The question of why women, in consultation with their physicians, should choose hormone therapy in response to menopause represents a renewed controversy at the beginning of the new century. Conflicting messages regarding the health risks and benefits of HT have been conveyed in the mainstream media, especially information in the media regarding the results of large-scale studies of the health impact of hormone therapy. Women who have been on one or another of the hormone replacement regimes have been forced to (...) reconsider continuing on HT. Doctors who suggest these hormones to their patients are somewhat confused, as are perimenopausal women who are considering HT. Pharmaceutical companies that produce these compounds are worried, and public health officials are on the defensive.Media coverage of HT research has been extensive. In particular, two large-scale studies, one here in the U.S. and the other in Great Britain, have recently cast a negative light on the use of hormone therapy, after years of routine prescription of HT for menopausal women. (shrink)

Commercialization of medicine is a growing trend that threatens to undermine physicians’ commitments to patient care in favor of personal financial interests. Bemoaned by Arnold Relman as early as 1980, growing for-profit sectors of health care have been reshaping medicine from a profession into a business, forming the foundation of what he terms a “medical-industrial complex” that threatens to undermine professional identity and reshape health care funding. Commercialization poses new ethical challenges for health care providers who have a financial stake (...) in their health care decisions and may undermine their fiduciary duties to patients.Certainly, commercialization has brought about new trends in medicine — one need only to look as far as the rise in for-profit hospitals, diagnostic laboratories, and proprietary nursing homes to see how opportunities for financial gain reposition physicians’ orientations vis-à-vis patients. (shrink)

The decision for women to go on hormone therapy remains controversial. An historical oscillation of beliefs exists related in part to expectations of the medicinal value of HT over longer-term use beyond the initial peri-menonpausal period. Studies thought to resolve issues surrounding the efficacy of HT were perhaps overstated as confusion still permeates the decision making with regard to HT. Overzealous advertising and exaggerated understanding of the results undermine patient and physician decision making. There remains no magic bullet with regard (...) to HT. What remains is still the possibility of HT longer-term efficacy on diverse end organ systems with pockets of clinical and scientific ambiguity while working to engender reasonable expectations. (shrink)