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A Hot Flash on the Good Life

July 11, 2002

Feminine forever. That was the sizzle that first sold millions of menopausal women on estrogen pills in the 1960s. This fountain of youth in a bottle would keep women from becoming "dull and unattractive," according to one of its early pitchmen, and make them "much more pleasant to live with."

Who could resist? What woman would choose to shrivel and sag when she could remain dewy and pert by popping a pill? Who wouldn't rather avoid the drenching night sweats, embarrassing hot flashes and mood swings?

The 1960s were, after all, an era of medical miracles. The birth control pill, for example, unleashed a sexual revolution and allowed women to choose, as they never could before, when or if they would become pregnant.

No wonder many women and their doctors came to regard aging, menopause in particular, as a perilous emotional and physical passage, a disease that could be medicated away. Heart disease, stroke, osteoporosis--until this week many physicians believed that estrogen could keep the grim reaper at bay.

But Tuesday, scientists abruptly ended a large national study on hormone replacement therapy after concluding that the regimen did more harm than good. The government-funded trial, which tracked 16,608 women taking either estrogen and progestin or a placebo, was halted after it became clear that the drugs caused a slight but significant increase in the risk of breast cancer, heart attacks, blood clots and strokes.

Six million American women who until this week had been taking the drugs now have new fears.

It's too facile to see the story of hormone replacement therapy as one of drug companies and physicians putting something over on gullible women. It's also a story of women who took these drugs, sometimes for decades, because they--along with the men in their lives--equated femininity and sexuality with youth and nubility. And it's the story of women who simply sought relief from the sometimes-debilitating symptoms of menopause and hoped to prevent catastrophic hip fractures and heart attacks.

The silver lining to this week's news, if there is one, is that women's medical issues, too long ignored, now finally command the attention of researchers. Also more visible is an emerging acceptance of menopause and aging.

Like other health issues once discussed only in embarrassed whispers, menopause has in recent years become the subject of comedy sketches and talk show confessionals, generating a cottage industry of support groups and products. As of Tuesday, it was also dinner- table conversation.

The new developments underscore what most women knew all along: that aging is inevitable, that there is no magic pill to stop the clock. Vigorous middle and later years--what Anne Morrow Lindbergh called "the flowering that waits for afternoon"--are likely to rest on the basics: a healthful diet, regular exercise and a life of meaning.

Now there's a hot flash.

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