What do you think of when you think about menopause? The word might conjure ideas related to ageing and growing older. You might think of your sweet overheated auntie desperately removing her sweater in the midst of a hot flush. Or perhaps you imagine new freedom in being past your reproductive years. No more periods!
The meaning you attach to the menopause phase of life comes from your culture and your upbringing. And your perspective, what you think about when you hear the word “menopause,” isn’t necessarily the same as what others might think.
No surprise there, right? But, did you know that how you experience the symptoms of menopause (or if you experience them at all!) might also be heavily influenced by your culture and background? And did you know that people in menopause around the world have very different experiences when it comes to which symptoms they feel? No, really!
But, wait…isn’t menopause a universal experience? Isn’t it just one of those things that everyone goes through the same? Like, a second puberty or something?
Menopause is a unique and individual experience that varies from person to person. And as we’ll see, it also varies from culture to culture in some interesting ways. Let’s explore the intersection of culture and menopause a bit. And look at what all of this means for you.
What is culture?
Culture is obvious, right? And yet totally intangible. It’s simultaneously rooted in history and extremely modern. It’s like the air we breathe. It’s all around us, in us, a part of who we are and how we see the world.
Some definitions of culture are:
"A culture is a configuration of learned behaviours and results of behaviour whose component elements are shared and transmitted by the members of a particular society"
"Culture has been defined in a number of ways, but most simply, as the learned and shared behaviour of a community of interacting human beings"
"Culture encompasses religion, food, what we wear, how we wear it, our language, marriage, music, what we believe is right or wrong, how we sit at the table, how we greet visitors, how we behave with loved ones and a million other things"
Clearly, culture washes over every aspect of our lives. But how does culture, however we define it, intersect with menopause? How does culture influence our menopause experience?
Culture and menopause
At first glance, menopause appears to be a universal experience. Symptoms related to changes in oestrogen levels (hot flushes, night sweats, vaginal dryness and insomnia, for example) are often the core symptoms of menopause.
However, research looking at the experience of menopause across cultures has shown that menopause isn’t the same for everyone. Variations in the menopause experience seem to be, at least in part, due to culture.
This shouldn’t be a complete shock, really, that there may be differences across cultures, because how menopause is felt and lived can vary quite widely within a culture, too.
Maybe your friend had really bad hot flushes and night sweats for months, but you lucked out with a few headaches over the last year. And maybe your mother felt like she was turning into an old lady during menopause. But, you find it liberating to no longer be in your reproductive years.
Let’s dig into this a bit more and look at what some of the research about culture and menopause has found.
Different menopause symptoms
One review of research looking at menopause experiences within Asian American communities in the US found that “postmenopausal women from Asian countries reported backaches, muscle pain, shoulder pain, or joint pain, but suffered less frequently from vasomotor disturbances than Western women.” But, the authors are careful to caution that the results are preliminary, and the reason for these results isn’t known yet.
Another study found that geographic, socioeconomic, and cultural contexts influence how many and how often people report postmenopausal symptoms. This specific study found that people from the UK, US and Canada reported the greatest number of symptoms. Meanwhile, women in Sweden and Italy reported fewer symptoms.
Another review of the research found that the symptoms associated with menopause vary quite a lot from one population and study to the next.
For example, they found that women of European descent reported more symptoms than other groups they looked at, especially psychosomatic symptoms like brain fog or irritability. They also found that African American women reported more vasomotor symptoms like hot flushes, and women of Asian descent reported the fewest symptoms overall.
Alright, so menopause looks different to different people. And maybe those differences are due to culture in some way. Let’s take a closer look at some of the theories about how culture might influence menopause.
Why do people have different symptoms during menopause?
When trying to explain why people have different menopause experiences, it gets a little blurry. We just don’t know enough. And more research is needed to really say any of this for certain.
But there may be some clues in the research already done. And perhaps knowing about these factors can make people in menopause more aware of how their own culture interacts with their midlife experience.
The following factors might impact your menopause experience:
diet
smoking
exercise
reproductive behaviour
expectations of menopause
meanings assigned to menopause and aging
previous health history
predisposition to symptoms
physical environment
the menopause experience of others around you
attitudes toward childrearing and women’s roles
marital status
relationships with others and how they view menopause
level of social support
career
religious beliefs
Some of these things are clearly in the realm of “culture,” while the connection to culture may be less obvious with others. For instance, what you eat and drink is your choice, but it is heavily influenced by culture.
The same goes for smoking and exercise. If these things are common in your culture, you may partake in them. If they aren’t, you are less likely to do them. For better or worse.
It’s also challenging to differentiate between symptoms of menopause and those of ageing in general. Brain fog, for example, can be a sign of menopause. But, it can also be a side effect of ageing more broadly whether a person is in menopause or not.
And it makes sense that views on ageing in general, whether positive or negative, could influence how people view menopause.
When it comes to cultural views of menopause and ageing, Dr. Mary Jane Minkin states, “In societies where age is more revered and the older woman is the wiser and better woman, menopausal symptoms are significantly less bothersome. Where older is not better, many women equate menopause with old age, and symptoms can be much more devastating.”
It seems pretty logical that cultures that view ageing as something positive would also have positive views of menopause. And cultures where ageing is avoided or seen as something negative might also have negative views of menopause.
We could spend a lot more time exploring how these different things may or may not influence menopause. But, let’s zoom in a bit and look at how the language we use influences our ideas of menopause. Because did you know that some languages don’t even have a word for “hot flush”? Yes, really!
