I have been writing about the medicalization of menopause for several years now. So I was intrigued when I stumbled across a review in the Journal of Aging Studies discussing how the social construct of menopause has shifted to “an increasingly more medicalized perspective that emphasizes the biological deficits of the aging female body.”
In this piece, researcher Rebecca Utz reports on qualitative interviews that she conducted with a small group of pairs of mothers and daughters, divided by generation and apparently, attitudes towards menopause. Medicalization, she writes, “is defined as the way in which the apparently scientific knowledge of medicine is applied to a range of behaviors that are not self-evidently biological or even medical, but over which medicine has control.” Therefore, in the case of menopause, our definition has shifted from something that a natural part of our development to an illness-based perspective “requiring medical intervention.”
Accordingly, when she interviewed both groups of women (mothers born during the 1920s and 1930s, and daughters born in early to mid-1950’s) she discovered that despite the commonality of physical symptoms, attitudes were significantly different:
- The older women did not perceive menopause as a problem or disease but rather, something that “just happened.” As such, it was not part of their narrative and most were uncomfortable discussing it, primarily because they considered it private and “inappropriate for public discourse” much like sexuality or emotional instability. And the steps taken to address it: Watch and wait for it to be over.
- The daughters, on the other hand, were likely to seek medical treatment as soon as symptoms appeared. This behavior is consistent with the premise that menopause has been increasingly medicalized. However, it wasn’t simply menopause that the younger women were fighting but on a larger level, aging. “In other words, menopause was just the beginning of a long, downhill battle that cannot possibly be won,” but can be controlled and self-managed. Moreover, these women’s fear was not necessarily entrenched in hot flashes and night sweats, but in what the start of menopause meant in terms of the delineation between youth and middle/old age and even “end of life as we know it,” a new older life stage that was unwelcome. The “cure” of course, were hormones and other pharmaceutically-derived interventions, which represented a way to “suspend old age” and control the physiological aspects of aging.
Not surprisingly, Utz also points to the ‘Menopause Industry:’ a “profit-seeking enterprise comprising pharmaceutical companies and perpetuated by the media intent on “turning 40 million baby boomer women into patients for life by defining menopause as an estrogen deficiency disease requiring significant medical intervention.” While the companies create the drugs, the media (whose increased attention attention to menopause, largely fueled by the wave of 1970s feminism and in part, funded by corporate interests) not only provide women with access to the information and resources that they seek but also contribute to perceptions of personal control among women who do not want to “sit back and let menopause just happen to them.” The result is that the Menopause Industry has not only developed products that these women crave that allows them to win their battle against old-age, but, continues to highlight the need for them.
Where does this leave us?
Although some women have fallen off the HRT wagon post-WHI study findings, others have remained. And even more expect the pharmaceutical industry to come up with something different to “quell the realities of their aging bodies.” Are we/they in for a surprise? Perhaps, because as Utz writes, aging is inevitable, even with quick fixes, and that at some point “the perceived autonomy and need for personal control may make [these women] more vulnerable or less prepared than their mothers to face the realities of old age.”
I’d like to offer another, more positive construct up for consideration:
Taking control doesn’t have to mean that the aging process is denied, stopped or obliterated, medicalized or industrialized. Rather, it means taking charge to feel better, more vibrant, healthier so that you/we/I can live the best life I can live while we are alive. For me personally, that doesn’t mean hormone replacement or botox or lipo; it means trying to make more healthier decisions, control or address my symptoms with evidence-based alternatives and accept the transition as a natural part of my journey. So, much like the mothers in this research, I consider this time an opportunity for shifting priorities and interests that open all sorts of possibilities. And like the daughters, I want to take the experience out of the closet and foster discussion and sharing. Ultimately, I’d like the see a more natural course driven by women themselves, as opposed to societal expectations and stigmatization of the aging process and as opposed to the Menopause Industrial Complex.
What about you?