The End of the Age of Estrogen: Women were told for decades that hormone-replacement therapy would protect their hearts and preserve their youth. Now the evidence is in, and an era is over.

Byline: Geoffrey Cowley and Karen Springen

Menopause may be a natural event, but the medical establishment has never viewed it as an auspicious one. "The years of the climacteric are the most troublesome in married life," the Czechoslovakian physician Arnold Lorand declared in his 1910 classic "Old Age Deferred"--"not only for the wife, who is directly affected by it, but also in almost equal degree for the husband, who must show the greatest forbearance." Luckily there was good news for the menopausal woman, "if only she be a clever member of her sex." Lorand had discovered that extracts from pigs' ovaries could "put off old age for a score of years," or at least "mitigate its effects when it has asserted itself with all its terrors." By the early 1940s, drugmakers were mass-producing estrogen from pregnant mares' urine (hence the brand name Premarin). And by 1960 the august New England Journal of Medicine was recommending the stuff for "everyone with evidence of an estrogen lack"--which is to say virtually every woman over 50. Last year U.S. pharmacists filled some 45 million prescriptions for Premarin and an additional 22 million for Prempro, which consists of the same drug with a progestin chaser.

Small wonder, then, that news last week about hormone-replacement therapy caused such gasps. This wasn't just another isolated study contradicting the last one to make headlines. Federal health officials announced last Tuesday that the jury was finally in--and that Prempro does significantly more harm than good when taken for long periods. Women had been told for decades that estrogen taken with progestin would not only ease hot flashes…