Language and menopause
Language and culture are inextricably linked. There are even studies that show the language you speak influences your perspective and personality. People who speak more than one language learn to shift personalities from one culture to the other.
That’s all really interesting, but what does that have to do with menopause and culture?
The language we use (or don’t use) to describe the experience of menopause colours our perception of the experience. For example, in English, the time of life after the reproductive years is called “menopause.” This word holds a lot of different meanings for people. It includes typical symptoms, acceptable social roles, ideas about the value of ageing, and medical history.
In Japanese, however, there isn’t a direct translation of “menopause.” The word with the closest meaning is “konenki.” This roughly means the period of time in a person’s life starting somewhere in their 40s lasting through their 50s when a person undergoes a transition. This period of time is associated with a decline in oestrogen and symptoms directly correlated to that decline, but not to other symptoms commonly associated with menopause in other cultures. Oh, and men can experience “konenki”, too.
The researchers concluded that in addition to ideas about menopause, access to good healthcare and social benefits, a relatively even distribution of wealth in Japanese society, diet (soy!), and perhaps genetics contributed to low symptom reporting during menopause.
Other words may carry different meanings when it comes to menopause, too. For instance, the word “hot flushes” in English is distinctly connected to menopause.
But in other languages, in other cultures, there isn’t necessarily a word for this sensation. And if people report feeling such a sensation at all, they don’t always associate it with menopause. Japanese, again, didn’t have a word specifically for hot flushes until relatively recently.
Mind blown.
Ok, so the very definition of “menopause” (or whatever you label this phase of life) is shaped by cultural ideas, and those ideas create the language we have to talk about it all. Which, in turn, shapes how we view this time of life.
Menopause and western medicine
From the western European perspective, menopause is often regarded as a negative experience. In fact, going back to the importance of language, many definitions of menopause include words like “diagnose” or “condition” or “syndrome.” They make us think of illness and disease.
But, isn’t menopause a natural phase of life? Why does it need to be “diagnosed”?
How menopause is defined and experienced is influenced quite a lot by the history of menopause in modern medicine. The author of The Slow Moon Climbs: The Science, History, And Meaning Of Menopause writes, “Modern medicine uses the term ‘menopausal syndrome’ – syndrome means a number of symptoms that seem to occur together but whose relationship is not understood. The symptoms are the problem, not the transition.”
This view, that menopause is a collection of negative symptoms, is a rather recent perspective, though. The experience of menopause as a medical disorder, as a lack of oestrogen or collection of symptoms, is only typical of modern societies, not traditional ones.
This medicalised definition of menopause seems to have been spread by modern medicine, and it’s not the same definition in cultures where western medicine isn’t so prevalent.
As we wade through the muddy waters that are the relationship between menopause and culture, we maybe start to see that our experiences are coloured, if not partially defined, by culture and the culture of institutions like western medicine. And it’s hard to learn about the experiences of people in menopause across cultures due to all of the nuances involved with cross-cultural research.
But, why does any of this matter? What does this mean for us as we transition into and through menopause?
Why should I care about menopause and culture?
Menopause isn’t a disease. But some may view it as a “menopausal syndrome” with a collection of different symptoms.
As we’ve seen, though, even the symptoms that people feel during menopause vary quite a lot across and within cultures. Some worldviews tell people that menopause is something to fear or avoid or struggle against.
And other perspectives paint a picture of newfound freedom, liberation, and more positive views of menopause and ageing.
Menopause isn’t a monolithic experience. And it doesn’t exist in isolation. It’s an integrated experience influenced by all aspects of our lives before menopause. These conclusions aside, there’s a lot to be learned about what menopause is and how people experience it around the world.
Perhaps the two greatest tools we can give ourselves when it comes to living through menopause and into our post-menopause years are education and an open mind.
We can maybe avoid being blindsided by our own menopause experiences by learning about what we might expect, what other people have reported experiencing across cultures.
And if we approach the menopause phase of life with an open mind, maybe we can take things in stride. We can recognise when we may be making assumptions about what we think menopause is and how it should be experienced.
New roles in our families and society. New conceptions of our personal identities. Whatever we experience, we can adjust and grow and embrace ourselves.
We can go easy on ourselves. Practice self-compassion. Maybe we can embrace the transition into menopause and minimise the stress of trying to avoid all of the new things that may come with it.
For more information about menopause, check out the Olivia menopause app in the app store.
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References:
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Mattern, Susan P. The Slow Moon Climbs: The Science, History, And Meaning Of Menopause. 1st ed., Princeton University Press, 2019, pp. 328-366.
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"Menopause In Cultural Context." https://doi.org/10.1016/0531-5565(94)90011-6. Accessed 18 May 2022.
"Prevalence Of Postmenopausal Symptoms In North America And Europe." https://doi.org/10.1097/gme.0000000000000464. Accessed 18 May 2022.
“Subethnic differences in the menopausal symptom experience of Asian American midlife women.” doi:10.1177/1043659609357639 Accessed 18 May 2022.
"Symptom Reporting At Menopause: A Review Of Cross-Cultural Findings." https://doi.org/10.1258/136218002100321965. Accessed 18 May 2022.
"The Center For Advanced Research On Language Acquisition (CARLA): Culture." https://carla.umn.edu/culture/definitions/html. Accessed 18 May 2022.
"Women's Attitude And Perceptions Towards Menopause In Different Cultures." https://doi.org/10.1016/j.maturitas.2004.07.011. Accessed 18 May 2022.