Menopause, local biologies, and cultures of aging

Abstract

Menopause marks the end of menstruation, once generally accepted as the closure of women's reproductive lives. The current medical view of menopause, however, is as a pathological event with its own distinct set of symptoms and diseases. Researchers have described women as facing a dramatic increase in the risk of heart disease, osteoporosis, stroke, and Alzheimer's, all as the result of the impact of changing hormone levels, particularly the decline in estrogen. The clinical literature has interpreted these findings in terms of the absolute necessity of replacing these lost hormones for all women who are menopausal regardless of any other physiological, social, or cultural characteristic they might possess. Using research done in Japan, Canada, and the United States, this paper challenges the notion of a universal menopause by showing that both the symptoms reported at menopause and the post-menopause disease profiles vary from one study population to the next. For most of the symptoms commonly associated with menopause in the medical literature, rates are much lower for Japanese women than for women in the United States and Canada, although they are comparable to rates reported from studies in Thailand and China. Mortality and morbidity data from these same societies are used to show that post-menopausal women are also not equally at risk for heart disease, breast cancer, or osteoporosis. Rather than universality, the paper suggests that it is important to think in terms of "local biologies", which reflect the very different social and physical conditions of women's lives from one society to another. Am. J. Hum. Biol. 13:494-504, 2001.

Chinese medicine treatment for menopausal symptoms in the UK health service: Is a clinical trial warranted?

“…In fact, a survey we conducted in preparation of the present study, which compared the symptoms experienced by London women to those in China, Japan, the United States, and Canada, corroborated the existence of these differences [11]. As the Chinese medical tradition makes available a range of different approaches to the treatment of menopausal symptoms [12][13][14], we argue that rather than claiming universal validity and reach, treatment approaches must be tailored to what anthropologists of menopause refer to as 'local biologies' [38].…”

“…As the presence or not of menopausal symptoms appears mediated by a range of personal and cultural rather than being strictly the result of the biological cessation of periods [12,38], for the purpose of this study we selected women between 45 and 55 years who experience menopausal symptoms such as night sweats and mood changes. Women were excluded from the study if they had one or more of the following characteristics: receiving HRT treatment; with surgically or drug induced menopause; menopause occurring before age 45 or unnatural menopause; already receiving Chinese medicine or acupuncture and not willing to suspend such treatment for the duration of the study; on warfarin or other drugs with a very narrow therapeutic dosage that required constant monitoring; suffering from severe systemic disorders such as cancer or multiple sclerosis who were receiving immunosuppressive treatment, radiation treatment, or chemotherapy; suffering from severe psychiatric disorders who were being treated with lithium or neuroleptic medication and required constant psychiatric supervision; with known allergies to herbal products; diagnosed during their initial assessment interview as requiring treatment for the Chinese medical disorders diankuang 癲狂 (mania and withdrawal) or benglou 崩漏 (uterine bleeding), or were already participating in another medical study.…”

“…Besides issues relating to the quality of research design, we contend that in most of the studies carried out to date the interventions lack validity, as their therapeutic processes are not rooted in an appropriate theoretical framework [8] [9]. In addition, they have failed to engage with the cross-cultural variation known to exist in women's experience of menopausal symptoms [7,11,[12][13][14]38].…”

The Biosocial Event: Responding to Innovation in the Life Sciences

“…Our agenda however is neither predicated on increases in human technical competence, nor restricted to those biosocial sites at which human identity is at issue. Our approach is closer to that underlying the concept of 'local biologies' Kaufert 2001, Lock andVinhKim 2010). Lock's observation that not only the experience of but also the bodily manifestation of menopause varies by culture led her to the view that, in different locales, life processes and social processes come together in different ways to create a diversity of menopauses.…”

Entre muertos y especímenes: hacer cadáveres, anatomía y medicina legal en el laboratorio

“…Desde la antropología médica, por ejemplo, se ha cuestionado la idea de una naturaleza única de los cuerpos y se ha dado paso a modelos que piensan en sus "naturalezas locales" (Lock y Kaufert, 2001;Martin, 1990;Napier, 2012). Carnalidad, así pues, embebida de contexto.…”