Menopause

OBJECTIVES: In North America and Europe, it is usually assumed that biological changes associated with the end of menstruation and the onset of specific diseases commonly associated with the postmenopausal condition are universal. Using an anthropological approach in which menopause is understood as a concept that is historically and culturally produced, an argument is made for additional systematic investigation of what protects the majority of women from distress at menopause, and what factors contribute to a healthy old age. METHOD: Survey research based on questionnaire responses, together with open-ended interviews and textual analyses, were used. RESULTS: Differences are demonstrated in postmenopausal experiences and symptom reporting in Japan as compared with Canada and the United States. Reporting of hot flashes and nights sweats is significantly lower in Japan. These findings, together with the well established figures about greater longevity and lower incidence of heart disease, breast cancer, and osteoporosis in Japan, compared with North America, indicate that cultural and biological variables act in concert to produce this variation. Theories about the evolution of menopause and demographic data on aging are also discussed. This data challenges the widely held assumption that populations of postmenopausal women only recently have come into existence because of cultural and technological interventions. CONCLUSIONS: Postmenopausal women have been present in human populations since homo sapiens first evolved. Culturally mediated life styles affect both the menopausal experience and the health of women as they age. Additional investigations are needed.