Politics, Ideology, and Medicine THE MEDICALIZATION OF MENOPAUSE: CRITIQUE AND CONSEQUENCES

Menopause is in the process of becoming medicalized. Midlife and older women are being told that natural menopause is actually a deficiency con-dition requiring replacement hormones to maintain health and increase longevity. The three major diseases that are being linked with the lower estrogen levels of midlife and older women are heart disease, osteoporosis and, most recently, Alzheimer’s disease. Primary prevention of these diseases is the rationale used for urging healthy women to take long-term hormones. Although there have been many challenges to these links and warnings against the widespread use of hormones, they have been either ignored or trivialized. In this article, the author examines mortality and morbidity statistics across and within nations and over time, critiques the major arguments used to support the notion that menopause places women at an increased risk of disease and that exogenous hormones reduce this risk, and discusses the adverse consequences of defining all midlife and older women as hormonally deficient and in need of medical intervention. “Medicalization ” refers to changing a process or a condition considered normal into one requiring medical intervention (1). Midlife and older women are being told that the normal process of menopause is actually a hormone-deficiency condition requiring replacement hormones to maintain health and increase longevity. This deficiency notion originated primarily in the United States (2–5), as has much of the research supporting it, and is being actively promoted in many countries throughout the world. The three major diseases that are being linked with the lower estrogen levels of midlife and older women are heart disease, osteoporosis, and, most recently, Alzheimer’s disease. Primary prevention of these diseases is the rationale use