Menopause is a biological process common to almost all women, medically recognised as the change in women’s production of
hormones and the cessation of menstruation, starting on average at 51 years of age and lasting over three years (Williams et al., 2009).
Medical and psychosocial disciplines and approaches dominate
current scholarship, focused on symptom reporting and alleviation, and providing insights into the multiple biological, psychological,
social and cultural factors that interact to shape women’s
experiences of menopause (Hunter & Randall, 2007). Whilst some experience menopause as a relatively neutral event, up to a half of women may suffer some bothersome episodes, and a significant but smaller minority present severely distressing symptoms, including hot flushes, sleep disturbance,fatigue and concomitants (e.g.
sweating, embarrassment, depression, anxiety, impaired short-term memory) (Keefer & Blanchard, 2005).
Medical and psychosocial disciplines and approaches dominate both scholarship and evidence-based practice surrounding menopause. According to Utz (2011), a significant shift has occurred in the
definition of menopause in Western countries in the post-World War Two period. Bell (1990) locates this shift even earlier in the 1930s and 1940s. Previously viewed as a natural change in women’s bodies, it is now predominantly conceived in Western societies from a medicalised and symptomatological perspective in terms of the
biological ‘deficits’ of the individual, ageing female body. Substantial research is conducted by the biomedical disciplines on and into women’s bodies to chart the physical and psychological symptoms, diseases and disorders that are found to accompany menopause. Hot flushes and night sweats (known as vasomotor symptoms) are the most commonly reported, and typically severely experienced (Ayers et al., 2010; Keefer & Blanchard, 2005); other symptoms may include sleep disturbance, memory loss, fatigue, uterine bleeding, diminished libido and vaginal dryness (Ayers et al., 2010; Keefer & Blanchard, 2005; Zapantis & Santoro, 2003). Medical research also investigates diseases commonly associated with decreased ovarian steroid production in post-menopausal women (for instance,
osteoporosis and cardiovascular diseases; Sarrel, 1991) and the risks and efficacy of Hormone Replacement Therapy (HRT)
Relatedly, the biopsychosocial paradigm recognises that women’s
experiences of the physiological symptoms of menopause are
associated, mediated and differentiated by a complex interplay of psychological, social and cultural issues (Ballard, Kuh & Wadsworth, 2011). On the one hand, psychosocial studies show that women’s
experiences of vasomotor symptoms, for instance, are important markers of various somatic and psychological symptoms, including anxiety (Juang et al., 2005), depression (Joffe et al., 2002), and low self-esteem (Hunter & Randall, 2007). Reynolds’ (1997) study of menopausal women describes negative thoughts and emotions
associated with physical symptoms, including shame,
embarrassment, and anxiety. On the other hand, these psychological and emotional responses can serve to exacerbate the experience of physiological symptoms (Keefer and Blanchard, 2005). There is also noteworthy cross-national and ethnic variation in symptom
reporting, notably of vasomotor symptoms (Lock, 1986, 1991).