Menopause doesn’t come symptom free in India⸺with women reporting heavy bleeding in the perimenopause stage as well as joint aches and fatigue⸺but there appears to be an overwhelming attitude that this is a time of liberation.
China
In China, menopause is also seen as a ‘rebirth’; a time when energy that was used for child-bearing and fertility can be saved.
Chinese women generally experience less hot flashes than Western women and rarely experience embarrassment of their symptoms. However it is interesting to note that women’s experiences differ, depending on whether they live rurally or in the city, with city professionals experiencing more symptoms than farming women.
HRT use remains fairly low in Asia. In a 2010 study of women across several Asian countries, only 19% of women took HRT to manage their menopause symptoms, while 37% used herbal or natural remedies. In China it’s thought HRT use could be as low as 2.1%.
Menopause in the Middle East
In a region that spans 20 countries and many ethnic groups, there are no doubt a wide variety of menopause experiences in the Middle East. In the few studies that have been conducted into women’s menopause experiences in the Middle East, there are some interesting common themes.
From a symptom point of view, it appears that women in Saudi Arabia experience similar frequency and severity of hot flashes to women in the West. But cultural attitudes to menopause are quite different.
The word for menopause in Arabic translates to ‘the hopeless age’ or ‘the age of desperation’ but this is thought to have more to do with the end of child bearing years, than the actual experience of menopause or ageing.
Postmenopausal life for women in the Middle East can be a time of renewed life, greater inclusion, and higher position in society.
Qatari women look forward to menopause as a time of liberation. In one study, many women talked about being more socially active after menopause. Postmenopause they could take part in religious activities that were previously off limits while they were menstruating.
Interestingly, the same study showed some women’s experiences largely depended on how supportive their husbands were. When women in the study were asked of their perceptions of menopause in the West, many believed that western women would not have the same support from husbands and families and therefore have a more negative experience.
A review of social impacts on menopause experiences showed that in Iran, prayer played a major role for women. While participating in prayer may provide an element of social support, there is also a level of comfort from the perception that menopause is a natural happening, and part of God’s predetermination.
Currently there is very little data on menopause treatments used by women in the Middle East to manage their symptoms, but it’s thought there is a preference for natural remedies over HRT.
Menopause among First Nation peoples
First Nations women may have quite different experiences than their caucasian counterparts.
For some North American First Nations groups there isn’t even a word for menopause, it’s just a time known as ‘when the period stops.’ This doesn’t mean symptoms are experienced to any lesser degree, but hot flashes, mood changes, and sleep issues just aren’t as well associated with the menopause process.
In a 2010 study into First Nations experiences of menopause, some participants spoke about how entering this stage of life changed their status within their communities. They were now seen as ‘wise’, because of their lived experiences.
Many Mayan women experience menopause at a significantly earlier age (44 compared to 51 in the West) but their transition comes almost symptom free. Even those who do experience symptoms, approached menopause with optimism and a positive attitude about their change in social status.
For Maori women, hot flashes and other menopause symptoms happen at a similar frequency to non-Maori New Zealanders, but they are less likely to seek healthcare support for their symptoms.
Less is known about the experiences of Australian Aboriginal women. In a study of Indigenous women from Queensland, there seemed to be little understanding of menopause, or even recognition of the word.
This may be because ‘women’s business’ within Australian Indigenous cultures is very private. The study found that around 59% of women surveyed weren’t aware that their periods would eventually stop. In another small study, Aboriginal women who participated mentioned fear of the changes they were experiencing, but also talked of gaining respect in their community as they aged.
Maori, North American Indian and Indigenous Australian women may experience menopause symptoms to the same degree as their caucasian counterparts, but studies suggest they are less likely to use management tools such as HRT. Whether this is because of cultural influences, or a lack of health literacy and access to healthcare needs to be studied further.
Reclaiming menopause
It’s clear that the way we approach menopause can have an impact on our experiences.
As Dr. Sandra Thompson explained to Reuters Health, “If menopause symptoms were due solely to hormonal changes then the menopausal experience would be more homogenous.”
In an article for the British Psychological Society, the authors said, “In Western societies women tend to be valued for their physical and sexual attractiveness, reproductive capacity and youthfulness. Ageing is often viewed negatively among women and wider society.”
And while our individual experiences of menopause may be unique, perhaps our collective experience can be improved if we work towards a culture that celebrates the wisdom that comes with ageing, and the benefits of moving to this next stage of life.
A natural first step is to normalize menopause through open conversation with friends, mothers, family and work mates.
A second step is to educate ourselves on our physical symptoms and understand the menopause management tools available to us.
A final step is to be kind to ourselves. Appreciate all that our bodies have been through to this point and all that they are capable of now.
The Wrap Up
Millions of women experience perimenopause and menopause every year, but the extent that it is a positive or negative experience may reflect cultural influences. In the West, menopause can be seen as a time to dread, while in the Middle East, Asia and for some First Nations people it is a time of renewal, rebirth and improved social status. By normalizing the menopause experience and educating ourselves on management tools, we can reclaim this time of our life and create our own positive experience.
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