Health
Older and wiser
by Linley Boniface
The menopause has been hijacked by the medical profession, says a UK author, who is attempting to dispel some of the anxiety about this stage in women’s lives.
When she was 42, UK historian Louise Foxcroft saw a medical consultant about a minor health problem. The young male doctor told her she was probably pre-menopausal – a dismissive, catch-all diagnosis that, to her surprise, infuriated Foxcroft.
“I was totally appalled and really cross with him. It seemed like a weird reaction, and I started to ask myself why I hated the idea of being pre-menopausal so much,” says Foxcroft.
The consultant was wrong – now 53, Foxcroft has yet to go through the menopause – but his remark prompted her to investigate why so many women greet menopause with anxiety and fear. In the resulting book, Hot Flushes, Cold Science: A History of the Modern Menopause (Granta, $39.99), Foxcroft argues that menopause has been hijacked by the medical profession. She attempts to knock down some of the taboos surrounding this natural stage of life – a stage that she believes is nowhere near as astonishing, or as potentially difficult, as pregnancy.
Most women experience menopause between the ages of 45 and 55; the average age is 47. The factors that define age at menopause are about 85% inherited, which means a woman has a good chance of going through menopause at about the same age as her mother.
The term perimenopause is used to describe the time between the start of irregular periods, or having hot flushes, and the 12 months after a woman’s final period. Although the process lasts up to four years, 10% of women cease menstruation abruptly and don’t go through a long transition. Hot flushes are almost synonymous with menopause, yet up to 40% of women don’t have them.
Until the 18th century, menopause was barely mentioned in medical literature. For millennia, women had simply been getting on with it. But as doctors’ interest in menopause increased, says Foxcroft, it came to be seen as “a gateway to disappointment, disease and death”.
She believes these attitudes evolved because Western medical thoughts about women were underpinned by the Greek and Roman tradition, which regarded women as inferior creatures of interest largely because of their reproductive systems. “The shame, contempt and con-fusion that shrouded diseases peculiar to women was extremely hard to dislodge … as the menopause was transformed from a natural phenomenon into a disease, this aspect of medicine became a form of purgatory for older women.”
The notion of menopause as evidence that a woman has outlived her usefulness was perhaps best summed up in Cicely Hamilton’s 1912 book Marriage as a Trade, in which an older man shares with a young woman his view that all women over 50 should be shot. Her response is to feel insulted that “she and her like should only be supposed to exist so long as they were pleasing … I knew others who have felt the same sense of anger … as they recognised that character, worth and intellect were held valueless in women, that nothing counted in her but the one capacity.”
It might seem an outdated view, but in 1969 American psychologist David Reuben was still able to argue in his bestselling Everything You Always Wanted to Know About Sex that “as estrogen is shut off, a woman becomes as close as she can to being a man … having outlived their ovaries, they have outlived their usefulness as human beings”.
Studies have suggested there is no such thing as a universal experience of menopause, with symptoms varying widely between cultures. Canadian women, for example, tend to associate menopause with depression, yet women from the Rajput caste in India do not: for them, menopause is the liberating time when they are permitted to take off their veils, come out of seclusion and mix with a wider social circle. In China, a society with great respect for older women, there are few reports of menopausal symptoms.
Foxcroft believes most women can easily get through menopause without medical help, and is particularly sceptical of the sex hormone industry. “There is still a perception that women will at some stage have to decide whether to take HRT [hormone replacement therapy] or not. I find that unbelievable. The idea that HRT should almost be a cosmetic -hormone, -to stop you from becoming dull and -unattractive, is extraordinary.”
The baby-boomer generation’s willingness to explore the process of ageing makes this an ideal time to attempt to remove some of the anxiety around meno-pause, says Foxcroft. “I’m not saying the menopause is fabulous. I’m just saying let’s be honest about it, and sweep away all the fear and dread.”
