Intended for healthcare professionals

Rapid response to:


Incidence of breast cancer falls with less HRT use, Canadian study confirms

BMJ 2010; 341 doi: (Published 27 September 2010) Cite this as: BMJ 2010;341:c5307

Rapid Response:

A first step in the trivialization of iatrogenic violence

That "the emperor has no clothes" (as stated by E. G. Breen) does not
only concern the risk of breast cancer, but also the innumerable hazards
of hormonal contraceptives: cardiovascular or muco-cutaneous adverse
reactions, effects on libido, etc. But even more, it concerns the
staggering myopia of the scientific community regarding this iatrogenic

I am currently reading a paper from women's magazines, written by a
gynecologist colleague who acknowledges that "hormonal fluctuations" may
certainly play a role in the development of vaginal mycosis, without
saying one word regarding those hormonal fluctuations potentially due to
the pill... Likewise, other papers in the lay press make me know that when
an attempt was made to submit elephants to hormonal contraception in order
to limit their overpopulation in the Kruger National Park (South Africa),
this triggered an intolerable "traumatism in the horde" as females were
"permanently" on heat. To say nothing on the now classical lamentation
regarding the threat on fish reproduction due the release of hormonal
contraceptives in natural water...

In his famous book (whose subtitle was significantly altered in its French
translation as "La brutalization des societes europeennes" [Brutalization
of European Societies]), the historian George L. Mosse explained how the
first world war, with its unprecedented savagery, accounted for a
brutalization of postwar politics and a trivialization of war with far-reaching consequences in the development of Nazism and subsequent
atrocities [1]. All other things being equal, it seems to me that one
could consider the introduction of oral contraceptives, at the beginning
of de 60ties (and with incredibly high doses of estrogens in that time),
as an unheard-of violence in the history of medicine, all the more
terrifying that it was not aimed at curing any disease but simply at
modifying probably the most valued object of humanity (for the aim of easy
consumption): female body [2]... This formidable transgression went far
beyond a betrayal of Hippocratic principles to go up to something close to
sacrilege; once this barrier was over, the door was open for a
reorientation of pharmaceutical research based upon an absolute contempt
for human body in its integrity and its beauty. To that extent, one can
say that the development of hormonal contraceptives accounted for the
contemporary trivialization of iatrogenic hazards and brutalization of
medical care, of which we are now the powerless witnesses.

[1] G. L. Mosse. Fallen Soldiers: Reshaping the Memory of the World
Wars. Oxford University Press, Oxford, 1990

[2] M. Girard. La brutalisation du corps feminin dans la medecine
moderne (

Competing interests: Dr M. Girard works as an independent consultant for pharmaceutical firms, including a number of contraceptives manufacturers.

02 November 2010
Marc Girard
Consultant and psychoanalyst
76 route de Paris, 78760 Jouars-Pontchartain, France