Menopause

Preparation for menopause evolves from stories a woman hears or reads about the experience (McAdams 1993). In cultures with taboos against intergenerational communication, communication between the sexes, and open discussions about physical functions, women have only limited opportunities for learning about menopause. Women among Indian South Africans are seldom prepared for menopause (du Toit 1993). There is little discussion or preparation for this women's issue, and consequently women become aware of many myths (duToit 1993). These include the idea that women with no children will have delayed menopause or none at all. Similarly, another myth is that women with many children will experience menopause at a younger age because the uterus is "exhausted" (p. 266). Gabriella Berger (1993) reported that Filipino women may feel less satisfied with themselves as they adopt the Western values of youth and beauty that have been imported from Australia. In many cultures, sometimes women may feel a lack of purpose in society when they are no longer able to reproduce (Spira and Berger 1999).

Women have the opportunity to experience several versions of menopause through relationships with mothers, aunts, grandmothers, and friends, as well as encounters with the culture, media, and health professionals (Spira and Berger 2000). They tend to make the explanations internally consistent with their self-understanding. They may focus on their lost capacity to bear children, the aging process and loss of memory, and the impact these have on their work and social life. Because of the stresses created by these events, some women may become more sensitive to their own adaptive abilities and self-esteem (Kaufert 1982).

Kathryn Hunter (1991) describes how difficult it is for doctors to diagnose menopause based solely on objective measurements of medical symptoms, without the woman's subjective account. Both are important in assessing the need for care. Health professionals must help women to communicate the symptoms in order to anticipate these natural changes. Those who suffer a loss in self-esteem and fear the end of their personal worth need to recognize the biological facts and the cultural influences on their responses. Most of the women report that freedom from childbearing responsibility and the discomfort of monthly periods are welcome aspects of menopause.