Narrative review of changing medical and feminist perspectives on menopause: From femininity and ageing to risk and choice

Meanings and descriptions of menopause have shifted focus over the past century and a half; more particularly the past sixty years has seen a shift from descriptions of hormone decline and its relation to ageing, femininity and symptoms of menopause since the 1960's to the possibility for preventive medicine afforded by menopause. Medicine is not a static field in its construction of menopause. It has changed, not least by its engagement (positively or negatively) with critique from both within (epidemiological) and without (feminist and social sciences). In this review we identify three recent changes: (1) Increasing concern with women's decision-making. (2) The emergence from within medicine of the rejection of the use of language which defines menopause as a condition of deficiency. (3) New insights from postmodern and poststructural analyses of menopause that examine the epistemological foundations of medical and feminist concepts of menopause and contest fixed descriptions of the experience of menopause. Key aspects of a ‘medical menopause’ nevertheless remain constant: menopause is a loss of hormones that results in predictable effects and risks and may be ameliorated by hormone replacement therapy. A question therefore emerges about how and to what effect medical practitioners have engaged with critiques of the medical menopause?

[1]  L. Dumble,et al.  Disempowering midlife women , 1994 .

[2]  A. O'Connor,et al.  What factors are associated with a woman's decision to take hormone replacement therapy? Evaluated in the context of a decision aid , 2003, Health expectations : an international journal of public participation in health care and health policy.

[3]  R. Thomson,et al.  Engaging patients in decisions: a challenge to health care delivery and public health. , 2001, Quality in Health Care.

[4]  B. Armstrong,et al.  Hormone replacement therapy and breast cancer: what are the facts? , 1996, The Medical journal of Australia.

[5]  W. Utian.  A01 Pieter van Keep memorial lecture: Menopause—A modern perspective from a controversial history , 1996 .

[6]  S. Coney.  The Change: Women, Ageing and the Menopause , 2002, BMJ : British Medical Journal.

[7]  Alan Petersen,et al.  The new public health : health and self in the age of risk , 1996 .

[8]  B. Latour,et al.  Laboratory Life: The Construction of Scientific Facts , 1979 .

[9]  W. Utian.  The menopause in perspective. From potions to patches. , 1991, Annals of the New York Academy of Sciences.

[10]  Colleen M McBride,et al.  Evaluating participants' use of a hormone replacement therapy decision-making intervention. , 2002, Patient education and counseling.

[11]  L. Speroff.  It's time to stop using the word 'replacement'. , 2000, Maturitas.

[12]  S. Meredith,et al.  Decision-making about hormone replacement therapy by women in England and Scotland , 2004, Climacteric : the journal of the International Menopause Society.

[13]  A. Maclennan.  Hormone replacement therapy and the menopause , 1991 .

[14]  A. Maclennan,et al.  The prevalence of oestrogen replacement therapy in South Australia. , 1993, Maturitas.

[15]  J. Ussher.  Women's health : contemporary international perspectives , 2000 .

[16]  L. Lanzl,et al.  Estrogens and the aging process. The detection, prevention, and retardation of osteoporosis. , 1966, JAMA.

[17]  S. Whitcroft,et al.  Current therapy Hormone replacement therapy: risks and benefits , 1992 .

[18]  M. Murtagh,et al.  Feminist ethics and menopause: autonomy and decision-making in primary medical care. , 2003, Social science & medicine.

[19]  Frances B. McCrea.  THE POLITICS OF MENOPAUSE: THE "DISCOVERY" OF A DEFICIENCY DISEASE* , 1983 .

[20]  J. Stevenson,et al.  Hormone replacement therapy: risks and benefits. , 1992, Clinical endocrinology.

[21]  H. Selye,et al.  A PROGERIA‐LIKE SYNDROME PRODUCED BY DIHYDROTACHYSTEROL AND ITS PREVENTION BY METHYLTESTOSTERONE AND FERRIC DEXTRAN , 1963, Journal of the American Geriatrics Society.

[22]  J. Emery,et al.  Women's views of optimal risk communication and decision making in general practice consultations about the menopause and hormone replacement therapy. , 2004, Patient education and counseling.

[23]  R. Klein.  The unethics of hormone replacement therapy* , 1992 .

[24]  J. Ussher.  Body Talk : The Material and Discursive Regulation of Sexuality, Madness and Reproduction , 1997 .

[25]  A. Wass.  Promoting health: the primary health care approach , 2000 .

[26]  C. Obstetrics,et al.  Hormone Replacement Therapy and the Menopause , 2002 .

[27]  S. Harding.  Whose Science? Whose Knowledge?: Thinking from Women's Lives , 1993 .

[28]  Godfrey Fowler,et al.  THE STRATEGY OF PREVENTIVE MEDICINE , 1992 .

[29]  S. Crawford,et al.  Is there a menopausal syndrome? Menopausal status and symptoms across racial/ethnic groups. , 2001, Social science & medicine.

[30]  D. Wanless.  Securing Our Future Health: Taking a Long-Term View. Conclusions and recommendations , 2002 .

[31]  Sue O'sullivan.  The Change - Women, Aging And The Menopause , 1993 .

[32]  S. Nettleton,et al.  The Sociology of Health Promotion: Critical Analyses of Consumption, Lifestyle and Risk , 2003 .

[33]  M. Murtagh,et al.  Menopause as a long-term risk to health: implications of general practitioner accounts of prevention for women's choice and decision-making. , 2003, Sociology of health & illness.

[34]  W. Utian.  Pieter van Keep Memorial Lecture. Menopause--a modern perspective from a controversial history. , 1997, Maturitas.

[35]  T. Kuhn,et al.  The Structure of Scientific Revolutions. , 1964 .

[36]  Kristin Taylor,et al.  Women's decision making about the use of hormonal and nonhormonal remedies for the menopausal transition. , 2003, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[37]  N. Worcester,et al.  The Selling of HRT: Playing on the Fear Factor , 1992 .

[38]  R. A. Wilson,et al.  THE FATE OF THE NONTREATED POSTMENOPAUSAL WOMAN: A PLEA FOR THE MAINTENANCE OF ADEQUATE ESTROGEN FROM PUBERTY TO THE GRAVE , 1963, Journal of the American Geriatrics Society.

[39]  Reinterpreting Menopause : Cultural and Philosophical Issues , 1997 .

[40]  P. Kaufert.  Methodological Issues in Menopause Research , 1990, Annals of the New York Academy of Sciences.