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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
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.