For many women worldwide, menstruation brings debilitating physical and mental side effects. This can make menopause a welcome change. For others, including those who have prioritized professional ambitions or suffered medical setbacks, the years of peak fertility are far too short. And with menopause comes a new menu of irksome side effects and serious health concerns, which include a sharp increase in the risks of cardiovascular disease and osteoporosis. For these reasons, biomedicine views menopause not only as a public health priority but also often as a medical condition.

The medicalization of menopause, similar to that of ageing or pregnancy, serves a practical purpose in directing research efforts towards improving health and quality of life for women. At its most literal, this perspective has stimulated new interest in clinical interventions to delay menopause¹. However, the development of sound clinical approaches can be improved by understanding menopause within its context as a natural phenomenon that is shaped by evolutionary processes. Evolutionary thinking about menopause often involves hypotheses about the past that are only of tangential interest in medicine, but evolutionary perspectives also have a lot to offer for understanding the interactions of reproduction, health and our complex environments.

对于世界各地的许多女性来说，月经会带来使人衰弱的身体和精神副作用。这可以使更年期成为一个受欢迎的变化。对于其他人来说，包括那些优先考虑职业抱负或遭受医疗挫折的人，生育高峰的岁月太短暂了。随着更年期的到来，出现了令人讨厌的副作用和严重的健康问题的新菜单，其中包括心血管疾病和骨质疏松症的风险急剧增加。由于这些原因，生物医学不仅将更年期视为公共卫生的优先事项，而且通常也被视为一种疾病。

更年期的医学化，类似于衰老或怀孕，在指导研究工作改善女性的健康和生活质量方面具有实际目的。从最直白的角度来看，这种观点激发了人们对延迟更年期的临床干预的新兴趣¹。然而，通过将更年期理解为一种由进化过程塑造的自然现象，可以改善健全临床方法的发展。关于更年期的进化论思考通常涉及关于过去的假设，这些假设在医学中只是无关紧要的，但进化论的观点也为理解生殖、健康和我们复杂环境的相互作用提供了很多帮助。