Climacteric hormone therapy in medical and lay texts in Finland from 1955 to 1992.
The "social shaping of technologies" approach holds that a technology is both socially embedded and that it shapes the social environment. The aim of this study was to investigate how hormone therapy use during the climacterium and subsequently was socially shaped in texts published in the main Finnish medical journals and lay magazines during 1955-1992. In these two arenas physicians, especially gynecologists, played the major role in the debate and their professional knowledge on hormone therapy was mixed with their views on women's status and roles, the quality of life and fears about aging when they were promoting hormone use, especially in the lay magazines. This type of argument for the promotion of hormone use persisted in the most recent texts, despite the availability of substantial evidence both for the against of hormone therapy. Overall, the texts clearly favored the benefits of the therapy. Three periods of differing orientation can be discerned. Attitudes towards hormone therapy tended to be cautious from 1955 through the 1970s, more enthusiastic in the 1980s, and mixed at the start of the 1990s. In the most recent texts critical comments came from individual women who had used the therapy or decided not to, including female physicians and other professionals. The results suggest that hormone therapy is socially embedded, but may also shape perceptions and the understanding of women's aging. The social shaping of the technology approach may improve our understanding of the development of health policy towards women at and after the age of the climacterium.
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National Research and Development Center for Welfare and Health, Helsinki, Finland.
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002979:Climacteric / Q000187:drug effects*; D004059:Diffusion of Innovation; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000639:trends*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010348:Patient Care Team / Q000639:trends; D011643:Publishing / Q000639:trends*; D012945:Social Values