Risks and benefits associated with hormonal and surgical therapies for healthy midlife women.

The view that menopause is a disease is dominant in Westernized societies, where menopause has long been considered an estrogen deficiency disease and, more recently, an endocrinopathy. The definition of menopause as disease has its origins in patriarchal views and beliefs about women as defective and imperfect, likened to machines that continually need to be fixed. This view of menopause has overshadowed the concept of menopause as a normal biological event, resulting in increased pressure to prescribe steroid sex hormones and perform surgical interventions on healthy women to prevent disease. Institutionalization of the "menopause as disease" ideology has legitimated, and thus condoned, the use of risk/benefit criteria normally used to assess risks versus harms in sick people. The use of these criteria assumes that acceptable risks for the sick are acceptable risks for healthy, well women.