I’m not against HRT but are we once again medicating women for being angry?

It is horribly regressive to say that all women lose their minds in midlife. Did you know that men have hormones too?

Prescribing tranquillisers was the first-line treatment for women’s anger and despair for much of the 20th century

One of the British Victorian objections to women’s entry to universities and professional life was that our reproductive cycle made us unreliable, incapable of reason and prone to emotional distress. (Naturally, none of these was a barrier to low-paid manual or domestic labour. Your monthly madness meant you couldn’t be a doctor but posed no obstacle to nursing.)

It took decades of struggle and eventually the loss of half of a generation of men in the first World War to overcome this argument. More women went into traditionally masculine work during the second World War, and when those men returned, women were pushed back into ‘the home’, which is to say into unpaid domestic and caring labour, financial dependence on men and oppressive definitions of femininity. Many became depressed and were prescribed tranquillisers which continued to be the first-line treatment for women’s anger and despair for much of the 20th century.

I reflect on this history with growing dismay as I read about my generation’s apparently universal ‘need’ for hormone replacement therapy or HRT. I think every woman should have access to the full range of reproductive healthcare and should be supported in making informed choices about her own body; I am in no way suggesting that any individual is in any way wrong to take or want HRT or any other medical treatment. I would take it myself, as many of my friends do, if I thought I had distressing symptoms of menopause.

But I am worried when we define women’s anger, anxiety and changing body shape as pathologies in need of medication. Girls and young women are considered emotional, excitable, foolish. In our 30s we are doubtless preoccupied by having or not having babies; hormonal, liable to take maternity leave and then either distracted by childcare or by childlessness, possibly post-natally depressed but in any case not quite with it. It used to be that there was then an interval in our 40s and 50s, before we became invisible and then crones, when we were almost as competent and reasonable as men; often, with the kids grown, achieving seniority and even authority at work, before old age closed in. Now the coining of the ‘peri-menopause’ extends the years of irrationality and unreliability to fill women’s whole lives, returning us to a Victorian understanding of the reproductive system’s control of the female mind.

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(Did you know that men have hormones too? Theirs also fluctuate, and make them crash cars and start wars and beat people up, but we don’t medicate for that.)

Maybe women in midlife are angry because they have reasons. I heard one woman on a podcast about the peri-menopause saying that for years she’d just sighed and tidied up the kitchen when her partner and kids left their day’s dishes and crumbs all over the counter, but in her mid-40s she found herself suddenly enraged by their habits. It wasn’t fair, she said, all those years they’d relied on her and now her oestrogen levels had dropped and she was being horrible, angry and selfish, so she’d gone on HRT and now she was willing to clear up after them again. Relief all round.

I’ve read other women appalled to find themselves changing shape, as if we all have the right and obligation to live out the decades of life we are now blessed to expect in the bodies we occupied in our 20s. Of course ‘femtech’ companies will tell us that every women needs their products, that to be in a woman’s body is necessarily to be broken, defective, in need of medical and technological repair. That’s how they make their money, and the more of us who believe it, the more money they make.

For some women, I don’t doubt that menopausal symptoms are debilitating and HRT life-changing, and all women should absolutely have access to supportive healthcare to help us to discern if we are in that category. But it is horribly regressive to say that all women lose their minds in midlife and that the condition of having a female reproductive system is pathological. Is no-one else worried that we’re once again medicating women for getting uppity when maturity and experience show up? I think in men my age, this behaviour is often called authoritative.