As a menopausal woman and medical professional who’s seen the worst of it whilst having with a strong medical contraindication for HRT; as someone who had to dig her way out from probably the worst menopause someone can fathom, I found myself asking this question: why is menopause treated as a disease?

An excellent critical question which demanded an objective answer. 

This approach is a complex issue rooted in medical history, cultural bias and commercial interests. And here’s a blunt breakdown of the key reasons:

The Medicalization of a Natural Life Stage

Menopause is a natural biological transition, not a pathology. However, since the 19th century, medicine has often framed normal female biological processes (menstruation, menopause) as conditions requiring medical management. Consequently, this “medicalization” shifted the perspective from a natural transition to a “deficiency disease”; specifically, an estrogen deficiency disease.

The “Disease” Model

This model, which became dominant in the mid-20th century, argues that menopause represents a hormonal deficiency (estrogen loss) that leads to a host of “symptoms” and long-term health “risks” (like osteoporosis, heart disease). While hormone therapy (HRT) can be incredibly effective for symptom relief, framing it as a lifelong treatment for a deficiency pathologizes a universal life transition.

The Pharmaceutical Industry Influence

The development and aggressive marketing of Hormone Replacement Therapy (HRT) in the 1960s-1990s solidified the disease model. As HRT was promoted not just for relieving hot flashes but as a “fountain of youth” to prevent aging itself. This created a multi-billion-dollar market that benefited from viewing menopause as a disorder requiring life- long treatment.

The Cultural Stigma & Ageism

Western culture often values youth, fertility, and productivity. Therefore, menopause, which marks the end of fertility, is frequently associated with decline, loss, and invisibility. Treating it as a disease offers a “solution” to what society frames as a problem: aging in women. This stigma is less prevalent in eastern cultures that view post-reproductive women as wise elders.

The Focus on Symptoms Over Support

Like it or not, western medicine is best equipped to prescribe pills than to provide holistic support. It’s easier to code a diagnosis (like “menopausal disorder”) and offer a prescription than to address complex needs like gut health, sleep, mental health, workplace accommodations, and societal attitudes that women face during this transition.

The Impact on Women’s Experience

This “disease model” has a double-edged effect:

Positive: It legitimizes severe suffering (e.g., debilitating hot flashes, brain fog, joint pain) and creates pathways for effective medical treatment. Many women feel heard and finally get help.

Negative: It makes women feel broken, pathological, or in need of “fixing.” 

It overlooks the many women who have neutral or positive transitions and frames inevitable aging as a failure.

The Paradigm Shift 

There is a powerful movement taking place, led by menopausal women, activists, and many clinicians, to reframe menopause as it is: a naturally developmental stage (like puberty) or an 𝐞𝐯𝐨𝐥𝐮𝐭𝐢𝐨𝐧𝐚𝐫𝐲 𝐫𝐞𝐜𝐚𝐥𝐢𝐛𝐫𝐚𝐭𝐢𝐨𝐧 𝐨𝐟 𝐩𝐨𝐰𝐞𝐫 (how I like to call it), with a wide spectrum of experiences.

Finally, we’re focusing on empowerment, education, and holistic care (including lifestyle, diet, therapy, and informed choice about medical interventions) while distinguishing between managing disruptive symptoms (which is valid healthcare) and treating the entire transition as a disease.

In short, menopause is treated as a disease due to a historical and profitable medical model that conflates symptom relief with pathology. The current push is to separate the two: to provide robust, compassionate healthcare without labelling a normal phase of life as an illness.