Hot Flushes Cold Science: A History of the Modern Menopause [Paperback]

No, Foxcroft's book isn't bristling with funny anecdotes nor is it a 'what to expect book' - but it never claimed to be. I fail to see how the previous reviewer could punish the book by not being quite a different book. It's like giving a poor review to a chair on the grounds that it doesn't make a very satisfactory table.

This book - which, although not a scream, is rather witty - is quietly erudite, with a strong argument concerning the patriarchal construction of the Western menopause and female complicity with, and panic about, that construction. While I don't agree with all of Foxcroft's conclusions - is using HRT a necessary and sufficient condition of collusion, or might it be to reclaim something good from a dodgy premise? - this book is never less than fascinating and serious. It isn't vaguely feminist, it is feminist, and thank goodness for that. There are plenty of What To Expect books out there, and that's fine; this is more Why To Expect, and it is what some of us need far more.

Presumably the one star review reflects the reviewer's disappointment with her choice, rather than the book itself which is exactly was the cover says it will be- only much wittier -a look at how and why a natural stage in almost every woman's life has become a time women dread and rarely acknowledge, even though many intelligent, attractive women (Helen Mirren? Joanna Lumley? Meryl Streep? Susan Sarandon?) must have reached it without self-combusting or watching their sex life turn into sandpaper. Whether or not you choose to use HRT isn't the half of it. What Foxcroft unravels, discovering some wonderfully extreme opinions and treatments from old medical texts on the way, is why women have learned to feel so vulnerable at a vague point about two thirds through their lives, that they fell unqualified to make judgements and decisions about their own bodies, and why youth is such a paradigm of desirability that the pleasures of maturity become frightening.

L.S.Sinclair's ventilations are worthy of opposition. She agrees, it seems, with Dr Foxcroft's main line of argument, yet ends by referring to menopausal women as "victims of" ovarian failure, which is surely the central point that the "Hot Flushes, Cold Science" takes issue against: it's not a failure, but a point in a natural cycle. Nor are they "drugged with" anything, an image which suggests carriage-horses, fog and Evil Doctors with stovepipe hats doing that syringe-quirting thing they always do in movies.

It is true that some women have "unpleasant symptoms"? What would L.S.Sinclair do with them that would keep her clear of the once-useful, now less so, catch-all argument of "paternalism"? Tell `em to perk up, read the scriptures and perhaps do a little light tatting?

Meh. Louise Foxcroft has produced a delightful and unusual blend of scholarship and empathy, of careful reasoning and playful wit, which reminds me of the late Roy Porter, looking at the way in which the (until recently, male-dominated and institutionally paternalist) medical profession regard women as inherently defective, and the normal course of female life as a voyage through frailties and sicknesses to which we more perfect and magnificently robust men, the highest creations of God and Nature alike, were quite immune.

Show a doctor a woman, and he will come up with a disease. (Followed, probably, by a cure and, of course, a bill.) Women doctors aren't free of guilt in the business of menopause either, though. Far too many women face a stony lack of sympathy from their female GPs and now that medicine is becoming a primarily female profession, certainly in Britain, it will be interesting to see how things proceed.

This book's not before its time. Only a couple of weeks ago a (female) friend had to listen to a retired lawyer well stricken in years, with the allure of a gibbon, explaining to her that women over fifty (i.e. menopausal/post-menopausal) were useless for anything; were inherently ugly; were repugnant to any healthy vigorous male (thinking, perhaps, of himself?) and should do the world a favour and, like Mr Toots in "Dombey & Son," should "...glide into the silent tomb with ease and smoothness."

To give a book one star because one is personally affronted (that silliest of emotions) by its conclusion seems to me both unfair and a category mistake. Nobody sets out to write a book of this sort with the intention of confirming the prejudices of any reader, let alone one particular individual, and to think otherwise argues a robust egocentricity and a failure to respond to other points of view which is surely a necessary (if not a sufficient) cause of the very "paternalism" of which the reviewer complains. My instinct would be to give Dr Foxcroft four stars because one never, ever gives full marks, but purely out of a desire to redress the balance, I shall give it five.