Is menopause a negative aspect of midlife for women? Changes or declination in physical functions will benchmark our midlife ( Bee & Boyd, 2002). In that aspect there is a single significant physical change that occurs in the midlife, which is menopause, especially for women. Menopause is a natural part of ageing process where women experience declination in their reproduction ( Bee & Boyd, 2002). This indicates cessation of menses. Perhaps this is the most important change in a woman’s life in terms of physical and emotional health.
This paper attempts to explore the factors contributing to the negative and positive aspects of menopause. Past medical views, which had created the myths and stereotypes of menopause, which had psychological effects on women, because menopause has been associated with old age, fertility and health (Bennett & Degeling, 1995). Therefore in society’s view menopause appeared to end the creative life of women. Media also interprets and reflects that a young, glamorous woman only has gracefulness. These media images are used by women to judge themselves and may lead to internalisation of standards for judgement of beauty (Magezis, 1996).
Understanding and acknowledging the biological, emotional and physical stresses of menopause on women and providing adequate support may relieve symptomatology. This also implies that if individuals accept their own mortality, physical limitations, health risks and adapting to the changes of their roles, this may contribute to an approach to menopause in a positive or negative way. Cultural expectations and structure have various influences over menopause (Craven & Stojanovska, 2001). Societal views of menopause have varied greatly over the years and it has been considered as a natural developmental change or medical problem requiring treatment (Hall & Jacobs, 1992).
Until the nineteenth century, menopause was treated as a natural part of life. In the mid nineteenth century, Victorian Gynaecologist Edward Tilt established that menopause was a ‘gradual loss of feminine grace leading to mental diseases’ (Hall & Jacobs, 1992, p. 12) According to him excessive blood is stored in the head which in turn leads to menopausal disorders and particularly severe headaches (Hall & Jacob, 1992).
Another exponent, Dr Andrew Curtier, viewed menopause as a socio economic factor as a result of ‘irregular and unwomanly’ occupations, he described such woman as ‘pitiful spectacles of decrepit and wrinkle and worn out creatures’ (Hall & Jacob, 1992, p. 13). He advocated for hysterectomies. In Psychoanalytic literature, Freud viewed menopause as a potential crisis and his follower Helen Dutch developed this as the stage where women’s services to the species ends ( Wilbur, Miller & Montgomery, 1995). In 1960 the oestrogen replacement therapy was popularised because medical practitioners viewed menopause as an oestrogen deficiency (Wilson & Wilson, 1963 cited in Wilbur, Miller & Montgomery, 1995).
In 1980, hormone replacement therapy was introduced in Britain and United States. This contributed to the fact that women allow drug companies, medical practitioners, and gynaecological surgeons to take control of them ( Hall & Jacob, 1992). These therapies also emphasises the ageing process in a woman. Dr Sandra Cabot says women are worried about the ageing and deterioration of their looks as a result of menopause ( Cabot, 1991). Psychological transition occurs for women experiencing menopause. Because women had to accept the fact that the chances of them bearing a child is very low (Jones & Abraham, 1992).
This implies that a woman’s usefulness equates to her fertility. Apparently there is also a widespread feeling that women will ‘shut up’ sexually (Coope, 1996). As a result women have a negative approach to menopause, which reflect in their feelings. Another myth, which revolves around menopause is that we are starting our journey of old age at menopause. Medical workers and health workers reflect this in their findings and research (Bennett & Degeling, 1995). This reflects that health of a woman equates to physical health and ageing is the same as old age ( Bennett & Degeling, 1995).
All these myths and stereotypes emphasise that menopause is a time of diminishing physical and sexual attractiveness and worth. In turn this reflects how society values women and how a woman may value herself. This is also emphasised in media reflecting the dominant values and expectations of the society. The media idealises the image of femininity as young (Magezis, 1996). Older women get less coverage and they are often portrayed as victims of crime, grannies or witches. The wisdom and fulfilment of older women have been hidden in the media, because of society’s expectations of older women being unhealthy, inactive in sexual activity and over matured for fun ( Magezis, 1996).
Therefore women feel they only have a place in society if they retain their illusion of youth ( Hall & Jacob, 1992). This increases the concern about menopause that stresses the youth. These feelings of lost hopes, lost femininity and confusion add to the ongoing stress of women in perimenopausal years. Another major stressor for women facing midlife experiencing menopause is likely to come from their families. As we are aware, women play numerous family roles such as daughter, wife, mother, grandmother and mother-in-law and they have to balance these roles along with careers and community interests (Bennett & Degeling, 1995).
