There is a way that seems right to a man, but its end is the way to death. (Proverbs 14:12)
Not long ago, on our local CBC Calgary radio morning show, medical contributor Dr. Raj Bhardwaj—speaking about hormone replacement therapy (HRT) to relieve the symptoms of menopause—provided some insight into why this particular treatment has been surrounded by controversy.1
Dr. Bhardwaj began by stating that, today, only about 10% of post-menopausal women are receiving HRT, compared to about 30% of them some 20 years ago.
In other words, doctors used to employ HRT much more frequently. Why the change?
The history around this is fascinating. Back in the 1960s, Dr. Bhardwaj explained, physicians reasoned that—since menopausal symptoms are caused by decreased estrogen production—it made sense that replacing the estrogen would relieve those symptoms. And so, doctors began prescribing estrogen pills for their middle-aged female patients. However …
“After about 10 years of giving estrogen to women,” Dr. Bhardwaj said, “research started to show that doing that actually increased their risk of uterine cancer!
“So then they changed things around, and another 10 years of research showed that if women took both estrogen and progesterone—another hormone that’s in most birth control pills—it actually decreased their risk of uterine cancer, and it looked like it decreased their risk of heart disease, as well. So in the ‘80s, a lot of middle-aged women were getting put on hormone replacement therapy to protect them from heart disease, not because they had menopause or any kind of menopausal symptoms at all.
“And then, [in] 2002, this big study called the Women’s Health Initiative Trial hit the media.2 And it hit hard, because it was actually stopped early, because they found that the effects of hormone replacement were significantly different from what they were thinking. So they found that not only was there no big protective effect of hormone replacement on heart disease, it also showed that there was an increased risk of stroke, breast cancer, blood clots—all sorts of bad things—for women who were on hormone replacement pills, compared to women who weren’t.”
That totally changed the “risk/benefit equation,” and physicians began thinking that HRT’s dangers outweighed its benefits. As a result, hormone treatment for menopausal symptoms fell out of favour.
But that was in 2002. As the good doctor put it, “Science marches on!”
Closer examination of the Women’s Health Initiative (WHI) Trial revealed a problem: it focused exclusively on women between the ages of 50 and 79.
“But menopause happens sort of in the 48- to 52-year range,” Dr. Bhardwaj said. “And the perimenopause—that four-or-five years when women approach menopause—that’s really when a lot of them get their symptoms. And there were no women in their 40s in this study.”
As medical scientists investigated further, they discovered some facts that were not emphasized in the WHI results. For one thing, there was no evidence of increased heart disease risk in women under 60. Plus, the breast cancer risk seemed to virtually disappear if HRT was used for less than five years.
So the HRT pendulum, Dr. Bhardwaj said, has swung from “Use it in everyone” to “Better not use it in anyone” to “now, it’s sort of panning out to use it judiciously, not for too long, and expect bigger benefits in women in early menopause rather than in late menopause.”
In other words—based on the most up-to-date research—the bottom line for HRT is that it’s safe if carefully administered. As Dr. Bhardwaj went on to say, “This is why science is science and not alternative medicine … As [new] evidence comes out, we change. We change our practices.”
“That’s why science is science.” Indeed. And that is why, for the most part, we can rely upon scientific methods to produce accurate results and beneficial applications … in the end.
The trouble is, it’s not always clear when that “end” has been reached. It’s not beyond the realm of possibility that future research—reported next year or next week—will yet again point to HRT being unsafe or ineffective.
Or so it seems to this layman. Like most people, I am not scientifically trained, and so I rely upon science journalists for my information about new medical advancements, or about developments and discoveries in other scientific fields. And so, when I hear about the latest Killer Asteroid hurtling toward earth—or when I hear conflicting “expert” opinions about the efficacy of flu vaccines … Well, that gets my attention. But it doesn’t always satisfy my appetite for clarity.
That’s why—despite the number of high-profile scientists appearing in the news media to assert the absolute perfection of the scientific method—I’m unwilling to embrace science with the kind of almost-religious fervor of folks like Richard Dawkins.
I can only judge scientific advancement according to the information I’m given. And much of that information points to a very widely- (and often wildly-) swinging scientific pendulum. Which means that (again, I think, like many other people) I tend to take much science reporting with a grain of sodium chloride.
Don’t get me wrong. I’m not preaching some kind of anti-scientific gospel here. Obviously, the benefits of science to humankind far outweigh its detriments. Science has provided blessings in abundance: improved agricultural methods yielding greater harvests; jet transportation that has brought the world closer; internet technology that’s brought the world to every desktop; surgical techniques that can repair an infant’s defective heart. Plus smart phones, espresso machines, and microwave ovens. Not to mention penicillin, organ transplants, and emergency defibrillators. The modern world is much better off because of science.
However, I would argue that science—being, after all, a human enterprise—will always be less than perfect. I refuse to make an idol out of the scientific method, or to build a scientific religion around it.
Yet it’s true that science and religion have much in common. They both seek Ultimate Truth. Yet, inevitably, each falls just short of its goal. Or, sometimes, very far short of the goal. Often, each one just plain gets it wrong.
When science gets it right, it yields all the benefits named above, plus a cornucopia of life-enhancing fruit.
When religion gets it right, we are blessed with ethical systems of law, love of neighbour, equitable sharing of resources, ways of reconciliation and peace, spiritual enlightenment. Salvation.
When science gets it wrong, we get thalidomide babies,3 radioactive fallout, biological weapons, bogus racial theories and Nazi eugenics.
When religion gets it wrong, we get suicide bombers, pogroms, crusades, doomsday cults and residential schools. We get false prophets forecasting specific dates for Armageddon, rejection of needed medical treatment, entrenched bigotry and racism.
Yes. Science and religion do, indeed, have much in common. When we get it right, human existence is made better, Ultimate Truth is more closely apprehended, society benefits, and lives are saved. When we get it wrong, truth is obscured. And people die.
In fact, it seems to me that—for all of their shared positives and negatives—neither science nor religion can afford to view the other with scorn. Of professor and priest alike, smugness is unbecoming.
“Without the Way, there is no going; without the Truth, there is no knowing; without the Life, there is no living.” —Thomas à Kempis (1380–1471)
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1 http://www.cbc.ca/news/canada/calgary/programs/eyeopener/dr-raj-bhardwaj-on-menopause-1.4358646
3 http://www.thalidomide.ca/the-canadian-tragedy/