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Population in the Human SciencesConcepts, Models, Evidence$
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Philip Kreager, Bruce Winney, Stanley Ulijaszek, and Cristian Capelli

Print publication date: 2015

Print ISBN-13: 9780199688203

Published to Oxford Scholarship Online: May 2015

DOI: 10.1093/acprof:oso/9780199688203.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 01 December 2021

Hormones and Disease

Hormones and Disease

contested knowledge of exogenous hormones in the evaluation of oral contraceptives and hormone replacement therapy

Chapter:
(p.572) Chapter 20 Hormones and Disease
Source:
Population in the Human Sciences
Author(s):

Klim McPherson

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199688203.003.0021

This chapter describes a half-century of research and debate over the synthesis of exogenous hormones for oral contraception and replacement therapy, together with associated risks of heart disease and cancers. Two current methodologies and their limitations are discussed: controlled randomized trials designed to pick up short-term effects of exogenous hormone preparations by comparing a representative sample population taking a new drug with a sample taking a placebo; and observational epidemiology which tracks large cohorts over longer periods. There has been a recurring failure to specify populations at risk accurately or at least agree on adequate procedures for doing so. Differing institutional interests have led to different base populations being used for estimation, and hence to continuing disagreements over appropriate trial criteria. The choice of population models becomes a material factor that may allow biomedical products with significant counter-indications to go on being prescribed, despite evidence of risk to individual women.

Keywords:   hormones, oral contraception, hormone replacement therapy, clinical trials, epidemiological cohort studies, population models, women’s health risks

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