Menopause Around the World

Delhi-womenMenopause, defined by the World Health Organization as the permanent cessation of menstruation, marks the end of a woman’s reproductive years.  As a biological event for women around the world, menopause itself is universal, however, research shows that the symptoms and cultural significance of menopause are not.

In the United States, women (and the media) commonly associate menopause with symptoms such as hot flashes and night sweats. Surprisingly, these complaints are not universal, and in fact the main symptoms of menopause vary among cultures. In 1970, Marcha Flint, an anthropologist, first attempted to look at the menopausal experiences of women in non-Western cultures. She studied 483 women in India and found that most complained of no symptoms during menopause other than menstrual changes. A decade later, Margaret Lock found that the symptom most likely to be reported by Japanese women during menopause was shoulder stiffness, and that hot flashes were actually very rare. In a study in Hong Kong, researchers found that joint and muscle problems were the most common symptoms. In all of these studies women reported symptoms as “mild.” What could be the reason for these very different physical experiences of menopause? Some researchers suggest that lifestyle may play a bigger role than previously thought. We know that hormone levels are largely influenced by how we eat, sleep, and exercise, and many studies have shown a direct relationship between diet and menopause symptoms (for example, the inverse relationship between hot flashes and the amount of soy products consumed in the traditional Japanese diet). Is it lifestyle, then, that makes menopause such a different experience for women around the world?

Another idea is that the most important factor determining a woman’s experience of menopause is the culture in which she finds herself before, during, and after menopause. In our youth-idolizing Western culture, menopause can seem like an ending. However, in many cultures, menopause is a time of new respect and freedom for women. A study reported that Mayan women, although experiencing some uncomfortable symptoms, looked forward to menopause, as it provided newfound freedom and status (Stefanopoulou). Marcha Flint found that in Rajasthan, India, women who were veiled and secluded before menopause, could now “come downstairs from their women’s quarters to where the men talked and drank home brew” and could publicly visit and joke with men after menopause (Flint 1975).

Do American women report more symptoms of menopause because of the impact of our Western lifestyle choices and stress levels on hormones? Or is it that we live in a culture where menopause is sometimes treated as a “disease,” rather than the transformative and elevating experience it is in other cultures? Both are very good questions worth pondering this month. In the meantime, if you or someone you know is experiencing uncomfortable menopausal symptoms consult with a qualified health care provider whom can help you feel balanced and improve your quality of life.


  1. Flint M. The menopause: reward or punishment? Psychosomatics. 1975.
  2. Lock, Margaret. Encounters with Aging: Mythologies of Menopause in Japan and North America. Berkeley: University of California Press, 1993.=
  3. Stefanopoulou, Shah, Shah, Gupta, Sturdee, and Hunter. An International Menopause Society study of climate, altitude, temperature (IMS-CAT) and vasomotor symptoms in urban Indian regions. Climacteric. 2014 Aug.  Epub 2013 Nov 7.

Written by Kaitlyn Pote, NCNM Naturopathic Medicine Program
Edited by Dr. Elise Schroeder