Health

Menopause: How to Navigate This Transformative Time?

Menopause: How to Navigate This Transformative Time?

  Author: Photography, iStock

Health

Menopause: How to Navigate This Transformative Time?

Sooner or later, menopause affects every middle-aged woman, but all women don’t experience “the change” the same way.
In fact, in addition to the biological effects we may encounter, cultural factors can play a part in how we navigate this transformative time, too. 

The word menopause was coined in the 1820s by French physician Charles-Pierre-Louis de Gardanne; in the 200 years since, menopause has continued to be defined as a medical condition. The result is that women’s bodies and their natural processes, such as periods and their cessation, are considered to be “women’s problems.” 

The emphasis on symptoms, causes and “cures” has had a sizeable impact on the way women are seen, and the way we see ourselves, argues Cécile Charlap, a French sociologist and author of The Factory of Menopause (La fabrique de la ménopause). In her book, she notes that modern medicine has corralled menopause into an inseparable trio of issues: hormonal deficiency, which was only identified in the 20th century; symptoms, such as hot flashes and vaginal dryness; and increased health risks like osteoporosis and cancer. Charlap, on the other hand, disagrees with the characterization of menopause as hormonal deficiency rather than hormonal transformation. She believes that taking the hormone levels of a young, fertile woman as the standard of a healthy woman’s body throughout her lifetime means that society seeks to “right” the shortfall, and essentially lumps all women’s experiences together. It’s this kind of rhetoric, Charlap maintains, that can produce an inaccurate depiction of female old age. 

Wise men versus wicked women

What is said about menopause, Charlap says, strongly depends on the power relations between men and women, at a given moment, and in a given community. In our society, there is often a double standard when it comes to how men and women age. In men, age equals maturity and wisdom; women, conversely, are seen as harridans or cougars. As an example, consider the way George Clooney’s fatherhood at age 56 was looked upon, as opposed to how news of Janet Jackson’s geriatric pregnancy (current medical literature designates pregnant people over the age of 35 as of an advanced maternal age) was received. A woman’s value is tied to physical appearance and sexual viability in a way that is seen to decline well before the cessation of menstruation. 

Montreal anthropologist Margaret Lock argues against the preoccupation with med­icalizing menopause and the focus on women’s estrogen levels and symptoms, pointing to the lack of discussion surrounding men’s aging bodies as an example of our society’s unequal attitudes. She notes that men are rarely offered drugs or treatments to combat the natural changes that come with aging. This is despite research that says 30 percent of men over the age of 55 have hot flashes, or that impotence affects 40 percent of men in their 40s and 70 percent of 70-year-old men. Men continue to enjoy the freedom of a body exempt from all monitoring and evaluation, says Lock, while women are educated in controlling their fertility and optimizing their appear­ance from a very young age. 

Illustrating this cultural reality, Charlap critically calls out the ways in which young women’s bodies and reproductive systems are examined and assessed very early on in their medical histories, while the same doesn’t happen with teenage boys. One only has to observe how the mental and physical burden of contraception still rests almost entirely on women. In order to address this disparity, Charlap posits, women should feel as though they can celebrate this time of life, when we’re liberated from menstruation.  

Universal phenomenon, local perspectives

Research has documented what is universal and what is relative in how women go through menopause, concluding that the physiological changes that are common to women give rise to incredibly diverse symptoms and experiences. And while the physical changes are real and can even be debilitating, Lock maintains that generalizing the path of menopause can cause more misunderstanding. She believes in the fundamental role of “local biologies,” a term she put into practice in the 1990s, that highlights the influence of community culture and environment on the body. This encompasses genetics, medical history and reproductive history, as well as marital status, socio-economic status, education, work experience, religious affiliation, diet, smoking and physical activity. These factors interact in complex ways to produce a woman’s unique body, one that will encounter menopause in an individual way. For example, Lock explains, migrating from a country home to one in a city modifies this local biology. Almost everywhere, she says of the research, rural women who reported little or no symptoms of menopause began to notice them once in urban areas. In the same vein, more Japanese women today report having hot flashes, compared to what was reported as a very marginal symptom in the 1980s. It’s possible this is a consequence of the westernization of the diet in Japan, she notes. Lock then goes on to describe the Japanese concept of konenki, which does not directly translate into the word menopause but rather a “turn of life,” which can be used to describe the gradual aging process of people regardless of their sex. Without diminishing the acute symptoms that some women suffer, Lock maintains the Asian concept may be a healthier way to think about getting older. 

Cultural cues

The way we look at aging and the place of women in society can have an impact on how women understand menopause. Recounting anthropological research on women’s experiences in traditional societies like the Hmong in Australia and the Maya of Mexico and Guatemala, Susan Mattern, historian and author of the book The Slow Moon Climbs: The Science, History, and Meaning of Menopause, describes how aging and menopause are often viewed as a relief from menstruation and the possibility of pregnancy. The significance of this has less to do with the cessation of menstruation and more to do with the social status and respect attached to becoming a mother-in-law or grandmother.

Another example of this changeable cultural attitude can be seen in KaYaMenTA, a documentary short by Cree filmmaker Jules Koostachin that was aired by CBC. In the film, Koostachin brings together a group of Indigenous women who share their experiences of menopause and address some of the many facets of it, including aging, healing, sexuality and spirituality. The women offer a refreshing take on getting older, noting they feel empowered, stronger, sexier and more confident as they age. 

Forward thinking

The physical reality of menopause is as undeniable as it is inescapable: Aging brings with it changes in the body. But let’s bring awareness of how our local biologies and society’s long-held, inherited assumptions shape our experience, too. Recently, things have been changing in a positive direction. Fictional and nonfictional works, films and other artistic endeavours are happily shattering the purely clinical framework. So with that in mind, what if, like Mattern, who attributes the survival of our species to the Grandmother Hypothesis—involving an essential menopausal transfer of resources between gen­erations—we look beyond the status quo for
reasons to see this change of life as something other, and more, than simply a burden? 

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Menopause: How to Navigate This Transformative Time?

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