Recently, I came across this product available for over-the-counter sale. It was one of a number of herbal remedies, each targeting different ailments, that were available at this premises. I was immediately struck by the information on the label. As it was quite expensive I was reluctant to buy it, so I asked the clerk if I could instead take it down and take a photograph. To my slight surprise he agreed without question.
Perhaps the oddest feature of this product is that, although it is ostensibly for “menopause relief”, it is advised that women not use it if they are pregnant. Now while menopause is difficult to define concisely, it is clear that all definitions involve one key premise: namely, that you can’t be pregnant at the same time. In clinical terms, menopause begins 12 months after a woman has had her final menses (assuming that no other physiological cause is affecting her menstruation, in which case it’s not menopause). So menopause can only be declared if a healthy woman has had no period for a full year, which should indicate clearly to all concerned that pregnancy will be impossible.
Why then does this product offer a warning to users that it shouldn’t be used during pregnancy? Well, one explanation is that the manufacturers are employing the term ‘menopause’ very loosely. They might intend that their product be used by women experiencing perimenopause (i.e., the irregularity in menstruation that for many women characterizes the years prior to menopause), rather than menopause itself. Alternatively, they might intend that the product be used by women during climacteric (i.e., the longer phase of time that encapsulates both late perimenopause, menopause, and early post-menopause), on the flimsy basis that it is technically possible to be pregnant during late perimenopause. These explanations are somewhat problematic because, if true, they reveal that the manufacturers are very poorly informed about major features of the medical conditions that they purport to be competent in treating. Major features such as their precise names, for example.
A further possibility is that the manufacturers might just feel that women in the general population use the term ‘menopause’ loosely themselves, and what these women really mean is perimenopause. In other words, the manufacturers are playing along with the shoddy nomenclature that they feel is typical of the everyday discourse of ordinary people. At one level this can be seen as reasonable (or, at least, semi-rational), but the question then arises: is it ethical to deliberately perpetuate medical misconceptions among vulnerable people when offering (i.e., selling) them treatments? It certainly seems a strange approach to take; unless, of course, their primary aim is simply to sell more of the product rather than less.
A more disturbing interpretation is that this product contains ingredients that would be harmful to a woman or a fetus during pregnancy. In other words, the manufacturers might be protecting themselves from litigation in the event that a pregnant woman (i.e., one not undergoing menopause) consumes the product anyway, and experiences adverse side-effects from doing so. This would mean that this (“certified organic”) herbal remedy is actually quite a dangerous substance, the availability of which ought to be controlled by proper regulation. However, this product was available over-the-counter in any quantity to anyone who wished to purchase it. Nonetheless, the fact that herbal products can actually be extremely toxic and dangerous and are generally of unproven safety is always a possiblity.
In passing, it might be worth noting that, like many complementary/alternative medical products, this one is intended for use for a medical condition that is: (a) difficult to ‘treat’ using mainstream medicine; (b) characterized by psychological as well as physical symptoms; and (c) more common in women than in men. Suffice to say, there is little or no evidence to suggest that herbal remedies are effective in reducing the actual symptoms of menopause (which include osteoperosis, vaginal dryness, and dyspareunia), but we can predict that the placebo-effect of taking any purported remedy will probably alleviate some of the general mental distress seen in some women, at least for a while.
And where did I see this product on sale? In an approved health facility or pharmacy? In a health food shop? No, actually, I found this product for sale in the gift store at Lissadell House in County Sligo, Ireland. Lissadell House is a stately home set in the Irish countryside that became a tourist attraction on the basis of being the former country retreat of poet W. B. Yeats. So as well as postcards, key-rings, and CDs of poetry, fans of the Nobel Laureate and driving force behind the Irish literary revival can also stock up on menopause relief…so long as they remember not to use it when they’re pregnant.
Brian Hughes is an academic psychologist and university professor in Galway, Ireland, specialising in stress, health, and the application of psychology to social issues. He writes widely on the psychology of empiricism and of empirically disputable claims, especially as they pertain to science, health, medicine, and politics.