It happens to every woman, naturally, but doctors sometimes have to get involved. The menopause is not yet `medicalised'

Do you deplore the medicalisation of the menopause? I didn't until last week, when I had to support a motion that did. As a prescriber of hormone replacement therapy, I'd rather assumed I'd be opposing but the drug company behind it decided I was just the sort of chap to speak for it. Not an easy task without coming across as a big, ginger hypocrite.

My partner Dr Ellen Grant had devoted much of her life to criticising the prescription of sex hormones because they "disrupt the balance of our bodies' vital nutrients, rob us of our protective immunity and threaten our genetic integrity". She has fine medical credentials and speaks with a conviction I find unsettling, not least because I prescribe these hormones for all the conditions she says I shouldn't. It wasn't going to be an easy partnership.

Opposing the motion was Professor David Purdie, a consultant gynaecologist, and Angela Rippon. The chair was a gynaecologist and the audience consisted of, um, gynaecologists, members of the British Menopause Society and employees of an HRT manufacturer. I felt like a Chelsea fan up the wrong end of Old Trafford.

The thrust of Professor Purdie's argument was to emphasise the benefits that medicalisation has brought women over the centuries (eg they tend not to bleed to death in childbirth these days) and that HRT should rank alongside these great achievements. Thanks to medicine, women are now likely to spend 40 per cent of their lives post-menopause, and it will take another medical advance to maximise the quality of life of many (but not all) of them. There are oestrogen receptors all over the body, and a daily oestrogen fix in those who need it has benefits for bone, heart, arteries, mental and nervous function which greatly outweigh the increased risks. End of story.

Dr Grant begged to differ. "The menopause is a natural event in the life of a woman. So why medicalise it?" Good point. "Women and doctors have been brainwashed into believing that the menopause heralds an oestrogen deficiency disease. This is physiological nonsense. Do young girls have an oestrogen deficiency disease before puberty?"

Every drug has the potential to do harm as well as good, but Dr Grant believes sex hormone prescribing is almost exclusively harmful. "The time course of the breast cancer epidemic in developed countries correlates uncomfortably well with the changes in sex hormone prescribing." Angela Rippon wanted women to have informed choice. Hand over the evidence and let individual women decide if HRT was for them. You can't really argue with that unless you believe women aren't capable of making rational decisions - and I know some gynaecologists who do. Dr Grant is convinced that much of the evidence on which the benefits of HRT are founded is flawed and so rational decisions are impossible. Professor Purdie was quick to poo- poo this, but admitted that a large controlled trial of HRT versus placebo had yet to be completed. This is the gold standard test to check if a treatment works or not but it's very expensive and there is so much hype about HRT that one such trial in America is having difficulty recruiting volunteers because no one wants to risk taking the placebo.

For me, the debate hinged on the word medicalisation. "It doesn't mean offering women medical choices but rather making it very difficult for women to have anything other than a medical choice. Take childbirth: 98 per cent of women have hospital births even though low risk deliveries are just as safe at home. Yet it's impossible for many women to get home births because we've all been brainwashed into believing hospital is safer. If the menopause was truly medicalised, women wouldn't be allowed to have it at home. They'd be strapped to a hospital bed with their legs in stirrups until the flushes had passed." Somebody laughed or choked. "And medicalising the menopause is far more than HRT. A gynaecologist in this room offered his wife a hysterectomy and ovary removal for her 40th birthday." Nobody laughed. "Eighty per cent of the wives of American gynaecologists have had their wombs removed. Is this a good thing or are they just married to scalpel-happy chaps? If you're going to whip out the womb and ovaries because they're redundant and potentially cancerous, why not the tongue and ears? No one listens or talks to you when you're old.

"And why do men become gynaecologists anyway? You don't get women queuing up to be urologists saying, `Surround me by dribbly willies, yes please.' Medicalisation of women's health means men controlling and making decisions for women. Would a woman have come up with the idea of allowing pensioners to have babies? No, it's a man's experiment and it stinks. Imagine your grandmother in labour, and for that alone, I urge you to deplore medicalisation of the menopause." I was absolutely brilliant and completely irrelevant. We were thrashed. As for HRT, I heartily recommend it if you are at particular risk of brittle bone disease. For anything else, it's up to you.

PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Arts and Entertainment
From Mean Girls to Mamet: Lindsay Lohan
theatre
Sport
Nathaniel Clyne (No 2) drives home his side's second goal past Arsenal’s David Ospina at the Emirates
footballArsenal 1 Southampton 2: Arsène Wenger pays the price for picking reserve side in Capital One Cup
News
Mike Tyson has led an appalling and sad life, but are we not a country that gives second chances?
peopleFormer boxer 'watched over' crash victim until ambulance arrived
Arts and Entertainment
Geena Davis, founder and chair of the Geena Davis Institute on Gender in Media
tv
News
i100
Travel
travelGallery And yes, it is indoors
Life and Style
tech
Arts and Entertainment
The Tiger Who Came To Tea
booksJudith Kerr on what inspired her latest animal intruder - 'The Crocodile Under the Bed'
News
i100
Arts and Entertainment
British actor Idris Elba is also a DJ and rapper who played Ibiza last summer
film
News
Alan Bennett criticised the lack of fairness in British society encapsulated by the private school system
peopleBut he does like Stewart Lee
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

ES Rentals

    iJobs Job Widget
    iJobs General

    Account Executive/Sales Consultant – Permanent – Hertfordshire - £16-£20k

    £16500 - £20000 Per Annum: Clearwater People Solutions Ltd: We are currently r...

    KS2 PPA Teacher needed (Mat Cover)- Worthing!

    £100 - £125 per day: Randstad Education Crawley: KS2 PPA Teacher currently nee...

    IT Systems Manager

    £40000 - £45000 per annum + pension, healthcare,25 days: Ashdown Group: An est...

    IT Application Support Engineer - Immediate Start

    £28000 per annum: Ashdown Group: IT Software Application Support Analyst - Imm...

    Day In a Page

    Syria air strikes: ‘Peace President’ Obama had to take stronger action against Isis after beheadings

    Robert Fisk on Syria air strikes

    ‘Peace President’ Obama had to take stronger action against Isis after beheadings
    Will Lindsay Lohan's West End debut be a turnaround moment for her career?

    Lindsay Lohan's West End debut

    Will this be a turnaround moment for her career?
    'The Crocodile Under the Bed': Judith Kerr's follow-up to 'The Tiger Who Came to Tea'

    The follow-up to 'The Tiger Who Came to Tea'

    Judith Kerr on what inspired her latest animal intruder - 'The Crocodile Under the Bed' - which has taken 46 years to get into print
    BBC Television Centre: A nostalgic wander through the sets, studios and ghosts of programmes past

    BBC Television Centre

    A nostalgic wander through the sets, studios and ghosts of programmes past
    Lonesome George: Custody battle in Galapagos over tortoise remains

    My George!

    Custody battle in Galapagos over tortoise remains
    10 best rucksacks for backpackers

    Pack up your troubles: 10 best rucksacks for backpackers

    Off on an intrepid trip? Experts from student trip specialists Real Gap and Quest Overseas recommend luggage for travellers on the move
    Secret politics of the weekly shop

    The politics of the weekly shop

    New app reveals political leanings of food companies
    Beam me up, Scottie!

    Beam me up, Scottie!

    Celebrity Trekkies from Alex Salmond to Barack Obama
    Beware Wet Paint: The ICA's latest ambitious exhibition

    Beware Wet Paint

    The ICA's latest ambitious exhibition
    Pink Floyd have produced some of rock's greatest ever album covers

    Pink Floyd have produced some of rock's greatest ever album covers

    Can 'The Endless River' carry on the tradition?
    Sanctuary for the suicidal

    Sanctuary for the suicidal

    One mother's story of how London charity Maytree helped her son with his depression
    A roller-coaster tale from the 'voice of a generation'

    Not That Kind of Girl:

    A roller-coaster tale from 'voice of a generation' Lena Dunham
    London is not bedlam or a cradle of vice. In fact it, as much as anywhere, deserves independence

    London is not bedlam or a cradle of vice

    In fact it, as much as anywhere, deserves independence
    Vivienne Westwood 'didn’t want' relationship with Malcolm McLaren

    Vivienne Westwood 'didn’t want' relationship with McLaren

    Designer 'felt pressured' into going out with Sex Pistols manager
    Jourdan Dunn: Model mother

    Model mother

    Jordan Dunn became one of the best-paid models in the world