更年期醫療論述在台灣的建構與轉變過程

The menopause medical service elaboration constructs the construction and the transformation in Taiwan

吳堃銘(Kun-Ming Wu)

指導教授 ： 成令方

高雄醫學大學/護理學院/護理學系碩士班/碩士(2019年)

https://doi.org/10.6832/KMU.2008.00078

摘要

中文摘要
女性更年期「醫療化」的問題在近幾年來廣受討論，尤其2002年WHI的報告引起極大的衝擊。本研究以相關文本資料為基礎，佐以個人的臨床觀察，檢視1995年到2007年之間，更年期在台灣的醫療化的建構及論述的改變，在2002年以前更年期的醫療化有清楚的脈絡、是無庸置疑的。WHI風暴之後的改變如何呢？本文發現受創嚴重的婦產科醫界，在媒體宣傳上一再強調更年期用藥的極低劑劑量及高度個人化，表面上考量了婦女個人需求，但實際上仍擺脫不了醫療化的思維，仍是奉荷爾蒙為圭臬，只在劑量上打轉。更年期的減醫療化在醫界上看不到希望。可喜的是政府政策的改變，原本與醫藥界掛勾的更年期關懷月，轉變成可以聽到婦女聲音的更年期成長團體的活動，將以醫藥為導向的更年期政策變成以生活為導向，將荷爾蒙變成只是選項之一；而受到WHI報告的刺激的更年期婦女也逐漸開始思考荷爾蒙的必要性，甚至逐漸找回了主體性與決定自我更年期生活的權力，使隱微知識得以再現，擴大了行動實踐的自由。本研究體現了更年期婦女做自己身體主人的可能性，藉由更年期成長團政策的持續推動，更年期的減醫療化將是可以期待的。

關鍵字

更年期 ； 醫療化 ； 荷爾蒙 ； 減醫療化

並列摘要

Abstract
Recently, the problem of “medicalization” of menopause for women has been extensively discussed. Especially after the publication of the report by Women's Health Initiative (WHI) in 2002, an extremely great impact took place. Based on the information of the related texts, and personal clinical observation, the study inspects the construction of the medicalization of menopause and the change of its discussion during the period from 1995 to 2007. Before 2002, it is no doubt that medicalization of menopause do have clear tracks to follow. However, after the turmoil created by WHI reports, what has been the changes? This paper discovers that many gynecologists promoted and emphasized on the extremely low dosage of hormone and personalized prescription for menopausal women. Superficially, these doctors had considered the personal requests from women users; but in fact, women’s actions still could not free from the frame of medicalization, and still took hormone as the top priority. The doctors merely made adjustments to the dosage. It seemed that no hope could be seen for the de-medicalization of menopausal treatment. Fortunately, there is one thing worth cheering –– the change of government policy. The original Menopause Concern Month in association with the medical and pharmaceutical circles has been changed to be the activities for raising the self- awareness of menopausal women. In these activities, the voices of women in variety can be heard. The medicalization-oriented menopausal policy has shifted to live-management-oriented. Hormone has become one of the options only. The menopausal women being frightened by the report of WHI gradually start to think about the necessity of using hormone. They have even gradually found their autonomy and their rights to determine how they live with menopause. Their tacit knowledge can now reappear to be useful. They also expand the scope of their actions. The study reveals the possibility for menopausal women to act as the masters of their own bodies. Through the continuous promotion of the policies of menopause awareness raising groups, the de-medicalization of menopause for women is foreseeable.

並列關鍵字

Menopause ； Medicalization ； Hormone ； De-Medicalization

參考文獻

參考資料

台灣更年期醫學會會訊第1至第24期

成令方（2002）〈醫『用』關係的知識與權力〉。《台灣社會學》，3，11-71。

成令方（2007）〈更年期成長團體---規訓？賦權？〉。國科會委託計畫編號 NSC95-2412-H037-002。

成令方、林秀怡（2004）〈HRT『風暴』後的婦產科〉。《第四屆性別與醫療工作坊》，高雄：高雄醫學大學。