Book Review: Medicalizing Menopause

Watkins argues, however, that the scientific data alone were not sufficient to induce HRT’s rise in popularity. Its resurrection in the 1980s was aided by a growing health consciousness among middle- and upper-class Americans, the country’s continuing cultural obsession with youth, and the emergence of a disease-based advocacy organization, the Osteoporosis Foundation, which sought to educate the public and the medical community about osteoporosis. By 1990 the annual number of estrogen prescriptions had reached 30 million, and in 1992 noncontraceptive estrogen became the most widely prescribed drug in the United States. It remained alternately the first or second most widely prescribed drug for the rest of the decade.

Although there are several themes in the book, to this reader one of the most important addressed by Watkins is the history of women’s health activism. Indeed, Watkins tracks the efforts of women’s health activists to expand women’s access to balanced information on HRT, rescue discussions of menopause and other natural events in women’s lives from a medical framework, and incorporate women’s health into the established institutions of medicine and medical research. In doing so Watkins describes the changing personalities, strategies, and priorities of the women’s health movement and highlights the multiple definitions, meanings, and conceptions of “feminist” health care and health feminism that have characterized women’s health activism over the last three decades.

The Estrogen Elixir, then, is more than a medical history of HRT. It is also a history of the medicalization of women’s health and changing cultural attitudes toward aging, femininity, female identity, women’s health activism, and the science of drug evaluations. Watkins implicates physicians, reproductive endocrinologists, drug manufacturers, journalists, and feminist health activists in the medicalization of menopause and in the rise and fall of HRT.

Dominique Tobbell is a historian of the pharmaceutical industry and program manager of biotechnology history and policy in CHF’s Center for Contemporary History and Policy.