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Women Behaving Badly?

Female Troubles
WebMD Feature

June 18, 2001 -- In 1875, Mrs. Lydia E. Pinkham of Lynn, Mass., began selling her famous Vegetable Compound, which she advertised as "a positive cure for all these Painful Complaints and Weaknesses so common to our best female population. It will cure entirely all Ovarian troubles, Inflammation and Ulceration, Falling and Displacements, and any consequent Spinal Weakness, and is particularly adapted to the Change of Life."

In 2001, drugmaker Eli Lilly and Co. began selling a product called Sarafem, also intended to treat a condition specific to women. According to the manufacturer's package insert, Sarafem is indicated for the treatment of premenstrual dysphoric disorder (PMDD), a newly proposed mental disorder not yet officially accepted by the American Psychiatric Association but listed in the appendix of that group's diagnostic manual.

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No doubt part of what made Lydia Pinkham's miracle cure so successful was that it consisted of a blend of herbs in a 20% mixture of alcohol, a common 19th-century approach to taking care of a variety of ills. Lilly's Sarafem, on the other hand, is completely new millennium in approach. For women struggling with PMDD, this repackaged, relabeled version of the antidepressant fluoxetine hydrochloride -- better known to millions by the brand name Prozac -- "helps you be more like the woman you are, every day of the month, even during your most difficult days," according to the company's web site.

'Disordered' Thinking

Although separated by more than a century, the tonics promoted by both Mrs. Pinkham and by Eli Lilly are emblematic of what is to many people an ancient but troubling tradition in medicine: The tendency to categorize the normal bodily functions of women as "diseases" or "disorders" that need to be treated.

"From the time you're a preteen, from your very first inklings of hormonal rhythms all the way to the end of life, you're given the message that your body doesn't work or that it's not OK," says Madeline Behrendt, DC, in an interview with WebMD.

Behrendt, a chiropractor in private practice in Boise, Idaho, is also vice chairwoman of the Council on Women's Health of the World Chiropractic Alliance. In that capacity, she recently spoke on the issue at the United Nations Women's Conference, where, she says, she found that people all over the world appear to share her concerns.

"Over the past year there have been so many shifts: Now girls are being given hormonal drugs because so many of them are starting puberty early. Another big topic is menstrual suppression, where they're saying that menstruation is not normal -- it's a nuisance, it's unnatural, it's unhealthy. When I was growing up, if you didn't have your cycle that was called amenorrhea and that was a problem. Then it goes into the reproductive years where there are birth control pills, or PMDD, or a new specialty created last year called female sexual dysfunction," she says.

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