The Wisdom of Menopause, by Dr. Christine Northrup, is dedicated to the "pioneering spirit embodied in the women of the baby boom generation." We are, after all, the women who came of age in the women's health movement of the 70's, advocating personal responsibility for health and a partnership relationship with health care providers. This book is not part of that tradition. Part new age polemic, part personal revelation, selectively scientific, it is a superficial talk-show approach to the health care of women in midlife.

    Northrup claims a holistic approach to menopause, but her emphasis is on its biological aspects--the body is a machine, its functioning perfectable by the right hormones, nutritional supplements and medical interventions. A bewildering array of tests is recommended (provided by a lab "allied" with Northrup's monthly newsletter), followed by an equally bewildering array of medications, herbs and nutritional supplements. Every problem has a hormonal or herbal or nutritional solution. Northrup enthusiastically embraces these interventions with little critical comment, relying excessively on "women's wisdom" to cut through confusion apparently unresolvable by her experience and training.

    Emotions serve as a yardstick of "biochemical health or...distress." Yet, "thoughts and emotions affect every single hormone and cell in your body," allowing control of our health by controlling our emotions. Got acne? Cure it by becoming less "thin skinned." Thyroid dysfunction? Speak up! Don¹t swallow your words! And worse, do you have breast cancer? You must be powerless in your relationships. Heart attack? You have trouble handling hostility. Never mind genetics, environmental exposures, lifestyle, or access to health care. Never mind the complexity of emotional state, or the unpredictability of life. Far from empowering women, Northrup blames the victim for her disease.

    More disturbing is Northrup's manipulation of scientific evidence to support her recommendations. She chooses studies that support her views while ignoring contradictory information. The worst example is her assertion that "bioidentical" estrogens are less likely to cause breast cancer than commonly used estrogens such as Premarin, despite the few studies that have been done on bioidentical hormones.. She bases this statement on references from the 1960's and 70's, ignoring evidence that estrogen supplements may all be created equal in their cancer-stimulating potential. This issue is hotly debated and is unresolved by research; women would be better served by understanding the limits of knowledge than by pat answers which obscure the controversy.