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Uncertainty in medicine: Meanings of menopause and hormone replacement therapy in medical textbooks

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  • Niland, Patricia
  • Lyons, Antonia C.

Abstract

Menopause is understood, portrayed, and experienced in diverse ways. The dominant biomedical perspective medicalizes menopause as a biological ‘hormone deficiency’ requiring ‘treatment’ with hormone replacement therapy (HRT). Alternative perspectives view menopause as discursively located within particular socio-historical times and places, or privilege women’s embodied experiences of menopause. We argue that the meanings of menopause and HRT should be debated within a context where the biological and the social, or the body and culture, intersect. The present study examined international medical student textbooks as sites of current biomedical knowledge, communicated for a new generation of health professionals. We undertook a Foucauldian discourse analysis on eight widely-used, international medical textbooks across physiology, pathology and pharmacology subject areas to identify the ways in which menopause and HRT are portrayed. Our results showed that menopause continues to be represented through dominant culturally infused ‘failure’ discourses and is portrayed as a ‘precursor to disease’ with HRT as the treatment. However, this knowledge is somewhat destabilized by a discourse of ‘uncertainty and speculation’ regarding the physiology of menopause and the potential effects of HRT. Knowledge about menopause, osteoporosis, and HRT was constructed as tentative, but the ‘quest’ for new knowledge was constructed as on the verge of ‘exciting discoveries’. We argue that bio-social understandings of menopause and HRT, and their medical uncertainties, need to be addressed in medical curricula to ensure that doctors engage with midlife women in appropriate and positive ways, especially given the increased call for women’s involvement in decision-making at this time.

Suggested Citation

  • Niland, Patricia & Lyons, Antonia C., 2011. "Uncertainty in medicine: Meanings of menopause and hormone replacement therapy in medical textbooks," Social Science & Medicine, Elsevier, vol. 73(8), pages 1238-1245.
    • Handle: RePEc:eee:socmed:v:73:y:2011:i:8:p:1238-1245
    DOI: 10.1016/j.socscimed.2011.07.024
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    References listed on IDEAS

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    1. Lyons, Antonia C. & Griffin, Christine, 2003. "Managing menopause: a qualitative analysis of self-help literature for women at midlife," Social Science & Medicine, Elsevier, vol. 56(8), pages 1629-1642, April.
    2. Mary C. Politi & Paul K. J. Han & Nananda F. Col, 2007. "Communicating the Uncertainty of Harms and Benefits of Medical Interventions," Medical Decision Making, , vol. 27(5), pages 681-695, September.
    3. Lingard, L. & Garwood, K. & Schryer, C. F. & Spafford, M. M., 2003. "A certain art of uncertainty: case presentation and the development of professional identity," Social Science & Medicine, Elsevier, vol. 56(3), pages 603-616, February.
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    Cited by:

    1. Clare Butler, 2020. "Managing the Menopause through ‘Abjection Work’: When Boobs Can Become Embarrassingly Useful, Again," Work, Employment & Society, British Sociological Association, vol. 34(4), pages 696-712, August.

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