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  • Tania Elfersy

Who’s writing the narrative on midlife women’s health?

“Have you any notion how many books are written about women in the course of one year? Have you any notion how many are written by men? Are you aware that you are, perhaps, the most discussed animal in the universe?” ― Virginia Woolf, A Room of One's Own (1929)

“It is the untreated [menopausal] woman – the prematurely ageing castrate – that is unnatural…. The mere fact that such women castrates are prevalent – and getting more so every day as the world fills up with older women – does not make them biologically natural.” ― Robert A Wilson, MD, Feminine Forever (1966)

Almost 90 years since Virginia Woolf wrote A Room of One’s Own, more women are writing about midlife women’s health. Unfortunately, all too often, the narrative is based on the assumptions of male doctors from mid last century.

Since the 1940’s, the medical world has considered menopause to be a hormonal deficiency disorder, treatable with estrogen based drugs. These drugs (known as hormone replacement therapy) are intended to reverse the female bodies’ natural course of estrogen depletion, which occurs when a woman moves beyond her reproductive years.

In the 1960s, doctors started recommending hormone replacement therapy, not only to cure menopause symptoms, but also to prevent the onset of diseases that menopause allegedly could cause: heart disease, cancer, osteoporosis and Alzheimer’s ― they claimed. This was the decade of the influential book Feminine Forever – quoted above and at the time, financially backed by Wyeth, the producer of the most popular estrogen drug, Premarin.

Fast forward to October 2016, when The International Menopause Society (IMS), a UK-based charity promoting education and research on women’s health, celebrated “World Menopause Day.” IMS’s theme for this year’s celebration was Heart Health Matters.

In the purply patient pamphlet accompanying the celebrations, IMS explains how our reduced estrogen levels caused by menopause increases the danger of heart disease. They list our risky low estrogen levels before they even mention smoking, diet or exercise – clear evidence that modern medicine is still encouraging women to fear a natural next step in their life cycle, while offering them a solution through hormone replacement therapy.

If someone can explain the evolutionary advantage of women journeying through menopause with decreased estrogen levels so that they would only increase their chance of disease, please be in touch.

Don’t worry. No-one will. It makes no sense.

What does make sense is that drug companies have a big stake in the way we discuss and understand women’s health. In North America alone, estrogen based hormone replacement therapies hold a market size of $8 billion. In order for drug companies to protect and expand their market share, the demand for estrogen as a treatment for menopausal symptoms needs to remain high. Doctors need to prescribe estrogen based drugs and women at midlife need to be convinced they can benefit from them without risk.

How does this happen? Take a look at The North American Menopause Society (NAMS), an organization that educates doctors and the public at large, and is often quoted by the media when it seeks out expert opinions on midlife women’s health. With the URL, which appears on the first page of a Google search for menopause, the chances are that when a women starts suffering from symptoms associated with perimenopause and menopause, she’ll probably reach NAMS looking for trustworthy advice before she reaches her own doctor.

NAMS describes itself as such:

"The North American Menopause Society (NAMS) is North America's leading nonprofit organization dedicated to promoting the health and quality of life of all women during midlife and beyond through an understanding of menopause and healthy aging. Its multidisciplinary membership of 2,000 leaders in the field – including clinical and basic science experts from medicine, nursing, sociology, psychology, nutrition, anthropology, epidemiology, pharmacy, and education – allows NAMS to be uniquely qualified to provide information that is both accurate and unbiased, not for or against any point of view."

I highlighted the words “accurate and unbiased” because just this month, NAMS posted a document on their website detailing the financial relationships of their Board of Trustees. Nine of the fifteen members of the Board of Trustees are currently involved in, or over the last year have been involved in, financial relationships with pharmaceutical companies that market estrogen based drugs. The current president of NAMS is one of the nine, as is the president elect.

Oh, and just so you know, the current treasurer of the IMS is a past president of NAMS with a similar history of cozy relationships with numerous hormone therapy drug companies.

I leave this information in your wise hands.

Consider sharing it with your friends.

Also, next time you have an appointment with your doctor, consider asking them how she or he gets educated about perimenopause and menopause. It’s your right to know!

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