Metaphors of menopause in medicine : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Wellington, New Zealand

Abstract

Medical textbooks have previously represented women’s bodies and menopause life transitions by using notions of ‘machine productivity’ and ‘machine breakdown’ (Martin, 1987). This study aimed to explore whether these representations have changed, especially given recent HRT clinical trial results. Eight relevant compulsory medical textbooks for first and second year medical students at two New Zealand Universities were identified. A Foucauldian discourse analysis (Parker, 1990) was undertaken on relevant content to identify representations of menopause, HRT, women’s bodies, and ageing. Five major discourses were employed in the textbooks in descriptions of menopause and HRT: failure, estrogen deficiency as disease; HRT as saviour; obscurity and the new discovery discourse. Menopause continues to be represented as resulting from a ‘failure’ of a machine-like body. Although the recent HRT clinical trials were reported as a serious risk factor in half of the textbooks, HRT was also represented as a saviour particularly against postmenopausal osteoporosis. The discovery of ‘new’ drugs to ‘treat’ HRT and the ‘postmenopausal’ patient were heralded with much excitement. Medical textbooks continue to use failure discourses to describe women’s bodies at menopause. New risk-based HRT assessments for ‘patients’ with menopause ‘symptoms’ are promoted. These portrayals reinforce linear and reductionist ways of thinking about menopause and women at midlife and provide few spaces for resistance or alternative constructions to more accurately reflect women’s embodied worlds.