kind of estrogen our bodies make.

One you get away from that, the health risks are pretty minor. As in 'the breast cancer risk is lower than if you are fat.'

Yes I'm on HRT (perimenopause) because I'm buggered without progesterone. I use topical bioidentical, because the oral pill does not agree with me.

I also use estriol.. massively improves my circulation.

[–]itsnotaboutewe 7 insightful - 1 fun7 insightful - 0 fun8 insightful - 1 fun -  (4 children)

There was a lot of resistance to HRT when my mother was going through menopause because many women wanted to be 'natural' women and go through the stages of life that nature intended. It was seen as a weakness if you didn't tough it out without HRT so many women took it without telling anyone. It was never seen as an aid to staying youthful in my country but it did have the reputation of increasing sex drive so men would joke about their suddenly horny wives, which was another reason women didn't like to admit they were taking it.

In a couple of weeks I will be having a hysterectomy and I expect to be on HRT for the rest of my life. I feel the benefits far outweigh the risks and there is now no stigma attached to taking this medication that can help relieve so many terrible symptoms.

[–]MarkTwainiac 6 insightful - 1 fun6 insightful - 0 fun7 insightful - 1 fun -  (3 children)

When was your mother born? Attitudes - and the propaganda we were fed about this - vary enormously depending on one's age.

Good luck with your hysterectomy! I had a hysterectomy and oophorectomy in my 40s in the late 1990s. Afterwards, I was on Estratest, a combo of estrogen and testosterone that supposedly mimics what the ovaries make. But once the big study came out in 2002, my doctors made me go off it - and orgs like the USA's National Women's Health Network lobbied to have it taken off the market:

https://www.ourbodiesourselves.org/2006/09/popular-drug-to-treat-menopause-symptoms-lack/

BTW, I hope that as you age you will consider periodically re-assessing your present-day expectation to be on HRT the rest of your life. Depending on what country you live in, you will probably live to 85 or 90. Using drugs to try to maintain pre-menopausal hormone levels until such age might not turn out the be the best thing for you physically or mentally. Also, not everyone would describe the symptoms of diminishing or absent estrogen to be "terrible." For some, it's liberating.

I also hope your surgeon gave you the option of doing your hysto vaginally. And that you've discovered https://www.hystersisters.com/

Again, good luck! Hope it goes well. Best wishes to you.

[–]itsnotaboutewe 5 insightful - 1 fun5 insightful - 0 fun6 insightful - 1 fun -  (2 children)

My mother was born in 1933 in Sydney. She had a hysterectomy in her late 30's but kept her ovaries. She had very bad hot flashes and profuse sweating starting at around 40 but HRT was not on her radar even though menopause symptoms were not a good professional look and she suffered in her work because of them. I watched what she went through and it wasn't pretty. She died of cancer at 58 (the age I am at now) and as far as I know she was over menopause by then. She certainly didn't have flashes in her last couple of years.

Thanks for the links, they will be very helpful. I will be having a full hysterectomy including bilateral oophorectomy. The bowel cancer that I have genes for is linked with ovarian cancer so everything has to go. I have been opened up from hip to hip twice already so the surgeon is going over the same scars rather than creating a new one. I have problems with my joints which HRT should relieve to some extent as I can't take Celebrex or similar medications.

In March I was 10 days away from my surgery when all elective surgery was cancelled due to covid and it is only now that I have made it to the top of the list again. My surgeon is actually in Antarctica for a year so his colleague is slowly going through his list for him while he is away. He missed the entire pandemic by being on the only continent without coronavirus.

[–]MarkTwainiac 4 insightful - 1 fun4 insightful - 0 fun5 insightful - 1 fun -  (1 child)

Good luck! I hope it goes well. So glad they can use the same scars. And it's probably a good thing you can't take Celebrex and similar - they are awful drugs. As is so much of what Big Pharma manufactures.

Sorry for your mother's early death. My mother died of cancer at nearly the same age (57), and one of my older sisters died of it at 47. I've found it weird and disorientating to live beyond the age my mother died.

If you're 58, haven't you gone through menopause already? And it sounds like you're already on HRT, and have been for some time? I hope after your surgery, you'll post about it and your experience with HRT.

Again, good luck and best wishes.

[–]itsnotaboutewe 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (0 children)

I was on HRT for 5 years but had to go off it due to fibroids, polyps, and cysts. I no longer menstruate but I have been having very bad sweats and temperature fluctuations for at least 15 years except for the time I was on HRT. I have just lived through my second Tasmanian winter wearing just a t-shirt with a ski-jacket and no other layers because several times a day I have to throw off the jacket to cool down. I have to drive in a t-shirt with the heater on and then wind down the windows every 15 minutes to cool down and de-fog the inside of the windscreen. It is a ridiculous way to live.

I will definitely post about my experiences after my surgery. I am just waiting for the phone call that finally puts me out of my misery.

[–]MonstrousRegiment 6 insightful - 1 fun6 insightful - 0 fun7 insightful - 1 fun -  (0 children)

Take a look at this extremely unfeminist sales pitch for HRT from 1968.

It's a shameless pitch for women to be "feminine" (i.e. subordinated and sexualized) their whole lives with the aid of doses of hormones.

[–]jelliknight 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (1 child)

You're right there are many parallels here.

As far as I know, hormone replacement therapy was a completely untested assumption. The assumption being that women's bodies are "broken" when they stop being fertile and they need to be "fixed" with artificial hormones. This has actually been a default assumption throughout medical history, that women's bodies need constant "fixing", my favorite quote on the topic is that the doctors behave "as if god didn't know how to make a woman properly."

It was also related to the fixation on youth and youthfulness and achieving that through artificial means, as if we could 'pause' the aging process. You could think of HRT as "menopause blockers".

[–][deleted] 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (0 children)

I'm on BHRT, because my hormones apparently fell through the floor before menopause even started. I had/have pain in my vagina and urinary tract because the estrogen-sensitive tissues were atrophying rapidly. You can also completely lose your external clit from the same tissue atrophy process. I thought something like that would be a long, slow change to which I could adjust – nope, it happened within a few months. I wish hormones were more simple and clear-cut and also wish doctors knew more about menopausal changes. Note that HRT doesn't usually replace hormone levels to the same levels as those in years of peak fertility, it aims to alleviate symptoms at the lowest possible dose. What I'm saying here – it's not so black-and-white.