Endochronology: Part III (a): The Tabloid Addition
Goodbye Big Pharma, Hello Big "Natural"
Hi Beautiful Friends,
In the saga of estrogen, we are picking up here where we left off in Part II (b) after the WHI in 2002.
The NIH and the media had painted estrogen as a carcinogen that also caused heart attacks and strokes and was manufactured by a deceitful pharmaceutical company motivated by profit regardless of women’s safety and long-term health. All the money and strategy over decades of marketing Premarin failed to overcome the damning headlines. Yet symptoms of the great hormonal shift of midlife remained for most women who, confused, betrayed, and still suffering, were left in a void without solutions to address root cause.
Menoprofiting: A Side Effect of Distrust
Our economic system excels at profiting off needs of consumers, sometimes by way of ingenious innovations that solve real problems, and sometimes, regardless of safety and efficacy of products, marketing does all the heavy lifting. For hormonal solutions, where Big Pharma went down in a ball of lawsuits and distrust, Big “Natural” came knocking on the door.
The fields of holistic, naturopathic, and functional medicine recognized a well-deserved distrust in a patriarchical medical model that failed to look at the patient as a whole, that had a history of over-medicalizing and prescribing, and simultaneously under-dignosing and gaslighting women’s ailments. The distrust was the perfect breeding ground for menoprofiting to get a strong foothold. The more menopause becomes mainstream, the more we need to be careful consumers. A recent article in the journal for ACOG (American College of Obstetrics and Gynecologists) warns:
The past year has seen a significant increase in public interest in menopause in the press, in social media, among employers, and within the investment community.
It goes on to warn that this has led to:
…much misinformation and “snake oil,” in addition to direct-to-consumer marketing of supplements, devices, and products purporting to safely treat menopausal symptoms often withou scientific support or touting purposefully misleading evidence.
cBHT & “Non-Hormonal” Options
In the wake of the WHI, to set themselves apart from evil Pharma, medical providers went to independent compounding pharmacies and repackaged hormone therapy in the form of cBHT or compounded “bioidentical” hormones. Marketed as molecularly identical to what human bodies make, “bioidenticals” were promoted to replace the “dirty” equine estrogens that they made sure to remind us are natural to horses, not to humans. Those in favour of “bioidentical” hormones emphasized that they were sourced from nature. To be clear, all FDA-approved forms of estradiol and progesterone are extracted from the same natural sources: yams and soybeans.
A 2019 statement (originally issued in 2006 then updated twice) from the Endocrine Society states:
Compounded “Bioidentical” Hormone Therapy (cBHT), particularly estrogen and progesterone, have been promoted by some as safer and more effective alternatives to manufactured FDA-approved hormone therapies (HT) for relief of symptoms of the menopause. In fact, little or no scientific evidence exists to support such claims about cBHT.1
Dosage and purity being equal
… all estrogen/progesterone containing HT (cBHT or FDA-approved ‘bioidentical” preparations) would be expected to carry essentially the same risks and benefits.”
However, there’s no guarantee that dosage and purity are equal because formulations from compounding pharmacies are not subject to monitoring.
The second arm of Big “Natural” is the supplement industry, which provides “non-hormonal” or “hormone-free” products that avoid estrogen and progesterone altogether. Just like “bioidenticals” from compounding pharmacies, supplements are not FDA-regulated and lack clinical data to support safety and efficacy.
Testing Hormone Levels
A reproductive woman’s hormone levels are individual and fluctuate within her monthly cycle to make ovulation and reproduction possible. Fluctuations become more unpredictable and extreme during the time when the supply of viable eggs dwindles and ovulation becomes challenging. For this reason, when deciding to prescribe hormone therapy, testing hormone levels, whether by saliva or blood during perimenopause, is neither helpful nor recommended by experts.
If we tested hormone levels at the same day of our cycles beginning in our teenaged years once the body has established regular menstruation, and then again during our twenties and thirties, we would have baseline data for comparison. If this were common practice, we would have information about hormone levels, those that correspond to health and those that correspond to symptoms. We would have more information regarding fertility. We would be able to use hormone tests during perimenopause to better determine where we are in our journey towards menopause. FSH levels may indicate how close someone is to menopause, but even these can fluctuate.
