Friday, July 4, 2008

The Evolution of Menopause - From Nature to Illness and Back Again

It's something we've all seen before. From puberty to childbirth, the medical profession does it's very best to "medicalize" each and every condition that it possibly can. How many young women are being placed on birth control pills during puberty to "regulate" their cycles, even though though their cycles are supposed to be irregular during that point in their lives?

Even childbirth was once considered a perfectly natural event. Sometime during our grandmother's time, childbirth moved out of the midwife's hands at home, into the doctor's hands at the hospital. While the results of that change weren't universally negative (infant and maternal mortality rates were drastically reduced), the rate of cesarean births shot through the roof.

most recently, there has been a strong push by the medical industry to "medicalize' the perfectly natural condition known as menopause. The medical industries concept of "treating" menopause as an illness was born with the advent of antidepressants and tranquilizers in the mid to late 1950's. Although first used in mental hospitals, the pharmaceutical companies quickly grasped that a much larger market could be tapped in the form of middle-aged women. By the sixties, these drugs (among other psychotropics) were being widely promoted to doctors as a method to "cure" their menopausal patients of their "symptoms". Although prescribing tranquilizers as a form of treatment was quickly abandoned, the damage had been done: Menopause was now thought of as an "illness" that needed to be treated.

This approach then shifted quickly from the mind to the body. According to doctors, the women who were experiencing these menopause symptoms weren't nuts, they were just had a "estrogen deficiency disease". This, despite the fact that if estrogen deficiency were really a disease, all men should have been declared chronically ill. Instead, doctors declared this "disease" to be the result of a problem specific to Females which they defined in the gynecological texts as ovarian or reproductive "failure". In short, women who were entering this perfectly natural stage in their reproductive lives were being labeled as "sick" failures. What's worse is that this type of thinking continues to dominate the medical approach to menopause. It's an approach that echoes the age old attitudes that were held about menstruation and childbirth. While men are free to naturally progress from youth to old age, women's progression through life leads to "illness" and "disease".

A perfect demonstration of this attitude can be demonstrated by a 1967 entry in the Journal of the American Geriatric Society by F.P.Rhoades which went so far as to call menopause a tragedy: "Many women are leading an active and productive life when this tragedy strikes. They are still attractive and mentally alert; they deeply resent what to them is a catastrophic attack upon their ability to earn a living and enjoy life." (Rhoades, F.P. "Minimizing the menopause." Journal of the American Geriatric Society 1969; 15(4):346-354)

Today, despite the fact that more and more medical professionals have begun to accept a less melodramatic approach to menopause; describing it as simply the transitional period from reproductive to non-reproductive status, many of the "old school" still prefers to approach menopause as a disease, which can have a number of unfortunate implications. On a practical level (the one that is further trumpeted by the pharmaceutical companies), it implies a distinct need for medication. In their opinion, it is a disease to be "treated" like any other. Unfortunately, this has led to a mindset among middle-aged women that they are ill simply because they have entered the "change".

Follow the Money - Menopause is Big Business

Despite the fact that women in so many other cultures experience menopause as a natural stage of life, there is one overwhelming reason why menopause has been turned into a "disease". In a word - money, money, money. The fact is, diseases need treatment, and (at least in the for-profit health system that exists in the United States) treatment costs money. The medical establishment in the U.S. has long been both a victim and willing participant of manipulation by the pharmaceutical industry.

Although we may think of the medical establishment as (*ahem*) above manipulation and the drug makers as altruistic, the fact is that the big pharmaceutical industry exists first and foremost as a vast profit machine. You need look no further than the relatively recent proliferation of television advertisements that are touting drugs for treating "conditions' that just a few years ago literally did not exist. Couple that with the fact that they are just as adept at marketing to medical professionals as they are to the general public (if not more so), and you have the perfect environment for creating the perception that the body's natural processes not only need to be treated, but that it will actually be harmful NOT to do so.

Furthering this climate is the ongoing perception that because medical "treatments" are scientific, that the doctors simply MUST be right. If the doctors say I need hormones because my body is "broken", then it must be true, right?

The Media - A Willing Accomplice

Unfortunately, big drug companies and medical professionals are not the only one responsible for perpetuating the myth of menopause as a disease. The mass media have been more than willing and eager to spread the misinformation touted by big pharma. Almost weekly, the media confuse press releases, marketing, and tentative findings generated from very small studies as if they had already been proven in the mainstream. On the cover of the December 1995 Reader's Digest Premarin was boldly labeled the "pill that keeps women young", this despite the fact that an insert for Premarin stated plainly that "You may have heard that taking estrogens for long periods (years) after menopause will keep your skin soft and supple and keep you feeling young. There is no evidence this is so and such long-term treatment may carry serious risks."

Many popular women's magazine are even encouraged to run as many stories as possible about osteoporosis and heart disease, which attracts plenty of ads for hormone replacement therapy. Think that's a coincidence? consider this example:

In the first edition of Prevention magazine (a very popular monthly health magazine geared towards baby boomers), there were at least two major articles touting the advantages of hormone replacement therapy. In that very same issue were ads for Premarin. When they later ran articles advancing soy protein as an alternative to expensive estrogen treatment for reducing hot flashes, there were no hormone replacement drug ads to be found.

Is it any wonder that so many women are confused about their choices for dealing with the change? With so many people and companies invested in keeping menopause classified (at least in the minds of women) as a disease that needs medical treatment, it is getting harder and harder to filter out the noise and find what will option work for YOU.

Alternatives to Drugs - From the West to the East

The good news is, thanks to the internet there is a plethora of information covering natural and alternative remedies for menopause. Form natural supplements and herbs, to acupuncture and other alternative treatments, there are some great treatments that involve less risk and changes to your lifestyle than a strictly pharmacological approach. Here's a list of a few of the herbs that have been found useful (I recommend you Google each one) in treating many of the various symptoms of menopause:

  • Black cohosh (Cimicifuga racemosa)
  • Chaste tree (Vilex agnus- castus)
  • Damiana (Turnera diffuse)
  • Dandelion (Taraxacum officinale)
  • Dong quai (Angelica sinensis)
  • False unicorn root (Chamaelirium luteum)
  • Ginkgo (Ginkgo biloba)
  • Ginseng (Eleutherococcus senticosus, Panax quinquefolius)
  • Licorice (Glycyrrhiza glabra)
  • Liferoot (Senecio Bursas)
  • Raspberry (Rubus idaeus)
  • Red clover (Tritolium pretense)
  • Sage (Salvia officinalis)
  • St. Johns Wort (Hypericum perforatum)
  • Sarsaparilla (Smilax officinalis)
  • Saw palmetto (Serenoa serrulata)
  • Shepherd's purse (CapseIla bursapastoris)
  • True unicorn root (Aletris farinosa)
  • Wild yam (Dioscarea villosa)

There are, of course, legitimate uses for almost every approach to "treating" menopause symptoms. However, I recommend you weigh ALL the risks associated with hormone replacement therapy, the possible benefits to alternative treatments, and find what's right for YOU.

Dawn M. Olsen is an Advocate for Better Women's Health through Education, Recipe Developer, Soy Food Enthusiast and the Author of "Menopause A to Z - A Definitive Guide to Modern Menopause available online now at Find out more about how to deal with symptoms of menopause and life post menopause.