The Estrogen Elixir: A History of Hormone Replacement Therapy in America [Hardcover]

Elizabeth Siegel Watkins (Author)

Book Description

ISBN-10: 0801886023 | ISBN-13: 978-0801886027 | Publication Date: March 6, 2007 | Edition: 1

In the first complete history of hormone replacement therapy (HRT), Elizabeth Siegel Watkins illuminates the complex and changing relationship between the medical treatment of menopause and cultural conceptions of aging.

Describing the development, spread, and shifting role of HRT in America from the early twentieth century to the present, Watkins explores how the interplay between science and society shaped the dissemination and reception of HRT and how the medicalization—and subsequent efforts toward the demedicalization—of menopause and aging affected the role of estrogen as a medical therapy. Telling the story from multiple perspectives—physicians, pharmaceutical manufacturers, government regulators, feminist health activists, and the media, as well as women as patients and consumers—she reveals the striking parallels between estrogen’s history as a medical therapy and broad shifts in the role of medicine in an aging society.

Today, information about HRT is almost always accompanied by a laundry list of health risks. While physicians and pharmaceutical companies have striven to develop the safest possible treatment for the symptoms of menopause and aging, many specialists question whether HRT should be prescribed at all. Drawing from a wide range of scholarly research, archival records, and interviews, The Estrogen Elixir provides valuable historical context for one of the most pressing debates in contemporary medicine.

Editorial Reviews

Review

This is an excellent book, and one I would heartily recommend to anyone with an interest in the history of the health sciences or the history of the women's movement.

(Doody's Review Service 2007)

Much has been written about post-menopausal estrogen therapy... This wonderful book tells the story.

(Elizabeth Barrett-Connor, M.D. New England Journal of Medicine 2007)

A good read.

(Wulf H. Utian Journal of Clinical Investigation 2008)

The Estrogen Elixir sets a high standard for future histories of pharmaceuticals and of aging.

(Jimmy Elaine Wilkinson Meyer Journal of American History 2007)

This book takes an in-depth, socially analytical look at the evolution of menopausal hormone therapy in the United States, with a focus on estrogen since its discovery... Watkins tells the story accurately and objectively. No accusations and no praise, just the facts.

(K. Eddie Gabry, MD, MS JAMA 2008)

Watkins provides a fascinating, multi-faceted study of HRT, leaving no voices out of the debate.

(Wendy Kline History and Philosophy of the Life Sciences 2007)

Watkins presents a detailed account of the historical record of the subject.

(Carlos Sonnenschein Philosophy, Ethics, and Humanities in Medicine 2008)

More than a medical history of HRT. It is also a history of the medicalization of women's health and changing cultural attitudes toward aging, femininity, female identity, women's health activism, and the science of drug evaluations.

(Dominique Tobbel Chemical Heritage Magazine 2008)

A fascinating aspect of Watkins's story is how drugs can be rebranded in the face of falling sales.

(Bruno J. Strasser Historical Studies in the Natural Sciences 2008)

A significant work on the social history of American medicine and a major contribution to the growing literature on hormonal therapeutics and research.

(Chandak Sengoopta Isis 2008)

Estrogen Elixir has many strengths... a commendable and welcome addition to emerging literature in modern women's health history.

(Suzanne Junod, Ph.D. Journal of the History of Medicine and Allied Sciences 2010)

Review

An exemplary study of how the nation which first had access to oral contraceptives first came to terms with their advantages, and their drawbacks.

(Times Literary Supplement )

Intelligent and well-structured... An admirable exercise in social history.

(Nature )

A particularly fascinating issue, trim and focused, sophisticated and helpful, fresh and very interesting.

(American Historical Review )

In every carefully organized, lucidly written chapter Watkins provides surprising corrections to conventional thinking about the new birth control method.

(Journal of American History )

Anyone concerned with the debate over scientific advance and medical authority will find this a highly stimulating study.