Unfortunately, some providers encourage expensive tests that are not necessary for best care. The Dutch (Dried Urine Test for Comprehensive Hormones) test in particular is quite expensive and hasn’t been proven to be helpful in determining hormone therapy recommendations. Dr. Jen Gunter goes so far as to advise that those who are offered the Dutch test for hormone therapy management seek a different provider.
Gobbledygook of Marketing Jargon
Making sense of the term “bioidentical” has been one of the hardest hurdles in my research on hormones. The term originated from the holistic health movement of the 1980s, but became popular after a beloved celebrity appeared on Oprah to tell women that “bioidenticals” from compounding pharmacies were safer than “synthetic” hormones from Pharma. While “synthetic” and “bioidentical” were pitted against each other as opposites, all modern hormone therapy requires some extraction from nature (yams and soybeans) and some synthesis (combining pieces to make a whole). We have the term “bioidentical” because of marketing, not because of science.
“Bioidentical” hormone evangelicals, typically holistic or functional medicine doctors and naturopaths, argued that the compounding pharmacies provided a safer, superior preparation because they individualized dose and treatment. Many medical doctors, accused of being in bed with Pharma, made the case that, without regulations of dose and purity, compounded hormones were dangerous or at least less safe than the FDA-approved “bioidentical” hormones.
Ultimately, the wild west hormone experimentation through compounding pharmacies shone light on the differences in formulation of hormone therapy. Use of CEEs shifted to the use of the now more common formulations of modern menopause management: transdermal “bioidentical” estradiol and oral micronized progesterone, which match molecules that our bodies produce.
To fully understand why “bioidentical” is more marketing than science, please check out Dr. Jen Gunter’s chemistry lesson in her post on the term. She explains how 17-beta estradiol found in “bioidentical” hormone therapy is extracted from yams and soybeans and then synthesized to produce an isotope with a specific carbon ratio that renders the term “bioidentical” not exactly scientifically accurate. She even shares an analogy using Halloween candy! Go read it!
Nonetheless, on the Alloy (women’s telehealth) website under “Science” they assure us that their drugs are “bioidentical” and that:
The estradiol in the products Alloy prescribes is molecularly identical to the estradiol your body produces naturally.
To be clear, nothing produced in a lab, whether it be from a compounding pharmacy or from Pfizer, will ever be “molecularly identical” to what our bodies make.
So the question then is if doctors agree that “bioidentical” is not a scientific but a marketing term (which if you ask, most will confirm), why do they still use it?
To sell. The reputation of “hormone” has been so dragged through the mud that “bioidentical” has stepped in to replace it or at least dress it up. Doctors are compelled to keep calling the drugs “bioidentical,” a term strongly associated with safety, to help women move past the WHI fears in their search for effective treatment.
Doctors as Salespeople
Another hormone therapy crusader whom I love and trust, Dr. Rachel Rubin (a urologist who, among many other badass things, marched on Washington to demand that the untrue and dangerous warnings be removed from vaginal estrogen cream, and to fight for more funding for women’s health research) calls doctors salespeople. Given the sordid history of doctors in the pocket of Pharma, I was a little shocked to hear her cop to this so unabashedly. She even sounded proud of her skill in sales. She was just being honest. Doctors are salespeople.
But it’s their job to make sure they have the best information for long-term care of the patient before they sell the treatment. The system ensures that patients are at the mercy of their doctors, who alone control the means of providing (or withholding) medical care. The quality of a patient’s care therefore depends in large part on her doctor’s ability to listen and deduce the problem, the quality of the doctor’s training and continued education, their individual problem-solving skills, and their ability to communicate reasons for following their particular advice (i.e., the sale).
“The answer to all your problems is in this bittle lottle!”
The more things change the more they stay the same, including the marketing tactics in selling “natural” and “non-hormonal” products to women. Let’s take a little trip back to a once highly popular “Woman’s Cure for Women’s Ills,” all in one bottle and still sold today on Amazon.
In 1875, in her kitchen in Lynn, Massachusetts, fifty-four year old Lydia Estes Pinkham concocted a vegetable compound and marketed it as an herbal medicine. The compound included black cohosh (still lacking in evidence and linked to liver injury), life root, unicorn root, pleurisy root and fenugreek seed, but the secret ingredient was twenty per cent alcohol “to preserve the mixture.” Anyone remember the classic I Love Lucy bit where Lucy is hired to sell Vitameatavegemin? It could have been Pinkham’s cocktail. If you need a laugh, go watch.
