Uh, O!

When Dr. Lauren Streicher, an assistant professor of obstetrics and gynecology at Northwestern University's medical school in Chicago, got a call from "The Oprah Winfrey Show" inviting her to discuss menopausal hormones with actress Suzanne Somers, she figured she'd better read Somers's best-selling books on the subject. As Streicher worked her way through the first chapter, she started underlining every sentence she felt was inaccurate. "But pretty soon, I had to stop," Streicher says, "because I was underlining almost everything."The taping of the show, which aired Jan. 29, proved equally disconcerting. Somers, a self-styled hormone and anti-aging expert whose controversial books promise midlife women that they will feel young and sexy if they take unregulated hormone therapy (HT) in much higher doses and for much longer time periods than most experts recommend, was literally given center stage. She was seated next to Winfrey, the newly proclaimed convert to the so-called bio-identical hormones promoted by the 62-year-old Somers. (Bio-identical generally refers to products that are chemically identical to hormones produced by a woman's body.) While Winfrey, 55, encouraged "every woman" to read Somers's book, the guests with actual medical degrees were relegated to seats in the audience, where they had to sit quietly unless called upon. Interspersed were taped segments of Somers smearing her arms with hormone cream, standing on her head and lining up the 40 dietary supplements she takes with her morning smoothie. The whole setup seemed to give the drugs that Somers uses the same enthusiastic endorsement that turns everything Winfrey promotes into a blockbuster.

The resulting spectacle disappointed many doctors who thought Winfrey had higher standards for the quality of medical information she dispersed—or, at least, more of a commitment to balance. Some said they were particularly upset because doctors had complained to Winfrey's production company about what they saw as misinformation disseminated during the show she did on hormone therapy two weeks before that featured Dr. Phil McGraw's wife, Robin.

Some experts are far more than disappointed: "I found the program to be quite shocking, and full of audacious claims, not substantiated by evidence," says Dr. Wulf Utian, a gynecologist and consultant at the Cleveland Clinic and founder of the North American Menopause Society, who has also worked as a consultant to the pharmaceutical industry. "Oprah is the most influential woman in the world, and I don't think she comprehends the amount of damage she has done to women's health. I came away feeling like Oprah really didn't understand the issue. Personally, I feel like she has set us back 100 years."

Somers puts partial blame for the hailstorm of criticism she gets from doctors on the fact that some medical experts, like Utian, have connections to the pharmaceutical industry. While many bio-identicals are produced by drug companies (which has become a highly profitable business for pharmacies and those who prescribe the hormones) and regulated by the FDA, the ones that Somers promotes are made in compounding pharmacies that are not required to be tested for quality or safety. Many other doctors, Somers says, simply don't understand bio-identical hormones as well as she does, because they "don't learn about them in medical school" or go to the alternative-medicine conferences she attends.

But it's not just clinicians who take issue with her recommendations that women follow a long-term high-dose hormone-replacement regime; the bulk of scientific research on the subject suggests that prolonged use of these hormones is associated with an increased risk of serious health conditions including cancer and heart disease.

Somers concedes she's not a scientist, but she is "a lay person passionately interested in preserving the quality of life and appalled by the lack of knowledge about this." She is particularly annoyed with the criticism of male doctors, saying they've never experienced menopause. But even though Somers reminds people she's just a layperson, she wasn't presented that way on the Winfrey program. And that's a problem, say experts. "My concern is with someone like Somers, whose only medical expertise is a personal one, giving medical advice to other people," explains Dr. Isaac Schiff, professor of obstetrics and gynecology at Harvard Medical School. "When people see this on TV, they may be encouraged to try hormones, without fully understanding the benefits and risks. They should have had a physician, who is trained and experienced, sitting on the stage at the same level and presenting another point of view."