Menopause: the symptom? Or, the disease?

Posted by on Sep 23, 2011 in emotions, estrogen, menopause, women's health | 4 comments

A few years ago, I ran across the following story on the BBC:

“Woman’s Death Blamed on Menopause.”

“A woman who refused to take hormone replacement therapy died while suffering a menopausal episode, an inquest had heard. Margaret Drew…was killed when she walked out of her family home on to a nearby railway line and was hit by a train…There is no trigger to this at all, except hormones making her do things that she normally wouldn’t do, Dr. Carlyon [Cornwall Coroner) concluded…”

Menopause. The silent killer. Oh really?  Drew’s husband claims that his wife was “delightful, lovely and friendly” 99% of the time; the other 1% she’d become “totally irrational.” Yet, she refused to try HRT, he says. On the day of her suicide, he said that his wife was “clearly angry about something.”


Obviously, the conclusion is that that the “something” is hormones. This reminds me of vintage advertising copy that conveys the simple message that a pill a day can cure all that ails, wipe away the tears, mood swings and instability so that women can “transition without tears” (or better yet, without killing themselves).

Notably, a search in the National Library of Medicine’s PubMed database turned up only one recent study specifically dealing with suicide ideation across reproductive stages. In it, researchers compared data in 8,794 women, and found an increased risk of thinking about suicide among women during perimenopause, not before or after entering menopause. These findings remained after controlling for risk factors such as anxiety and mood disorders. HOWEVER, the researchers noted that the study design did not allow them to form any definitive conclusions about the specific reasons for thinking about suicide.

Another search yielded information that the risk for a major depression increases during perimenopause, primarily as the direct result of vasomotor symptoms. The same does not hold true for women before menopause begins or once they enter menopause. Note that while major depression is a risk factor for suicide, not everyone who is depressed will actually kill themselves.

So, are hormonal fluctuations the sole cause of such deep unhappiness that women want to kill themselves?

Interestingly, just a week after the menopause/train suicide story hit the interwebz, a rather controversial set of data also emerged: since 1972, women’s overall level of happiness has dropped. These findings held true regardless of child status, marital status and age. Researcher Marcus Buckingham, writing in the Huffington Post, said that women are not more unhappy than men because of gender stereotyping and related attitudes, due to working longer hours or because of the inequality of housework/responsibilities at home, but rather, the hormonal fluctuations of menopause may be to blame. What’s more, he leaves us hanging so we’ll tune in for part two of the piece to learn the true cause of our declining happiness or better yet, read his book (which evidently guides women through the process of finding the true role that they were meant to play in life).

Importantly, reactions to this study (and various pundits’ assessment of it) have been mixed. One of the most poignant comments I’ve read asks the question “how is happiness measured? What does it mean?”

I have no idea what caused Mrs. Drew to walk into a train and kill herself. Perhaps she was depressed. Clearly she was suicidal.

I have no idea why research shows that women are less happier than they were three decades ago.

However, is menopause the cause? Aren’t these conclusions an example of how the Menopause Industrial Complex perpetuates societal myths that menopause is a disease that requires treatment? That as women, our attitudes, belief systems and actions are hormonally-based and driven? That we are hysterical beings who need guidance on how to find our way and fulfill our dreams, realize our paths, but only if we calm down?

Feeling angry? Blame it on menopause. Unhappy? Blame it on menopause. Not realizing your dreams? Blame it on menopause. Overworked, overstressed, undervalued? Blame it on menopause.

Blame it on menopause.

I don’t know about you but I’m tired, tired of hearing that menopause is not the symptom but the disease. Isn’t it time we start fighting back?


  1. 9-23-2011

    Love this article and couldn’t agree with you more. Yes, menopause is not the easiest time in a women’s life but neither is child bearing, puberty, aging, marriage, work etc etc. Appears to be a throwback to the time when women in menopause were considered crazy.

    Regarding your second point:
    The reason that today’s women are reporting being less happy than previously? Women were full of hope that society was finally changing and was accepting the fact that women have a brain and can use it.

    But with that came more and more responsibilities and expectations without changes in other areas of women’s lifes. It is now expected that women have a fullfilling career, provide a comforting home, raise their children, look forever young AND be happy. Something had to give.

  2. 9-26-2011

    Bravo! I think this article reveals alot about the underlying issues around midlife women and happiness, and I think the Menopause Industrial Complex – like other disease complexes – has just the hammer to nail hormones as the cause. Our entire medical system loves to find the disease to our problems, doesn’t it? It seems obvious that fluctuating hormone levels wreak havoc on mood but her suicide could be something more complex…and have little to do with menopause per se…and more to do with a change in her expectations around her relationships, and desire for more meaning in her life. LIke “is this all there is?”

    • 9-29-2011

      Kelly – I think that the hysterical woman comes to mind, much like the pharmaceutical ads of the 40s when the answer to ‘the change’ was sedation! I agree, however, that finding excuses seems to be an underlying foundation of Western Medicine, excuses that need treatment. Thanks or commenting!

  3. 9-29-2011

    Hi Anna. Interesting comment and you are probably right. I’m not sure if that leads to unhappiness or simply more discontent. Perhaps they are one and the same. p.s. You mean we can’t have it all?!

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