Pinkham’s strong marketing campaign quickly made her a household name. Her grandmotherly image on the bottle branded the compound as wholesome and time-tested by a wise, older woman familiar with women’s woes.
Testimonials and Claims
The ads, as seen above, similar to the ads of today’s menopause supplements, contained large numbers of testimonials as proof of efficacy, and long lists of claims, all without scientific testing. Pinkham’s compound promised a long list of relief including: reducing faintness, dizziness, palpitations, depression, back pains, headaches, irregularity, menstrual cramps, alleviating menopause symptoms such as hot flashes (actually made worse by alcohol), curing prolapsed uterus, kidney and ovarian diseases, and preventing miscarriage. This concoction was widely used even in pregnancy at a time before the discovery of fetal alcohol syndrome. In fact, testimonials often included the phrase “There’s a baby in every bottle.” In retrospect, intoxication from the alcohol likely overwhelmed any benefits and rather, masked symptoms. In 1906, food and drug safety laws eventually tested the product and the alcohol content was discovered and over time, removed.
Dr. Jen Gunter writes a humorous passage in The Menopause Manifesto on her personal experiment “for science,” conducted by selecting a nice port wine of similar alcohol content to see if it could improve “those dull and listless days when you feel fit for nothing” as promised by Pinkham. Gunter chose a fitting day during the “pandemic and the smoke-filled skies of California’s fire season.” I remember one particular apocalypse-esque day I refer to as “Orange Tuesday” where it was as if the sun never rose. We were left to lurk about in an eerie haze and lean into maladaptive coping techniques. It might have been that same day when Gunter decided to take a tablespoon of port every four hours (the original prescription on Pinkham’s bottle), and found that it did in fact, “smooth the day a little.” Gunter reminds, and after many self-experiments with the same chemical compound I would agree, that alcohol is not recommended as therapy. (The Menopause Manifesto, p. 293)
Separating “Hormone-Free” from “Natural”
Before I parse the “natural” problem once and for all, let’s go over some definitions.
natural (adj.)
existing in or caused by nature; not made or caused by humankind
nature (n.)
the phenomena of the physical world collectively, including plants, animals, the landscape, and other features and products of the earth, as opposed to humans or human creations
Part of the problem with the word “natural” seems inherent in our definition. Humans are animals. Animals are considered part of nature, yet somehow humans are not part of nature. Believing we are separate from nature and often superior, might be the cause of some of our greatest problems.
But for the sake of this discussion, let’s stick with the above definition of “nature” where humans and human creations are outside of it. Does it follow then that hormones that come from horses (animals) are more natural, even if taking these hormones means introducing compounds into humans that are only naturally occurring in horses?
Under the same definition, can menopause supplements, which are “human creations,” be labeled “natural?” Supplements, like hormones, are sourced from nature and processed in a lab to create formulations that are hopefully well absorbed. They are human creations, just like the fears and insecurities around menopause. Big “Natural” profits by leveraging fear of the word “hormone” and creates a false sense of safety through the opposing marketing terms “non-hormonal” or “hormone-free.”
Everything is Chemistry; Everything Can be Poison
The food we eat that is labeled as “hormone-free” still creates a cascade of reactions that impacts our hormone levels. But let’s use the “non-hormonal” label strictly to define compounds that technically, are not already in the form of hormones. A non-hormonal compound is not by that fact more natural. In fact, the opposite argument can be made that hormones are inherently natural because they occur naturally in animals, plants, and humans. Let’s also not make the common false assumption that because something is natural, whatever that means to you, that it’s safer. Dr. Attia frequently reminds listeners on his podcast that even oxygen can kill in the wrong dose. It’s the dose and time of exposure that truly makes the poison.
Taking vitamin D? You’re on HT
Many choosing a “hormone-free,” “natural” lifestyle choose to take vitamin D. Produced in our bodies and one of the supplements whose benefits are most widely supported by scientific study, vitamin D improves immunity and overall health. Vitamin D is also technically a hormone and therefore, by definition, not “hormone-free.” It is, however, naturally occurring and naturally produced by the body. If taking a hormone to improve health is hormone therapy then supplementing with vitamin D is hormone therapy.
