Historically 80% of Premarin and Prempro sales have occurred in the US. Even in the US, the cessation of menstruation is a non-event in 75% of women, producing no physical symptoms whatsoever. In fact, most languages and cultures have no word for menopause. In Chinese medicine, so-called menopausal symptoms are considered a manifestation of an underlying “imbalance” and disappear with a few days of herbal treatment. Even untreated, the hot flashes, night sweats, mood swings and insomnia some women experience rarely last longer than a few months. In fact, many women report an overall improvement in their health and well-being when they stop having periods.
Senior Women are Honored in Non-Western Cultures
There are interesting cross cultural studies of the “menopause” phenomenon. Non-western cultures typically view the cessation of monthly cycles as a milestone signaling transition to the role of community elder. The Filipino women Berger and Wenzel studied in Women, Body and Society: Cross-cultural Differences in Menopause (http://www.ldb.org/menopaus.htm) were extremely pleased with their freedom from the inconvenience of menstruation. They saw it as an initiation into the joys of old age – better sex (estrogens produced during the menstrual cycle suppress libido – see below*), improved mood and energy and increase in productive time. However most of all they appreciated the new love and respect they enjoyed, as an elder, outside the family. I see this attitude here in New Zealand in the Maori culture, where senior women receive the title of “kuia” or “whaia” both designating immense esteem, prestige, and influence over community affairs.
The Female Body: a Reservoir of Aberrations
As Berger and Wenzel describe, western society’s medicalization of this totally natural life process stems in part from a stereotypical attitude American (mostly male) doctors have had toward the female body as a “reservoir of aberrations” which require constant treatment.” The most extreme example, of course, was the view in Victorian times that the spasms women experience during orgasm were indicative of dangerous pathology that could lead to insanity. The recommended treatment was to sedate them during intercourse.
The apparent male need to control the power of reproduction has also been seen in excessive and often harmful medical intervention during labor and delivery (which women rebelled against by creating the natural birth movement) and infant care. As late as the 1950s, the latter took the form of pressure to abandon breast feeding and demand feeding (i.e. when babies are hungry) for “scientific” formula feeding according to fixed timetables; scare mongering about mothers co-sleeping with babies (preferred practice in non-western cultures); and insistence that breastfed babies be weaned by 12 months (the World Health Organization recommends breast feeding, supplemented by solids, until age four).
Berger and Wenzel also note the strong association of western medicine with the military – with constant reference to “fighting” illness and to “battles” with cancer and other diseases.
America’s Aggressive Marketing of Youth
As Berger and Wenzel’s and other cross cultural studies note, attitudes in the US and other English speaking countries are also heavily influenced by a multibillion dollar PR industry that bombards women constantly with messages glorifying youth, thinness and sexual attractiveness – and engendering frank terror of gray hair, facial wrinkles, weight gain and cellulite. Aggressive marketing preys very effectively on the insecurities these messages create to sell billions of dollars of wrinkle removing creams and lotions, age concealing make-up, hair coloring, botox, diet products and programs and plastic surgery.
“You’re Worth It”
*Despite popular misconception, sexual drive in women isn’t regulated by the female hormone estrogen, but by testosterone (a male hormone) and oxytocin (a feel-good hormone in both men and women associated with social intimacy – and milk ejection in nursing women). Estrogen has a powerful suppressant effect on both hormones. Thus female libido is driven by a steep drop in estrogen levels in the middle of the menstrual cycle, which triggers ovulation. The result is an intense testosterone/oxytocin effect (and surge in libido) during the time of the month when a woman is most fertile.
To be continued with a discussion of Wyeth’s discovery and aggressive marketing of Premarin – despite its known cancer risks.