Is castration so bad?

It depends on who you ask and how you ask.

Recently I had a conversation with a man who heads up a menopause program in a local hospital and he just wasn't getting it. He was asking me for ways to help women understand that menopause is just a part of life and to accept it. He just couldn't understand why women complained so much about menopause. I tried my best to help him understand that any person, man or woman, would complain about being expected to engage in sexual activity even though sexual response was not possible. I said it was demeaning and frustrating for both parties. I tried to tell him that even if hormones are used, because they are usually not given in adult levels and not all of the ovarian hormones are replaced, that even if sexual function was partially restored, it may still be unfulfilling. I tried to tell him how not having restful sleep would impact thinking ability, significantly reduce patience with loved ones and co-workers, and would make a person, man or woman, just feel crummy. I tried to tell him that the loss of memory, loss of sexual function, loss of sleep, loss of energy, loss of stamina, loss of muscle tone, and living in fear of breaking an arm, foot, wrist, or hip was taxing and for many, depressing. I tried in every way I knew how to help him understand, but he just wasn't getting it.

He said women were meant for menopause and started going on about evolution and how menopause helped human beings survive. I reminded him that just 150 years ago the average life span for women and men was less than 50 years. Lots of illnesses that generally strike the old were not prevalent at all. Cancer, osteoporosis, heart disease, gall stones, kidney stones, and acid reflux were all rarer because people didn't live long enough to get these diseases.

He stopped and looked me in the eye and said "Women were built for menopause and men weren't and that's why men don't get it. We seem to attract bitter women in this clinic."

I couldn't believe I was talking to a person who was running a program that impacted so many lives and was so uninformed. He was clueless and just wasn't getting it.

Personally, I don't usually use the word castration very often because it is so harsh and if I can get my point across in less harsh terms I will. It is a valid word to describe menopause because menopause is castration and is just as punishing to women as it is to men.

Then I said it. I said menopause causes castration and without treatment it was permanent. Women had every right to complain because castration is punishing and permanent and it doesn't get better without treatment. Women are stuck being castrated and are told to embrace it and enjoy it. They were not receiving support from his clinic. Instead his clinic was dismissing their very real symptoms and telling them to accept and celebrate their newly castrated selves.

Then he looked me straight in the eye and said, "Is castration so bad?"

"Yeah, it's that bad. How would you feel if you were castrated? How would you feel if you joined a support group run by doctors who encouraged you to celebrate that you are now permanently castrated? How would you feel being turned down for treatment based on a clinical trial that said they used HRT but didn't? HRT for castration does not cause cancer. HRT, when given properly, prevents cancer. How would you feel if your life, your marriage, and your career were stolen from you for no good reason? These women aren't bitter they are simply looking to feel whole again"

The look on his face told me that he finally got it. Slowly and deliberately, he said, "I'm sorry, I'm really sorry but I didn't know. Most of us in this hospital ... we didn't realize. "

We went on to discuss ways he could improve his program, though he stopped short of telling women what he just discovered, that menopause causes castration. He said that his program would be improved and the doctors would be encouraged to replace all of the ovarian hormones but that women do not need to know the details, meaning castration.

I asked him if he remembered the old days when patients weren't told that they had cancer because it was assumed that patients couldn't handle it. We know that's not true anymore. I said that women could handle it, that women have a right to know. He shook his head and said, "Not on my watch."

That was a defining moment for me. I realized that I had to develop more frank educational material for women and for healthcare providers. Women can take it and so can their doctors.

In my next blog I will introduce you to a woman who gets it. I admire her forthrightness and her tenacity in seeking and then receiving effective treatment. She is a pioneer and far more knowledgeable than most doctors. She understands that treatment is available and effective. Her name is Louise and she lives in England. She graciously shared her journey with me and has agreed to share it with you.