The “Natural” Approach
So let me try to understand. Those marketing the more “natural” approach for facing the middle-age hormonal shift tell me to avoid estrogen and progesterone (naturally occurring hormones that serve important, protective functions in the body). Instead, the more “natural” approach encourages me to take supplements—compounds not naturally occurring in my body and sold on claims that they are “natural” ways to powerfully increase the very hormones this “natural” approach would have me avoid. Is anyone else confused? Please let me know if I’m missing something in the logic here.
Beef with Bonafide
There’s the type of evidence-based sales doctor like Ruben, whom I describe above. Then there are the many doctors in video ads for the supplement company Bonafide, a company that encourages “the natural approach” but resides firmly in menoprofiting territory. They leverage fear of hormones, fear of aging, and even fear of or disdain for female biology. For instance, they sell a product to eliminate vaginal odor and discharge. A healthy vagina is not odorless or free of discharge. But mysogyny says otherwise.
Bonafide taglines are confusing. They pair “natural” and “nature” with “hormone-free” while maintaining their products are “powerful” and “backed by science.” I’ve emphasized certain words that make me go “hunh?”:
“Naturally powerful solutions for the natural symptoms that occur throughout women’s lives.” This phrase runs into the issue I’ve noted before with referring to symptoms of aging, an inevitable process, as “natural.” Diabetes, cancer, and heart disease are all naturally occuring and increase with age. Loss of estrogen, which causes these “natural” symptoms of aging, also leads to an increase in osteoporosis and heart disease. Calling the symptoms “natural” can make women feel as though on some level they should expect and accept disruptive symptoms. If the hormone-related symptoms must be addressed, the fitting and “powerful solution” they recommend is “natural” (meaning non-hormonal).
“Inspired by nature, backed by science.” “Inspired” is so vague, I honestly don’t know what they mean.
“….a more natural approach to addressing menopause symptoms….” I’ve already addressed the “natural approach.”
“Hormone-free ingredients inspired by nature.” Also addressed this term above.
“You deserve relief without compromise.” Begs the question. Am I compromising my safety by seeking relief that addresses root cause?
“Our scientific approach to menopause relief and women’s health is grounded in a rigorous scientific discovery and development process that mirrors the pharmaceutical industry’s.” They want us to know their products are superior because they avoid dangerous hormones made by the pharmaceutical industry. At the same time, they hold up the pharaceutical industry as the model for rigor and scientific standards to measure safety and efficacy.
For all the claims on their website that their products are “clinically-tested,” the studies are hard to find. At the very bottom of the homepage in fine print you can find a short list. Some of the items on this list will reroute you back to their website. One is the statement that “Adequate calcium and vitamin D throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis.” The last item is a note about their three-month subscription discount. I was only able to find three randomized, double-blind, placebo controlled studies, two for the same active ingredient that they use in one of their products. The largest test group from the RCT studies was only fifty-four women. Not exactly robust.
If you want to explore studies of non-hormonal supplements, the FDA website shares data on a fairly comprehensive list from A-Z.
Hyaluronic Acid Vaginal Suppositories
Hyaluronic acid is one of the few ingredients in feminine products that has strong data showing it’s a powerful moisturizer. It’s able to better draw moisture in through the skin barrier making it an excellent choice for vaginal moisture. You know what has even more robust data to prove safety and efficacy? Vaginal estrogen cream.
Full disclosure, when I first started experiencing vulvo-vaginal symptoms, I explored my options and appreciated Dr. Gunter’s price comparison chart in this post. You can pay more for it on Bonafide, but I find the cheaper HYALO GYN brand, although the website is not nearly as slick, works quite well. I’ve found that I need much less vaginal hyaluronic acid and estrogen cream since beginning systemic trandermal estradiol. GSM is chronic, progressive and totally treatable. Please avoid urniary tract issues by bringing estrogen back to the bladder to maintain healthy bacteria through the use of vaginal estrogen cream.
