Feminists Face Off in War Over Menopause

The unpalatable truth must be faced that all post-menopausal women are castrates . . . . Our streets abound with them--walking stiffly in twos and threes, seeing little and observing less. It is not unusual to see an erect man of 75 vigorously striding along on a golf course, but never a woman of this age. . . .

Now, for the first time in history, women may share the promise of tomorrow as biological equals of men. Thanks to hormone therapy, they can be feminine forever.

--Dr. Robert A. Wilson

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It has been 30 years since the original estrogen evangelist, Dr. Robert A. Wilson, brought us the breathtaking news: Menopause can be cured!

The “change of life,” Wilson reported in his hot bestseller “Feminine Forever,” was just another disease--not unlike diabetes or other hormone deficiencies. And like some other diseases, it could be treated, even prevented.

For the “tragedy of menopause”--and its 26 awesome symptoms from frigidity to suicide--the balding Brooklyn gynecologist fed his patients “youth pills” of pure estrogen.

Freed from the shackles of hormone deprivation, he predicted, aging women of the future would universally reclaim their sexuality, stand up straight, even play golf. . . .

Well, the future is here. But the legions of women taking hormones to “escape the horror of living decay,” as Wilson put it, are not.

Welcome to the great menopause debate.

On one side, there are the “I Love My Menopause!” feminists who see “The Change” as the perfect time to celebrate the end of life as a sex object. “No longer am I a servant of the species!” crows one such believer.

With help from the New Agers and naturalists, they urge us to go with the flow, so to speak. Menopause is a breeze, they say--or can be with the right combination of vitamins, herbs, acupuncture and knees folded into chests.

In the biomedical camp are the Freudians, the drug companies, a good many doctors and other scientists who have seized the symptoms of ovarian shutdown as yet another opportunity for better living through chemistry.

Hormone replacement therapy, argue these guys--yes, most of them are guys--promises a veritable fountain of youth for over-the-hill gals. It is estimated that 15% to 20% of menopausal-age women are now using hormones.

What’s a feminist with hot flashes to do?

“This is the natural childbirth crusade all over again,” says Pam Cosby, director of an Indiana women’s clinic. “We learned all the breathing and exercises so we wouldn’t disappoint and then when we found out we needed drugs to get through it, we were devastated.”

A former leader of New York City’s National Organization for Women says she pored over stacks of medical literature before reluctantly deciding to begin a regimen of hormone supplements at age 52.

“I vowed I would not feel guilty about taking hormones, and I don’t,” she says. “But if you print my name, I’m through.”

Fear of selling out the sisterhood is palpable in some parts of the women’s movement these days.

With new bibles on how to do menopause from Betty Friedan and Germaine Greer, women eager to be politically correct are feeling angry and confused.

A San Francisco author writing about her decision to go against the feminist party line recalls that she was prepared to feel bullied by the medical Establishment--”but not by those sworn to protect women from patronizing men.”

Bay Area psychotherapist Alexandra Gotsch confessed recently to Menopause News that as a feminist, she thought that if middle-aged women became depressed, “it was because they have emotional problems which happen to coincide with menopause and are not caused by it.”

All that changed, she wrote, “when my personal experience forced a reassessment.”

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In Friedan’s book, “The Fountain of Age,” the mother of the modern women’s movement dismisses menopause as something that apparently happened to her, but not so as she would notice.

What did pique Friedan’s attention as she charged into her research on aging, however, was the intensification of what she calls “a new brouhaha” about menopause.

“My own feelings of uneasiness and dismay increased,” she wrote. “I didn’t exactly suspect a new conspiracy against women, which was somehow co-opting us. But there seemed to be a suspicious coincidence of the demographic emergence of this incredible market--50 million women hitting menopausal age--with the revived definition of menopause as disease.”

A few years ago, Greer began exhorting women to embrace age as “an art.” Menopause, she promised, was a time to explore the freedom of being non-sexual.

“To be unwanted is also to be free,” the author of the “The Female Eunuch” reassures us today.

According to the post-menopausal Greer, menopause brings one “back into the self you were before you became a tool of your sexual and reproductive destiny.”

Talk about mood swings. In the fight for women’s liberation, Greer was the spokeswoman for a generation of women who routinely fought the notion that they were prisoners of their bodies.

“Cramps and monthly mood swings had no place in our battles,” recalls therapist Gotsch.

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So now that science has shown menopause can be “cured,” the question remains: Should it be?

Until the turn of the century, most women didn’t survive long enough to be troubled by menopause or its politics.

Indeed, a fashionable new argument for the use of estrogen and progesterone supplements to restore pre-menopausal hormone balance is to look at the cessation of menses as an evolutionary oversight.

In ancient times, any woman who lived to see The Change was put on a pedestal and worshiped.

According to goddess historians, such survivors were believed to possess great powers and were given the title Great Crone, She-Who-Holds-Her-Blood-to-Make-Wisdom.

Today, as outspoken, body-savvy baby boomers approach their own menstrual pauses, menopause is a cause celebre.

As 21 million American women bear down on this milestone over the next decade, menopause is expected to replace kids, shrinks, even mortgage rates as the hot topic for the ‘90s.

No longer a mere medical event, the phase-out of fertility has become a political rallying point at which to reflect on the very essence of womanhood.

Women who fought for reproductive freedom in their 20s and had their first babies in their 30s and 40s now want to know everything and control everything about the next phase: the alarmingly titled c limacteric.

Emboldened by their ability to revolutionize women’s health care, they are determined to take charge .

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But unlike other female uprisings, the villains here are not obvious.

Certainly, the multinational pharmaceutical companies are still in the lineup, say the feminaturalists.

To this latest harangue against sexism, ageism, greedy drug companies and the male medical model has been added a new group of co-conspirators--the menopausal women themselves.

In San Francisco, a support group has formed to steel women against the power of hormonal temptation. “It’s based on AA,” one member explains. “We don’t want to give in to our symptoms--hot flashes, depression, headaches, whatever--and ask for a prescription.”

At the heart of the debate is not just the safety of hormone replacement therapy, but the very question of what makes a woman a woman.

Is it hormones? Is it ovaries? Or is it a female state of mind?

“It’s very upsetting to be caught in the middle of this,” confides the leader of one Southwestern menopause support group who is secretly devoted to hormone replacement therapy.

“It should be a much simpler decision than it is,” concedes T. Keta Hodgson, coordinator of the Heart and Estrogen-Progestin Replacement Study (HERS) at Cedars-Sinai Medical Center.

Although trained as a nurse, Hodgson recognizes the value of alternative answers. For example, she has found that cutting back on refined sugar can be helpful for certain symptoms.

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Refinements in hormone replacement regimens have almost universally convinced doctors that it is safe for most women who want it.

Many recent studies suggest that the risks of cancer--mainly breast and endometrial cancer--are minimal compared to the protection hormones can offer from the more common threats of heart disease, osteoporosis, even Alzheimer’s.

But the increasingly volatile politics of menopause is affecting the very research that will answer the questions about hormone replacement’s full effects. Hodgson and others say strong feelings for or against use of hormones have kept many women away from their scientific studies.

“It’s a backlash to the backlash, I suppose,” Hodgson says. “I’m seeing lots of passion on both sides of the issue.”

Can a woman re-balance her hormones without being a traitor to her nature, her sex, her true self?

“Let’s face it,” A.P. of Katonah, New York, recently wrote to a women’s newsletter, “we are all acting peculiar.”