People are focused on how Vance's comments are insulting to women, but I haven't seen much talk of the sick combination of Catholic doctrine, free market ideology, and psudoscientific bio determinism that underlies this "mystery" of how women don't just die at menopause.
The core assumption for these people is that human worth is determined by how much one contributes to society. When you think of it, this is totalitarianism that would embarrass Stalin, enslaves everyone to the State, and is straight out of Mein Kamph. Peeling away the layers of euphemism and plausible deniability, this is the concept of the "useless eater", something necessary if not sufficient to building death camps.