A Little More Jargon
Another word I often see supplement and beauty companies use to describe ingredients is “pure.” Purity connotes cleanliness and virtue. It sells. Scientifically, it means not contaminated. I would hope so because without regulation we have to take their word for it, even if studies proving efficacy and safety for those pure ingredients are missing. But at least they’re pure, according to them.
Often supplement advertising will purport to “balance” hormones, yet most medical doctors with education in biochemistry and endocrinology will tell you that balancing hormones is not a thing. “Boosting” and “unlocking” are also popular words in the supplement industry that sound good but mean what?
Just because something was used in “ancient” times does not give it more validity. Perhaps safety is assumed since people have been taking it for time immemorial, but again experiments with dosing and time of exposure would provide the science we truly deserve.
Read Asterisks and Reviews
Some of these companies have slick websites adorned with science-y looking images surrounded by science-y sounding language, but also, so many asterisks. Some of them (Bonafide again) reveal in the tiny fine print that the large number of women who experience relief is determined by surveys where participation provides the chance to make somewhere between fifty to six hundred dollars.
You may have to scroll to page three or four, but read the reviews from those who rated the products poorly, possibly written by those who did not experience the placebo effect that may impact a whopping 66% according to the 2023 NAMS Position Statement on non-hormonal treatments. (This statement is a great resource that explores the scientific data on many different supplements and modalities. Meditation and CBT are two of the non-hormonal options that have the strongest relief for hot flahses and insomnia respectively.) The poor reviews also share complaints about lack of company response when trying to cancel subscriptions. Plans and bundles where the more you buy the more you save are a popular option, especially for products that promise to show improvement over the course of several months. Subscriptions not only reduce cost but often include free shipping, but beware the auto-ship and billing cycle when you subscribe, which may make cancellation more difficult and result in continued, unwanted charges. Rarely, reviewers also complain of adverse effects such as worsening symptoms, weight gain, and even feeling so awful they are bed ridden for a day. Once a bottle is opened, few companies accept a return.
Because You’re Worth It
If something makes you feel better, then it works. Who cares about the mechanism? If spending a little (or a lot) of money on an eye cream with zero clinical data to support its efficacy makes you feel better, by all means, keep buying it. Particularly in the self-care arena, spending money may provide a boost to our sense of self-worth. L’Oreal tapped into this with the tagline “Because you’re worth it.” Of course we are! Wait, worth what?
Supplement Specialist: Dr. Jen Gunter
When it comes to most areas of women’s health, there’s one doctor who stands out in her unparalleled efforts to bring us informed choice through methodologically researched data, especially when it comes to supplements. I agree wholeheartedly with Dr. Jen Gunter’s statement below and didn’t feel like I could say it better.
There are all kinds of issues with Pharma and pharmaceuticals, but adulterated products aren’t one of them. Given the laxity of the regulations and the sheer number of supplements, the FDA simply can’t monitor the situation or protect the public. As shocking as it seems (heavy sarcasm), billion dollar industries just aren’t frightened by warning letters, and so it is best to think of supplements as untested, unregulated pharmaceuticals.
Dr. Gunter has recently organized all her posts on the problems with Big “Natural” for easy perusal.
Here are some of the main takeaways:
supplements including vitamins, minerals, botanicals (herbs), live microbials, dietary, Aryuvedic, and Chinese medicines are not regulated
supplements are a quick and relatively easy way to make a ton of money (the industry made $45 billion in the US in 2023)
the supplement industry is not financially incentivized to test their products
beyond a handful of supplements, we do not have strong clinical trials proving safety and efficacy
supplements may not contain the supposed active ingredient
supplements may contain the active ingredient but in amounts that vary drastically from what is listed on the bottle, and from bottle to bottle
supplements can suffer from contamination of toxins like lead and have been linked to liver injury which is on the rise
supplements can contain pharmaceuticals such as banned substances and anti-depressants only detected when tested off the shelf
proprietary blend = secret recipe that the seller won’t share; i.e., you have no idea
some products are backed by doctors who have a conflict of interest
The Vajenda is one of the trusted sources that I lean into quite a bit. It has opened my eyes, provided important lessons in biology, and demystified (and de-myth-tified) some of the more confusing hormone content. In particular, this post overlaps so frequently with content from The Vajenda, I considered merely pointing you towards a collection of Dr. Gunter’s posts, that is how highly I recommend her content.
