Blech, a German science journalist and nonfiction author, studied biology and biochemistry at the University of Cologne (Germany) and the University of Sussex (UK). Currently, he is a correspondent for Der Spiegel, a German magazine. Blech is widely known for his critique of the pharmaceutical and medical industries. In fact, at times, his book may even feel like an expose to the reader. Blech addresses a variety of issues within the healthcare system, especially the invention of diseases in order for pharmaceutical companies to generate profit. For instance, natural elements of the aging process are falsely advertised to the public as ailments which must be medically addressed. He refers to this concept as “medicalisation”, the reframing of previously viewed healthy and normal processes as disorders that must be treated. In fact, he cites many examples of physicians performing research on behalf of pharmaceutical companies. These companies routinely hire physicians to perform research supporting the so-called benefits of their medication, medication which the physicians may likely prescribe to their patients. Obviously, the physicians are aware that the companies are looking for a glowing report and for their medication to be endorsed. It is undoubtedly extremely difficult for these researchers to remain objective. This blatant conflict of interest calls into question the ethics, or lack thereof, inherent in such a process.
As a pelvic floor physical therapist, I found Chapter Seven, The Femininity Syndrome, to be of particular interest. Blech describes how the natural process of menopause is now viewed by many health care providers as a pseudo-diseased phase. The price tag imposed on insurance companies for these possibly superfluous treatments is astronomical. In fact, in Germany alone, approximately 500 million Euros are spent on hormone replacement therapies. According to Blech, “The medicalization of the menopause is an example par excellence of the way certain physicians’ groups and pharmaceutical firms are manipulating the evidence in medical issues. Nowadays menopausal woman is regarded as a deficient being…Women’s health seems to have vanished, washed away by unrelenting tides of disease- as one ebbs so the next advances. One is almost inclined to believe that to be of the female sex has become a disease in itself.” He points out that certain tell-tale menopause symptoms, such as night sweats and hot flashes, are much more frequently reported in Western countries. In fact, in Japan, these symptoms were only reported by approximately 15% of women older than age 50 in a study led my Margaret Lock (McGill University, Montreal). In 1960, gynecologist Robert Wilson wrote Feminine Forever, a popular book which encouraged menopausal women to initiate hormone replacement therapy in order that “they may look forward to prolonged well-being and extended youth.” It was only revealed later on that Wilson’s writing was financially supported by the pharmaceutical company Wyeth Ayerst.
There is a time and place for medication, and obviously hormone replacement therapy is more appropriate for some women than others. I am not shouting from the rooftops that medicine and all surgeries are bad! I have encountered many women who have been appropriately advised to take medicine and who have benefited tremendously from their usage. However, I do encourage you to discuss all treatment options with your physician, from conservative to more invasive. I encourage you to be your own biggest health advocate, and to obtain as much information as possible in order to make educate health related decisions. An excellent start is by reading Blech’s book. He has opened the door to a fascinating and important discussion, and I encourage you to join.
