POSITIVE RESEARCH RESULTS
In contrast to the compendium of deficiency and disease literature, recent evidence suggests that menopause is not particularly problematic for most women (Avis & McKinlay, 1991; Ballinger, 1990; DeLorey, 1992; Greene & Cooke, 1980). Cross-cultural and lifespan developmental studies have been particularly useful in constructing alternatives to unidimensional biomedical paradigms.
Cross-cultural studies have found that menopausal symptoms are more a function of cultural attitudes than biology (Datan, 1986; Flint, 1982). Women in non-Western, nonindustrialized cultures, in which the mother – in-law role is associated with increased power and status, associate menopause with increased freedom, sexual satisfaction, and frank relief that childbearing is over (Beyene, 1986). However, we feel compelled to point out that in many instances the enhanced role of a mother-in-law pertains to increased authority over only the traditional household domains of women and often comes at the expense of the servitude of younger wives and daughters-in-law.
Many cross-cultural studies document that women do not associate menopause with physical or emotional symptomology. Some cultures even lack the supposed universal symptom of menopause—the hot flash (Be – yene, 1986; Martin, Block, Sanchez, Amand, &. Beyene, 1993). Other studies of Japanese women (Lock, 1986, 1994), Mayan women (Beyene, 1986), African women (Todd, Friedman, & Kariuki, 1990; Udvardy, 1992), and Indian women (George, 1988) attest to the diversity of women’s experience and the interaction of biology and culture. Many of these studies point out the existing cultural differences in diet, exercise, and attitudes toward this phase of the female life cycle. Similarly, Nancy Woods (1993) delineates many dimensions of health that universally are unaffected by menopausal status, such as well-being, functional status, adaptability. These dimensions are likely a product of personal and social resources, past health experiences, socialization for mid-life, past and current social demands and patterns of coping with them, and health-promoting and health-damaging behavior patterns.
The life-span developmental paradigms also have contributed models of adult development that are sensitive to the multifaceted ecological contexts in which women create and maintain their identities. These offer the potential for more comprehensive and accurate perspectives for understanding menopause (e. g., Helson, 1992; Peck, 1986; Ryff, 1985; Schloss – berg, 1981). Beginning with a focus on healthy adaptation to transitions, these models hold potential for examining individual differences in coping with the challenges of the menopause transition. Similarly, qualitative methodologies that provide “thick description” of women’s experiences with the menopause transition have contributed alternative voices to the biomedical discourse (see Dickson, 1990; Gergen, 1989; Jones, 1994). These compelling stories of personal struggle with and against pervasive negative images of the mature woman remind us of the (sometimes destructive) power of culturally assigned meanings. As always, the personal is political. It is not especially useful to limit our understanding to individual adaptation to the challenges of menopause. It is more productive to question those challenges and work toward removing them where they serve to build barriers to the growth and development of women (and men). That is, the institutionalized forms of ageism and sexism that make it difficult for women to thrive and prosper in their later years must be rigorously addressed through both research and public policy. We must work to break the myths about mid-life women and begin to value all the female cycles, not in terms of the body as machine, but as body, mind, and spirit interacting.
More holistic approaches that integrate biological, social, psychological, and cultural factors are currently under way. For example, the Massachusetts Women’s Health Study (McKinlay, Brambilla, & Posner, 1992; McKinlay, McKinlay, & Brambilla, 1987) is a comprehensive, longitudinal study of more than 2,500 mid-life women that was undertaken in 1981 for the purpose of describing and understanding the normal menopause experience. Another notable example is The Healthy Women Study (Matthews, 1992; Matthews et al., 1990), which has followed more than 500 women from pre – to postmenopause, examining the relationships between their expectations, psychosocial stressors, and hormonal and physiological changes. It is our hope that these research programs and others will begin to counterbalance the predominant paradigm in ways that will contribute to the quality of life of mid-life women.
We challenge feminist researchers to construct a more balanced view, through increased interdisciplinary research and scholarship that are supportive of mid-life women. This is crucial for a complete understanding of the physical and symbolic nature of menopause. Certainly, alternate views of women and menopause will lead to different definitions and different questions. For example, if menopause is viewed as a developmental life phase (like adolescence), the focus of discussion may shift from technicalities about hormone levels to, for example, the changing status of the individual in personal, interpersonal, and social realms. New constructions will bring new perspectives on the training of health professionals and will educate the public in ways that will dispel current negative and unidimensional constructions of mid-life women.
We propose that the following research agenda will facilitate a move toward the goal of women’s sexual empowerment. First, more studies should examine sexual attitudes and experience among women from diverse socioeconomic groups, sexual orientations, religious groups, health statuses, ages, occupations, and ethnicities. In addition, the within group differences that characterize women from the same demographic address must be documented. Qualitative methodologies will be particularly useful in this endeavor as feminists seek to redefine what constitutes sexual experience for women and what subjective meanings they attach to their experiences.