Meno-celebrities
What do Oprah, Naomi Watts, Salma Hayek, Halle Berry, Gwynteth Paltrow, and Drew Barrymore all have in common? They have all spoken publicly and personally about perimenopause.
At age 48, Oprah’s heart palpitations made her think she was having heart trouble. She went through five doctors and ended up with an angiogram and on heart medication before she made the connection to perimenopause through something she read.
Salma Hayek mentioned her breasts grew along with the rest of her.
Halle Berry was told she had the worst case of herpes her OB had ever seen, but it was actually the vulvo-vaginal symptoms of low estrogen associated with perimenopause.
At age thirty-six, Naomi Watts went through perimenopause early, giving her a head start on developing her personal brand, Stripes, that boasts holistic care from “scalp to vag” and all of it “hormone-free.”
Paltrow decided menopause needed a re-branding and speerheaded a telehealth company that like Pinkham’s ad above, shares on the website “We are trusted by 160,000+ women.” Many women’s health companies report sheer numbers of users as though these are proof of efficacy and safety.
It’s great that celebrities keep coming out of the woodwork to normalize the changes, end stigma, and educate women about symptoms. The problem is some of them spread misinformation. Others have started lucrative telemedicine companies that are subscription-based clubs for those who can afford to join and have online prescriptions delivered to their door possibly without adequate rigor in the evaluation of an individual’s health risks. Others are selling expensive, cure-all “natural” and “hormone-free” supplements that promise impossible things without providing adequate science to back them.
I actually cannot bring myself to believe that sweet Drew Barrymore, whom I grew up with through E.T., Never Been Kissed, and The Wedding Singer, would knowingly try to sell a product that she didn’t actually believe was effective. I just don’t want to live in a world where Drew Barrymore is a bad guy. I’m going to let Dr. Gunter take it from here because… I. Just. Can’t.
Perhaps it’s catty, but I find it much easier to pick on Gwyneth Paltrow. Maybe it’s because I don’t want my fourteen-year-old daughter thinking it’s cool or healthy to subsist on extreme fasting (more on how intermittent fasting can poorly impact us during perimenopause), bone broth and IV vitamin therapy, or that a good way to celebrate your 50th is to post pics of yourself, naked but for gold paint, displaying a harmful, tired image of impossible, anti-aging beauty standards and privilege. As much as I want to withhold judgment for the sake of solidarity in the female fight for equality, I also believe that our next generation deserves role models who espouse a different set of values that aren’t dependent on appearance.
Then, of course, we have GOOP. Even as I start to think of the ridiculousness of some of the products and their claims, my soul begins to cringe, like it does when I think of the damage done by Jenny McCarthy’s insistance that vaccinations cause Autism. In case you haven’t heard, the small study published in the esteemed scientific journal Lancet, instrumental in the modern anti-vax campaign, has been completely retracted by its investigators who were found guilty of ethical violations, scientific misrepresentations, and deliberate fraud. It’s a fascinating story of how logic, facts, and corrections have little impact on movements where feelings guide the ship. Sound familiar?
Come and knock on my door!
The OG menopause celebrity was Suzanne Somers, who became famous for her role as “Chrissy” in the sitcom Three’s Company. In 1980, Somers took a bold feminist stand demanding equal pay relative to her male co-stars, only to be fired, ostracized from Hollywood, and treated like a criminal on set forced to finish filming a previous season with zero contact with the rest of the cast and a police escort at work. She recovered professionally, landing a residency in Vegas, breaking onto the sitcom scene once more, and of course, marketing her personal brand while selling thousands of thigh and buttmasters to create a business empire.
But one of her most memorable legacies came from numerous best-selling books and an appearance on Oprah in which she shared her “bioidentical” hormone regimen, the “juice of youth.” Somers’ claims about hormone therapy echoed Dr. Wilson’s from Feminine Forever. In the introduction of two of her books, she warns about the “Seven Dwarfs of Menopause: Itchy, Bitchy, Sweaty, Sleepy, Bloated, Forgetful, and All-Dried-Up.” She emphasizes the negative impact on a woman’s sexual relationship with her husband in ways that make it sound like sex is the primary function of a wife. Somers used her platform to reinforce sexism while making it look and sound like freedom, confusing feminism with traditional femininity.
