Hormonal Blues

JIM LEHRER:

Finally tonight, essayist Anne Taylor Fleming weighs the impact of recent news stories about hormone replacement therapy.

LAUREN HUTTON (ad):

When I started having hot flashes and night sweats at menopause, my doctor recommended hormone-replacement therapy.

ANNE TAYLOR FLEMING:

I remember watching that ad and thinking "great casting." After all, here was one of the original supermodels– not of the super plastic variety, but a real outdoorsy, all-American girl/woman with a famous gap between her teeth she had refused to fix:

The perfect someone to pitch hormone replacement therapy to us self-conscious trailblazing baby boomer women. As we slid towards menopause, we would take HRT as it's known, wouldn't we? Why not? The medical establishment was all for it. And it came with a well-known list of virtues trumpeted in the media by these frisky, glowy- skinned women like author Gail Sheehy, who had one of the first big menopause best-sellers.

Their message was simple and direct: HRT would mute our hot flashes, keep our bones strong, our skin supple, our libidos peppy, our hearts sound, even our brains more alert. In short, biology need not be destiny. That always got us; that had been our generational mantra from way back when.

After all we were the first generation of American women to go off to college with birth control pills in our purses, the first generation of women in history to have almost iron-clad control over reproduction. And it had been daring and thrilling and liberating, no question, allowing for a revolution– sometimes acted out in the streets– that put women on an equal footing and equal bedding with men.

Now there was a supposed panacea for the end of our reproductive lives: Hormones. And we took them happily, millions of us, until last July, when the first big study done by the Women's Health Initiative found that HRT did not do what it said, but precisely the opposite.

It increased the risks of heart attack and stroke, increased the odds of blot clots, increased the risk of invasive breast cancer. And now another sharp dissenting study: Not only does it not keep our brains sharper, but actually doubles the risk of Alzheimer's and dementia in women who began the treatment at 65 or older.

What's going on? What has been going on? All the women I know are asking themselves that. There is confusion and anger at the pharmaceutical companies, and a sense of betrayal by our doctors. Why have they been handing out this stuff if there were no real studies? But underneath there is the harder question: Why have we been so ready to take it?

I know there are women with maddening menopausal symptoms who were avid for relief, but there are millions of others were just following the prescription. What kind of rebels are we? Why shouldn't we age? What does it mean to age? Why must we conform to some commercialized notion of female appeal?

And it's not about men. They're caught up in the same market-driven, youth-defying sweepstakes, being offered a hair transplant here, a jolt of Viagra there.

When I went to buy a bathing suit recently, the young saleswoman assessing my age offered me something called the "miracle" suit, one of these euphemistically-named camouflage suits for the midlife women, a fierce bandage of a suit, with, as it says on the label "full cup support and a tummy- midrift toner." I grimaced. Has it come to this? Have I? Why not bare a little flesh, turn an aging body loose?

Getting older is scary, exhilarating. It's about wisdom and loss and grief and glee and it can't be fixed. We have to live through it, through the backwards longings and the lessening libidos. It is a chance to see, after all the fuss and after all the fun, what we're really made of.

I'm Anne Taylor Fleming.