A historical perspective on menopause and menopausal age.

Earliest known references to menopause have been very scarce. Aristotle referred to age at menopause being 40 years. A French physician coined the term menopause in 1821. Medical interest in menopause increased considerably in mid 19th century. In 1930s people started describing it as a deficiency disease. Consequently, various replenishment therapies were advocated eg. testicular juice, crushed ovaries of animals. In 1970s medicalization of menopause was complete. Menopausal symptoms were ascribed to estrogen deficiency and estrogen (hormone) replacement therapy was exhorted as the ultimate liberation of middle aged women. Synthetic estrogen was developed in 1938. Medical industry (Pharmaceuticals) entered the scenario of menopause in a big way and dominated the center stage. In 1970s International Menopause Society was established. First International Congress on Menopause was also organized in Paris, France in 1976. Various countries have formed national societies on menopause. Symptomatology of menopause differs in different ares of the world e.g In West - hot flush, in Japan shoulder pain and in India low vision are the hallmarks of menopause. HRT use rate is high in West while it is low or negligible in countries like India. Age at menopause is also higher in West as compared to the range of 45-47 years in developing countries like India. Historically also a lower age at menopause was range documented in earlier times. This rose to the range of 50-51 years in the present era.Overall, women in western countries view menopause negatively. This is contrasted with a positive outlook towards menopause in a developing country like India.