While celebs might be confused and make claims not backed by science, I’m less inclined to let the doctors who encourage them off the hook. There were several doctors in Somers’ camp who, after she conducted her own research, validated her belief in compounded “bioidenticals.”
It wasn’t a doctor but a persuasive actress who calls herself a “molecular biologist” (although her disputed B.A was in anthropology) who strongly influenced Somers. T.S. Wiley developed a protocol named after herself. The Wiley protocol promoted applying hormones in the form of topical creams at high doses in an attempt to bring blood serum hormone levels back up to those of a typical twenty year old. Somers’ book, Ageless, promoted this dangerous protocol, which after publication provoked an open warning letter from the group of doctors Somers had quoted within the same book. An excerpt of the letter reads:
We recognize the role you have played in raising awareness about the use of bioidentical hormone therapy. However, we want to ensure that women are not confused, nor harmed by some of the non-medical, misleading and unsubstantiated information contained in your book….a significant portion of the material in the book relies on information and opinion from T.S. Wiley.... (who) has no medical or clinical qualifications. To our dismay, Wiley dispenses gratuitous advice on…areas that are legally and ethically the domain of licensed medical practitioners.
Many of the claims throughout the book are scientifically unproven and dangerous. By mixing quotes from qualified physicians who are experts in their fields and bioidentical hormone treatments, with those of a person with no medical or scientific background, this book will further confuse women and we believe, may potentially put their health at risk.
Doing Your Own Research
More now than ever we have access to information and are thereby able to do our own research. However, there’s an important distinction between those who have developed a technical understanding of the material, who listen to experts, and who look at the evidence, and those who don’t.
Somers refers to a year of research where she chose sixteen doctors to build her camp and compares that experience to getting “a PhD.” She described her team of doctors as “cutting edge.” One of these doctors, Prudence Hall, author of the foreward in one of Somers’ books, had her license suspended for reckless application of compounded hormone therapy without adequate monitoring, leading to cancer in a patient who had paid Dr. Hall $7,000 for treatment over the course of three years.
Some oncologists, such as Dr. Avrum Bluming, who have practiced for over thirty years, still humbly maintain that we don’t understand cancer. This confession rings true based on the fact that people are still dying from incurable forms. Yet, no responsible oncologist would encourage the doses and types of hormones that Suzanne Somers took daily for decades.
Somers died of recurrent breast cancer this past October at age seventy-six. She stayed committed to taking her “bioidenticals” and refused certain treatments such as chemotherapy.
The Colourful Character of Christiane Northrup
One of the doctors foundational to the “natural” health movement of the eighties, who originally supported Somers, is Dr. Christiane Northrup. My first encounter with this doctor was completely haphazard. I was in the initial phases of research and listening to every podcast on hormones that I could get my ears on. A quick search on Spotify pulled up “Keys to a Blissful Menopause Experience with Dr. Mindy and Dr. Christiane Northrup.” Well, that sounded nice! I started listening on my headphones as I opened and prepared the yoga studio for my Sunday morning class.
At first listen, I thought I had found a great resource. Not only was this guest a medically trained OB who spoke clearly on the biology of the female hormonal cycles and the evolution of those cycles with age, but she also peppered her speech with talk of chakras and kundalini energy. Here was someone who sounded open-minded, bringing in other modalities beyond western medicine. Her level of woo didn’t scare me off. From my backgrounds growing up in a medical family and years of yoga training, I’ve learned how to translate mysticism into modern science. I’ve always loved how yogic tradition and philosophy are so often in accord with modern physics and neuroscience. When I hear magical things that I can’t translate, I agnostically file it away as possible but unproven. Northrup kept sharing ideas that sounded like inside secrets because I hadn’t heard them anywhere else.
When I got back from the yoga studio that day, I began researching Northrup only to find that she had stopped seeing patients in 1999 but had continued to write books. She explained, "At a book signing, you can steer a hundred women in the right direction in an hour…and I don't need to worry about being sued." Hmm.
