STATS ARTICLES 2009
Menopause, HRT and the media
Trevor Butterworth, October 27, 2009
STATS, the Center for Media and Public Affairs and The Hormone Foundation collaborated on a broad examination of the scientific research on the highly publicized risks surrounding hormone replacement therapy and the way the media covered the debate.
In a unique collaboration between media critics and health experts, STATS, its sister organization, the Center for Media and Public Affairs (CMPA), and the Hormone Foundation, the educational affiliate of the Endocrine Society joined forces to analyze one of the most vexing health issues facing women as they enter menopause: what are the benefits and risks of hormone therapy
The STATS part of the project surveyed the empirical research on HT, noting its strengths and weaknesses, and distilling the evidence into a FAQ; the CMPA study looked at the media coverage, which shaped women’s perceptions of this issue.
The CMPA study examined 335 news stories from over five years of media coverage from a sample of major print and broadcast organizations, including the three . This analysis yielded 2,597 statements either asserting the benefits or the risks of hormone therapy.
90 percent of opinions expressed in the media coverage affirmed a risk, which given the strong data available on the harmful effects of HT, was not surprising. Discussions of benefits were more ambiguous and speculative: 60 percent of assertions on benefits affirmed a benefit while 40 percent cast doubt.
It wasn’t a surprise either, given the longstanding reluctance of the press to delve into numbers, to find that just 22 percent of stories contained one or more qualitative or quantitative evaluations of the risks of hormone therapy. These assessments were most often in the form of a “small but significant” risk (26 percent of evaluations) or as a “miniscule risk to individual women” (11 percent).
This reluctance to think through the numbers had an unfortunate effect. Although heart disease led the media’s discussion of risk over time, even as deeper analysis of Women’s Health Inititive data showed that there was no increased risk for younger women on hormone therapy, the generalized discussion of harm was misleading. As STATS Director of Research Rebecca Goldin, Ph.D noted (in the FAQ):
“some media sources reported the lack of heart-protective effect in terms of “risk of harm.” This citation of possible harm was especially misleading when it came to those women who had had a hysterectomy, or those women without a hysterectomy and were under 70 years old. While the WHI trials showed that HT should not be prescribed for prevention of heart disease, it did not show that HT was categorically risky for women to use.”
This pointed to the strength and the weakness of the coverage: Overall, the media were good at identifying the risks and benefits of hormone therapy but, crucially, not how the risks or benefits specifically applied to women with different health profiles. Important qualifiers such as the age of the women being studied and the length of time they were on hormone therapy were often ignored. Thus, when numbers were cited without qualification, it seemed as if they applied to all postmenopausal women.