The medicating of menopause

In a Pennsylvania court case, a woman was awarded $1 million and her husband $500,000 Wednesday after jurors concluded the hormone replacement therapy Prempro was the cause of her breast cancer.

But when it comes to how most women decide to deal with menopause and its symptoms, the jury is still out.

The case goes beyond the continually shifting medical debate of whether hormone therapy reduces such risks as heart disease, thereby benefiting women's health, or raises their risk of breast disease or other problems. It goes beyond the more immediate reasons many women begin such therapy -- hot flashes, night sweats and irritability.

For many women, the debate is more philosophical than physical: Is menopause really something to "treat," or a natural biological process that is a healthy -- albeit somewhat challenging -- part of life?

Chances are most females have had other such body-conversations with themselves since they were adolescents. Do you pop a Midol for cramps and skip out of phys ed, or would a run and slight discomfort be a better approach? How about medication during labor -- are you a martyr if you choose to try natural childbirth, or a wimp if you ask for an epidural?

While it doesn't help that women must make some of these decisions while they wait for definitive research, the greater complication is that the noise surrounding them can separate a woman from instinctive wisdom about her own body.

Advertisements by drug companies make hormone therapy look as harmless and self-edifying as a pedicure or a bubble bath. So why not do it? Meanwhile, menopausal symptoms -- thinning hair, dry skin, memory loss -- make a female feel old. So we'd better do it.

Final resolution of the Pennsylvania court case is probably still years away as drug manufacturer Wyeth enters a second phase of the trial, and 5,000 other hormone-replacement lawsuits against it wait in the wings.

Meanwhile, the controversy will continue to be "tried" in tens of millions of private homes and ob/gyn offices as women decide if menopause should be medicated, managed, tolerated or -- as a badge of maturity -- even counter-culturally enjoyed.