A 2008 publication in Dartmouth Medicine described her writing as:
…standard, evidence-based medical information, together with more theoretical ideas about energy and mind-body connections. Her aim, she explains, is to combine "the best of conventional [medicine]—which is what I learned at Dartmouth," with alternative therapies—from qigong, yoga, meditation, and acupuncture to herbal and vitamin supplementation and good nutrition.
Northrup was once a beloved, highly respected, feminist renegade fighting patriarchal medical dogma, appearing on Oprah and PBS numerous times. In 2013 she was named one of the 100 most trusted people in America. She’s been a persuasive proponent of lower-intervention childbirth and fought for the end of circumcision. It was from Northrup that I first heard about the abuse of the horses in the manufacturing of Premarin, although she mentioned particularly heinous practices for which I haven’t found any evidence, not that the evidence I found isn’t bad enough.
Unfortunately, following a personal loss plus the pandemic, she went the way of many others and hit a downward spiral into the land of conspiracy and QAnon. While I might hold off on calling her “The Pandemic’s Worst Woman” as Dr. Gunter has, she was one of twelve people responsible for spreading the debunked documentary Plandemic, full of misinformation about Covid-19. She still spreads bunk on Facebook but has been banned from multiple other platforms.
You can catch Somers, Dr. Hall, and Dr. Northrup on Oprah in this clip from 2009 to get a sense of Somers’ messaging about “bioidenticals” that Dr. Northrup and Dr. Hall supported. Oprah endorses Northrup, referring to her book Women’s Bodies, Women’s Wisdom as “a bible.”
Episode #7 of the podcast Conspirituality takes a close look at the personal evolution of Dr. Northrup. It also delves into the marketing and allure of alternative medicine, including an analysis of the nature of intuition. Episode #8 criticizes the 1000+ page “bible” of broad content (pun intended). The open letter to Somers signed by Northrup criticized Somers for mixing scientifically proven with unproven material, exactly the same error Northrup commits in her writing and speaking as she seamlessly moves between science and magic.
On the podcast where I first heard Northrup speak, I was lured in by her knowledge of female endocrinology but also taken with her passion as she spoke of the essential midlife drive of a woman to find her authentic voice. She argued with an air of mystery that more than ever we need to hear “voices of midlife and beyond women who have not been bought by darkness,” although she doesn’t go on to explain what that means. She gives you just enough to keep you listening in the hope that she’ll dispense with this special knowledge that only she seems to have.
She has an undeniably captivating charisma that explains her large following whom she calls “the Warriors of the radical light.” She described the age of forty-two as the year of the “Uranus opposition,” a term I had to look up and which seems to be an astrological explanation for a midlife crisis. My ears perked up at the mention of forty-two since it had been a pivotal year for me in my hormonal evolution with symptoms popping up all over. According to Northrup, it was my Kundalini energy trying to move up through my chakras so my soul could get out. I’d much sooner chalk it up to perimenopausal struggles with consistent ovulation leading to erratic hormone fluctuations. But I can translate most of what she’s saying. I believe in mind-body connection and the power of meditation, but I also recognize the dangers of victim-blaming and shaming for disease that can result when too much power is put into thought alone.
If I had just written her off, as cancel culture would have me do, I would not understand why people believe her nonsense. And it’s not all nonsense. Part of her appeal is that she speaks about and to the soul in ways that many of us are hungry for in a society that mostly ignores spiritual and emotional health. She grasps the gaps in conventional medicine and artfully fills them in. While her “bible” may well be worth a read for helpful hints and perspectives on midlife, she also makes claims that are cuckoo for Cocoa Puffs, who uses expensive mediums to speak to the dead, who talks about her previous life in Atlantis surrounded by crystals while playing the harp. I try to judge content, not people, even those who have descended into the darkest cellars of madness.
Part III(b): Turning the Titanic!
I’m excited to turn now to some illumination from the most current science on estrogen. With an exciting new article released in the Journal for Obstetrics and Gynecology based on twenty years of follow-up from the WHI, another massive study looking at the electronic medical records for 10 million women from the US Centers for Medicare and Medicaid Services from 2007-2020, plus help from experts and members of the Menoposse, we can hopefully pull estrogen back out of the shadows and understand that it’s just a molecule, not inherently good or bad. From that scientific standpoint, we can use the available evidence today to support individualized care and informed choice in women’s health.
Stay tuned!