Understanding of Menopause Has Changed Through the Years

Patient Expert

How times have changed And how far we've come!

Recently, The Atlantic posted a video of how doctors treated women for menopause in 1953. Here are some of the highpoints and low points of the video (as well as what we've learned since then, which I've placed in parenthesis):

  • Changes in menopause occur near the end of the fifth decade of life between the ages of 45-50, but can happen as early as the age of 35 or as late as 52. (At Aristotle"�s time, menopause was considered beginning at 40 years of age. The term "menopause" was coincided in 1821. Today, the average age of women have their last period is 52. Furthermore, we know how there are stages that women go through to in the menopausal transition - perimenopause, menopause, and post-menopause.)
  • Menopause involves readjustments in physical activity and mental outlook. Many women are able to manage this transition through sensible management of their daily life, which is displayed in the film as a woman moving slowly from one chair to a rocking chair. (This information runs counter to recommendations that you should continue exercising throughout menopause and can lead a robust life. In fact, I have several friends who are running half-marathons in their 60s and 70s.)
  • The film notes that menopause is a natural stage of development. (This is a major development since people in the 193os started describing menopause as a deficiency disease that required replenishment therapies such as taking testicular juice and crushed ovaries of animals. We're finally getting to the point where we think about menopause as a natural progression.   However, a 2002 study noted that women in western countries view menopause negatively whereas women in some countries such as India view the transition with a positive outlook. Thus, for some women, menopause is stigmatized.)
  • The film states that ovaries become senile, causing reduction of estrogen to function and ovulation to fail. (Frankly, I have to admit that the use of the word "senility" gets under my skin. Also, the film doesn't discuss surgical menopause at all.)
  • Hot flashes are common as well as blushing of the face and neck, perspiration and chills. (A 2002 study noted that whereas hot flashes are common in Western countries, Japanese women experience shoulder pain while poor vision is part of the menopausal transition in India.
  • Neurovascular changes lead to a variety of subjective emotional disturbances that affect every woman to some degree. These can include deep depression, complete indifference to surroundings, and sexual maladjustments complicated by knowledge that a woman's reproductive cycle has ended. In addition, women may experience anxiety, tension, insomnia, and gastrointestinal upsets including constipation, diarrhea and stomach upsets. The film also noted that women may also experience "troublesome symptoms" such as nervousness, vague pains, headaches and itching. The film suggests that these issues can be relieved by psychotherapy, sedatives and other supplementary medications. (Needless to say, much of this information is really dated. The most important piece to know today is that you should work with your doctor to come up with a plan tailored to your specific situation if you experience distressing symptoms. Many of the "treatments" can involve lifestyle changes, such as meditation, exercise, and diet changes.)
  • Estrogens can increase libido, help well-being and modify signs of depression.   (Research has found major health risks associated with estrogen therapy. Therefore, you need to talk to your doctor if you are interested in pursuing any type of hormone therapy. The general wisdom is to take the lowest amount that addresses your symptoms for the shortest amount of time possible.
  • Problems are real and acute, and the doctor may recommend mild sedation. Additionally, diet, thyroid extract, estrogens, androgens, curettage, and occasionally radiation or surgery may be needed. (Diet is still a key recommendation for women as they go through menopause. However, doctors have much more knowledge now thanks to research so they are able to better target treatments to issues that women may be facing. Research also has provided new information on areas such as hormone therapy so we now know the potential dangers of these types of therapies that once were regularly prescribed.)
  • Getting back to normal will help with the important remaining years of her life. (Again, I may be biased, but I'm reading this as "it's all downhill from here." That's not the case. Women can lead exciting, fruitful and long lives after going through the menopausal transition.)

It's good to know that we've come to a better understanding and acceptance about the concept of menopause. It's a natural part of a woman's life and can be as much of a new start as an ending!

Primary Sources for This Sharepost:

Seaman, B. & Eldridge, L. (2008). The no-nonsense guide to menopause.   New York: Simon & Schuster Paperbacks.

Singh, A., Kaur, S., & Walia, I. (2002). A historical perspective on menopause and menopausal age. PubMed.gov.

Wells, K. (2013).   This is how doctors treated 'The Menopause' in 1953. The Atlantic.