Women have given HRT a fair trial and rejected it. Not to take their HRT is almost as bad as smoking. Why, they will get heart disease like men do (though probably fewer thrombo-embolic disorders). They will die younger without HRT, goes the argument, which does not go so far as to point out that this represents a valuable service for the public health authorities. It is unthinkable that women would not be delighted to live out their lives dependent upon chemotherapy supplied at a price by the pharmaceutical biochemical superpowers.

Modern women are much more highly estrogenized than their recent ancestors. An zoologist from Oxford calculated that over a mere 200 years the average number of menstrual cycles experienced by a European woman in her lifetime had increased from about thirty to 450. Her calculation is based upon the menarche’s occurring earlier and upon the infrequent pregnancies that modern women can expect to carry to term together with shorter periods of lactation. If we add to this the artificially estrogenized condition of modern woman post-menopause we end up with an astonishing 600 or so cycles. There is no precedent in the history of the human female for the raised and sharply fluctuating levels of circulating steroid hormones that we endure but, as we did not know what made the nineteenth-century female feel well or even if she felt well, we can hardly guess whether the modern women is better or worse off because of her vastly altered endocrinology. Only the rising cancer figures tell us that she is worse off.

How you answer the question, whether individuals should be persuaded to live their whole lives in a state of chemical dependency, first upon contraceptive steroids and then on replacement therapy, depends upon your regard for the autonomy of the individual. If men would not live their lives this way, why should women? Even though all teenagers should by now be convinced that condoms should be their contraceptives of choice, British physicians have begun lobbying for the right to prescribe synthetic sex steroids to women under sixteen. The caponized woman is now the norm.

They went back to natural estrogen, a cumbersome and expensive product, harvested from the urine of pregnant mares. The mares are fitted with a collection cup attached to a hose and confined in a narrow stall for the entire eleven months of their pregnancy. As soon as possible after the birth of their foals, who are routinely slaughtered, the mares are re-impregnated and the urine-collection process begins again.

If the pharmaceutical companies were to get women hooked the best time was at menopause when they were in estrogen withdrawal and begging for a fix. At least that was what the researchers thought that hot flushes, joint pains, sleeplessness, etc., added up to. The new mixtures were the methadone rather than the heroin. For some reason the women did not stay hooked. The selling and the product design were relaunched time and again. Sub-dermal implants seemed to lose their effectiveness; women required bigger closes, the implants became ineffective more quickly, menopausal symptoms recurred at shortening intervals. The manufacturers of sex steroid preparations, like the manufacturers of cigarettes, had what they wanted, addiction, and they were just as unwilling to talk about it. An underground network of pushers w-as set up; women, all users themselves, held HRT parties, bring-and-buy sales and coffee mornings, to spread awareness so that women would ask their doctors to prescribe.

Women who take estrogen definitely tend to look younger than their years. Their skin remains smoother, moister, oilier and more flexible – in other words younger. That doesn’t mean you should take estrogen for cosmetic purposes alone. Younger-looking skin is just one of the magical consequences of HRT that researchers have been unable to substantiate; as far as laboratory investigations can establish, exogenous estrogen has no effect on the epidermis or supporting structures.