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In the 11th episode of the 3rd season of House called Words and Deeds, the main character, Dr. Gregory House says the following:

Male menopause: high estrogen, low testosterone, explains temperature swings, disorientation, endocrinologically similar to female menopause but without the vaginas and mahjong tiles.

What do the mahjong tiles refer to in the above statement? I can't wrap my head around it.

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    A stereotypical pastime of elderly (post-menopausal) women is playing mahjong.
    – Dan Bron
    Aug 25, 2014 at 10:19
  • Even Urban Dictionary doesn't have any alternative meanings of mahjong. Perhaps middle-aged women going through menopause play lots of mahjong in House’s (a)typically male chauvinist view of the world? Aug 25, 2014 at 10:22
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    @Reg: "mahjong tiles" because tiles are symptomatic (evidential) of [playing] majohng, as a vagina is "symptomatic" of being a woman, and as all these things, together with changes in estrogen levels, etc, are symptomatic of menopause. As to "unnecessary": it's a joke, not a goddamn telegram. I mean, House is a sitcom; technically the whole thing is "unnecessary".
    – Dan Bron
    Aug 25, 2014 at 10:58
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    @Reg, there are approximately 40 trillion questions on this stack which ask about plain, non-confusing language whose answers are painfully obvious. Now, I wouldn't characterize this question as painfully obvious, but I would character its language as clear and plain, and the interpretation is obvious if you're aware of the old-ladies-play-mahjohng stereotype. I'm guessing neither you nor OP were aware of that particular stereotype, but that's not an indictment of the language.
    – Dan Bron
    Aug 25, 2014 at 12:03
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    No, don't delete it! I am enjoying watching certain of my fellow users not getting the joke (except @DanBron, who is clearly on top of things again). I mean, I watched House only sporadically, but I got the joke immediately. I don't see what is so obscure about it. Oh, well. Aug 25, 2014 at 18:14

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I actually agree with RegDwigнt that this looks like sloppy writing. The cause of the confusion looks to be that this line is very thinly related to the episode title (and probably theme of the episode).

In The Analects of Confucius, there is a section named "Words and Deeds," and is no doubt where the episode title came from. The show, House, is known for extremely subtle and/or obscure jokes and references. I would assume that if you rewatched the episode, there would be more references to Confucius as well.

Wikipedia description (emphasis mine):

The importance of education and study is a fundamental theme of the Analects. For Confucius, a good student respects and learns from the words and deeds of his teacher, and a good teacher is someone older who is familiar with the ways of the past and the practices of antiquity (Analects 7.22).

The link here is that there is some people believe that Confucius invented Mahjong.

One of the myths of the origin of mahjong suggests that Confucius,1 the Chinese philosopher, developed the game in about 500 BC. The three dragon (cardinal) tiles also agree with the three cardinal virtues bequeathed by Confucius. Hóng Zhōng (紅中 , red middle), Fā Cái (發財 , prosperity), and Bái Bǎn" (白板 , white board) represent benevolence, sincerity, and filial piety, respectively.

The myth also claims that Confucius was fond of birds, which would explain the name "mahjong" (maque 麻雀 = sparrow).

Usually, the menopause joke would probably have been about playing Bridge or Canasta, but the writers decided to tie this line to the episode theme by using Mahjong instead. However, because the reference is so obscure, and Mahjong does not fit in our Western stereotypes of post-menopausal women, the joke falls flat and becomes confusing.

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    I am innocent of Mahjong, except that one of the visuals I find in my stack is one of old women playing the game. I got this joke immediately -- I think it involved a Pirates of the Caribbean movie scene. Or maybe not. Aug 25, 2014 at 18:17
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    This answer is wanton speculation. Mahjong is simply a game elderly women play, and not just in China (it's quite popular here in the US; maybe it's less so in the UK, which is what's confusing the answerer). In any case, there is no need for obscure references to the Analects or anything else.
    – Dan Bron
    Aug 25, 2014 at 21:05

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