(Journal of American Studies )

See all Editorial Reviews

Product Details

• Hardcover: 368 pages
• Publisher: The Johns Hopkins University Press; 1 edition (March 6, 2007)
• Language: English
• ISBN-10: 0801886023
• ISBN-13: 978-0801886027
• Product Dimensions: 9.1 x 6.3 x 1.3 inches
• Shipping Weight: 1.4 pounds (View shipping rates and policies)
• Average Customer Review: 5.0 out of 5 stars  See all reviews (3 customer reviews)
• Amazon Best Sellers Rank: #1,636,622 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews

2 of 2 people found the following review helpful:

5.0 out of 5 stars Social History of a Medical Error, July 9, 2007

By 

Allan Mazur (Syracuse University, NY) - See all my reviews
(REAL NAME)   

Amazon Verified Purchase

This review is from: The Estrogen Elixir: A History of Hormone Replacement Therapy in America (Hardcover)

I came across this book while preparing to write my own book on the topic. I read it hoping to find shoddy work that I might improve upon, or huge unanswered questions that I might address. Too bad for me, Elizabeth Watkins has excellently covered most of the topics I intended: a social history of hormone discovery and medical replacement, the role of interest groups (medical, pharmaceutical, media, women's movement) in shaping cultural notions of menopause and its "treatment," the scientific evidence for estrogen's effects, and the promotion of estrogen replacement. The big issue, of course, is how Medicine (and its surrounding institutions) reversed itself so completely from widespread promotion of routine long-term estrogen replacement for nearly all menopausal women, to only short-term treatment for the relatively few women with severe menopausal symptoms. The highly-publicized pivot point was the cessation in 2002 of the Women's Health Initiation (WHI), a large experimental study that showed increased heart disease and breast cancer among estrogen users. This led to an abrupt decrease of prescription and use. (Though not covered in the book, there followed a drop in the U.S. breast cancer rate, possibly a consequence of the drop in estrogen users.)
If the book has a weakness, it is Watkins's regard of the WHI as the "gold standard" of research, as if it has definitively put to rest the major questions about estrogen therapy. Perhaps if she were writing ten years later, she would give more relevance to the scientific limitations of the study. Possibly, too, the publicity rush of 2002 produced an overweighting of risk factors compared to the benefits of estrogen replacement -- an issue not yet fully resolved.

1 of 1 people found the following review helpful:

5.0 out of 5 stars Any library seeking a comprehensive coverage of hormone replacement therapy needs, November 4, 2007

By 

Midwest Book Review (Oregon, WI USA) - See all my reviews

This review is from: The Estrogen Elixir: A History of Hormone Replacement Therapy in America (Hardcover)

Any library seeking a comprehensive coverage of hormone replacement therapy needs THE ESTROGEN ELIXIR: A HISTORY OF HORMONE REPLACEMENT THERAPY IN AMERICA. It describes both the medical and sociological spread of HRT theory and practices in this country, exploring how science and society shaped the idea and distribution of HRT and how medical discoveries on women's health and aging changed initial ideas. From pharmaceutical manufacturers and government regulators to feminist health activists and the media, chapters offer wide-ranging surveys of influences and changes which are key to understanding the science, history and promotion of HRT in this country.

5.0 out of 5 stars Major issues of drugs in medicine are covered., May 15, 2010

By 

Bow (Boston, MA USA) - See all my reviews

Amazon Verified Purchase

This review is from: The Estrogen Elixir: A History of Hormone Replacement Therapy in America (Hardcover)

As the other reviewers describe, this book has sociological aspects of HRT. This book really tells us that HRT is the most important agent involving major social and medical issues:
- FDA's approval without scientific rigidity during 1930s and 1940s
- heavy involvement of pharmaceutical industry in medicine
- ethics of human studies involving elderly subjects or prisoners without informed consents.
- bias in belief-based advocacy by medical doctors
- conflict of interest in relation to chemical and drug industries
- social psychology of fear against aging after population had achieved average longevity longer than 60 years.
- epidemiologic approach to study relatively-rare cancers such as endometrial cancer
- difficulty in dealing with a single agent related to multiple diseases; cancer, heart diseases, bone diseases
- difference between randomized controlled trial and observational studies

This book presets that these public health controversies have literally grown with HRT. In other words, HRT history can provide very important implications for public health in US. With respect to this, anyone who is interested in social aspects of medicine, not necessarily in HRT or menopause, will love this book.