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For what ails you - A dose of pregnant mares urine

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Point of View with Barbara Sumner Burstyn:

First published on…

With the recent high profile backtrack on the latest women’s wonder drug HRT; thousands of New Zealand women have gone on high alert. They’re terrified, as one of my Ponsonby friends reported over her soy latté, that the medical profession has once again used their bodies to rack up huge profits. And certainly with 50% of women aged 50 to 65 years in North America using HRT and over 194,520 prescriptions for HRT written in New Zealand in 2001, that’s undoubtedly a lot of profit from a drug touted to cure everything from hot flushes to Alzheimer’s. Instead the treatment has been shown to increase the relative risk of breast cancer by 30% and amoung other things to raise the risk of heart attack and uterine cancer.

But perhaps we shouldn’t be so quick to lay the blame at the medical profession’s doorstep. It was the 1966 book Feminine Forever that started it all. The book’s author Dr Robert Wilson sang the praises of HRT claiming it could keep women young and sexually attractive. It's this basic premise that has fuelled today's HRT frenzy. Sure, as women came out of the kitchen and into the professional world the marketing profile of HRT gradually changed to encompass a range of more specialized medical promises. But as a recent New Zealand study on HRT use confirmed, the most common reason for starting treatment was to relieve symptoms or enhance 'emotional stability', sex drive and appearance. Little different from Dr Wilson’s recommended use 36 years ago.

Especially in white middle-class communities (in a 1997 study European women were more than twice as likely to be using HRT compared to Maori or Pacific Island women) where until a couple of weeks ago going on the hormone had become almost a ‘coming of middle-age’ ritual. “Why wouldn’t you?’ the same enthusiast latté buddy asked me just a couple of years ago. But perhaps the question she should have been asking was much simpler; Just what is hormone replacement therapy?

The principal ingredient in Premarin, one of the two drugs presently under fire is PMU or pregnant mares urine. If you love horses you probably don’t want to read this. It turns out the pungent, frothy yellow stuff is rich in estrogen and the demand for it so strong there are around 40,000 horses being farmed for their urine in North America. Although Premarin can now be 100% synthesized, the industry prefers the ‘organic’ nature of the real stuff. So for the majority of their 11 month pregnancy the mares are confined to the ‘pee line’, standing in stalls often no more than three and half feet wide, with no exercise, strapped into urine collection harnesses with pouches cupping their genitals, their urine sucked from them. The mares are constantly pregnant and worn out by the time they’re 5 years old. That they suffer for our drug of choice goes without saying.

It’s not just the mares that suffer. In the United States the pleasure horse market is saturated so the foals, the by-product of PMU farming are shipped off for human and animal consumption. The pharmaceutical company that buys the urine says 8,000 foals in its farms are slaughtered each year but insiders report it’s more like 30,000.

Susan Wagner the founder of US organization Equine Advocates says she’d always hoped the treatment of PMU horses would be enough to put women off using the drugs. But of course it wasn’t. It’s taken a medical misadventure and good old self-interest to end what Wagner calls ‘a 60-year catastrophe for horses.’

But horses aside, some commentators, viewing the HRT debacle, have once again asked that old feminist question; who owns women’s bodies? The answers are typical. The male dominated medical profession gets it’s share of blame and of course the pharmaceutical companies that market HRT have been accused of exploiting vulnerable women – and yes Wyeth-Ayerst the manufacturers of Premarin, were recently revealed to have paid the good Dr Wilson handsomely for his 1966 best-seller.

But surely we’re not still that stupid. The predominant users of HRT are educated professional women. We consider ourselves media savvy; we pride ourselves on seeing through glossy advertising campaigns. ‘They’ didn’t sell us another medical travesty. We bought it. For all our ‘our bodies, ourselves’ feminist rhetoric we’re still in revolt from the natural process of our bodies. The question we should be asking is not ‘how did the medical profession allow the time bomb of HRT to happen?’ but why do we, the end-users, treat our middle age as a disease, virulent enough to have its ‘cures’ subsidized by Pharmac.

Ultimately it’s us, the latte women of Ponsonby (and every other well heeled middle class suburb) who need to re-evaluate our own roles in this debacle. As to what will happen to the mares now the bottom has dropped out of the urine market is anyone’s guess. Possibly they’ll be put out to pasture, but more likely they’ll end up in some trendy new burger. Or maybe Wyeth will discover PMU miraculously cures another illness. Wrinkles perhaps.

© Barbara Sumner Burstyn

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