Review

Changing ‘the change’

The Menopause Industry
Sandra Coney
The Women’s Press, 1995

Medicalisation of the menopause is nothing new but what is frightening is the continuing prevalence of an undoubtedly faulty model with its attendant myths and values. A friend has recently completed her first year at medical school and her recently published physiology textbook reveals that the symptoms of the menopause include irritability, anxiety and various psychotic states. Sandra Coney, like other writers before her, clearly and categorically dispels such myths but how many doctors-to-be will read this book in preference to their large and expensive approved course texts ?

The book’s impact is not just in its exposition of the medical myths surrounding the menopause, and the successful industries which depend on its medicalisation, but in the realisation that the message has remained unchanged for over 30 years. We may now be given hormones instead of tranquillisers but women still need protecting from their biology and the best protection is in the hands of doctors.

The focus of concern about the menopause has shifted in recent years from depression and anxiety to the risks of osteoporosis. Coney discusses the worrying and somewhat contradictory evidence about the benefits of both long and short-term hormone replacement therapy in avoiding osteoporosis but perhaps more crucially looks at who is at risk of hip and vertebral fractures and what the actual benefits of oestrogen are for individual women.

This clear analysis of what is meant by ‘risk’ and what is meant by ‘benefit’ is one of the book’s strengths and avoids the problem of dismissing HRT for all women. Nevertheless, it would be hard after reading this book to feel enthusiastic about either the use of hormones during the menopause or the medical profession’s attitude to women-both appear to be distinctly unsafe.