The strength of the family is dependant on ‘mothers’ as a source of emotional and practical support, but often with no reciprocation. As a result, the balancing act might topple and become a stressor for them. ( Kahn & Holt, 1987). However, women’s role as mothers become the ’empty nest’ when the children leaves them. Based on this, women face unexpected maternal urges, which brings in the urgent pressure to fulfil their biological creative function. Menopause is blamed for the life crisis ( Hall & Jacob, 1992).
If their traditional caregiver role changes the priorities and focus on their physical and psychological well-being would also ensure positive effects in midlife (Jones & Abraham, 1992). Studies in Britain in the 1970s reflected that at least twenty five percent of men were unaware of the nature and extent of the women’s menopausal problems. They were not aware that women needed more support, love, encouragement and understanding during the menopausal stage. In this case, lack of support may aggravate women emotionally Therefore knowledge and acknowledgment of menopause helps women to adjust (Jones & Abraham, 1992).
Along with this, we should also acknowledge women for their maturity and experience. Often menopause is associated with deterioration of women’s mental capacity, their ability to reason and to make deductions in life (Craven & Stojanovska, 2001). If women were acknowledged for their ability to cope and solve problems this would make them feel good and reflect positively on their approach to menopause (Bennett & Degeling, 1995). However this may not affect women who are often happier and focus on the development of their marital relationship.
They use this new freedom or new found financial freedom to further their education or to travel and indulge themselves (Craven & Stojanovska, 2001). Some women exercise assertiveness and diversify the responsibilities of their roles to the respective individuals. For example, midlife women ask the young parents to take care for their own children (Kahn & Holt, 1987). It might be said that middle age is a time for making all sorts of adjustments and adaptations. This implies that women have to review their attitude to their health.
If women actively engage themselves fully, this may relieve them from menopausal stress and also if they take care of their health they may feel more lively, young, attractive and healthy, which could reflect positively during menopause ( Coope, 1996). By making preparations and accepting the limitations of menopause this may give a lease of life and improve their mental and physical being (Hall & Jacob, 1992). Appropriate therapies and actions may remove the cause of the stressor for the menopause. In addition, self assertiveness, weight control, stress-management, personal communication, relaxation or medication may be the best possible options to build up the self-esteem and confidence during midlife ( Bennett & Deegeling, 1988).
For some women who are holding on to the old fears created by myths and stereotypes of menopause, they may be listening to the internal and external prompts increasing the rigid outlook of their lives. They will struggle all the way to fix up their bodies, families, careers, home and world endlessly ( Willis, 2002). They remain depressed and disengaged from the world. This then may lower their self-esteem (Willis, 2002). There is also cultural influence on individual attitudes and beliefs .
In some cultures the physical change is expected during menopause. This is a result of cultural expectations or the structure which acknowledges the change during menopause (Bennett & Degeling, 1995). For example in India older women are respected for their life-experiences. In Hindu culture women are kept in strict ‘seclusion’ and they are released at the time of menopause. This then allows them to associate and converse in male company. Their new, active role and freedom enables them to experience none of the negative symptoms of menopause ( Coope, 1996). In Western culture, women fear ageing and they are forced to compete with the young.
They regard menopause as a disease and label menopausal woman as deficient ( Bennett & Degeling, 1995). In 1999 Medical Journal of Australia Alastair Maclennan and his colleagues reported that women from western society use the hormone replacement therapy most in the world (Craven & Stojanovska & 2001)Based on this an article appeared in ‘The Daily Telegraph’ citing that ‘Australian woman still taking HRT (Hormone replacement therapy) despite cancer risk’. This tends to indicate that western culture views menopause as a medical condition that needs treatment. In contrast to this Asian women complain less even when they experience high levels of menopausal symptoms, because they accept menopause as a natural transition in their lives (Craven & Stojanovska & 2001).
Cultural influences appear to affect women’s ability to tolerate menopausal symptoms and also suppresses the psychological and physiological symptoms. In some societies in differing cultures menopause signals an increase in social status and sexual liberation. For example , African women in the menopausal stage attain higher status and can command the labour of their juniors, and for the Kung women of Botswana the post menopausal life stage is a time of sexual liberation ( Stoppard, 1994).