Menopause, evolution and changing cultures

Laurence M A Shaw ^*  and
Sebastian L J Shaw 

^* Bridge Centre, London, UK
Backdoor Productions, London, UK

Correspondence: Laurence M A Shaw FRCOG, 145 Harley Street, London W1G 6BJ, UK. Email: LMAShaw{at}aol.com

The menopause is an isolated event in a much wider process thatwas probably an evolutionary adaptation essential for survivalin the Pliocene. As a reproductive strategy, it is largely vestigialin the 21st century, part of an era that has seen a doublingof the average human longevity compared with that of the past.This process commences as an accelerated decline in female fertility,usually from the fourth decade of life, culminating in a totalcessation of reproductive capacity for those surviving. The20th and 21st century sees a huge increase in the numbers survivingand the duration of that postreproductive life phase extendingfor decades. This extended period of what is essentially a hormonedeficiency state is a recent phenomenon and by no means partof the natural history of the human individual. It is thereforenot surprising to see a postmenopausal increase in the incidenceof so many disorders above that expected by age alone. Recentreproductive patterns have seen increases in the birth rateand requests for fertility treatments among women in their late30s and 40s. Many try for pregnancy but are unsuccessful. Thegenes that permit later reproduction and hence later menopauseare therefore being preferentially selected. Slowly over generationswe will expect to see the fertility of future 40 year olds increaseand the age of menopause to extend much later into our, now,longer lives.

Key Words: Menopause • grandmother hypothesis • natural menopause • Pliocene • Hadza • evolutionary medicine • hormone replacement • age of menopause

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