a global perspective on menopause

The Menopause Map

A global perspective on menopause.

Every person born with ovaries and a uterus that lives long enough will experience menopause. That’s half the world’s population! And it’s estimated that by 2025, more than 1 billion people will be in menopause. In this blog we are going to take you on a journey across to help give you a global perspective on menopause.

As a Canadian woman, I’m all too familiar with the negative connotations of menopause and aging in North America. So I was really surprised when I started exploring menopause in other countries. Interestingly, the global perspective on menopause varies significantly around the world.

The phase of menopause is the same. It’s a biological decline in ovarian function leading to the end of a woman’s fertility and ability to reproduce. But the actual experience, significance and perception of menopause around the globe is incredibly different. In North America, women often feel shame and are stigmatized for their natural aging. Conversely, in other cultures, women are celebrated and are given elevated power for this same stage of life.

I found this fascinating. There’s such a huge range of experiences women around the globe have with menopause. Here’s what I discovered…

Menopause in Western cultures:

Western perspective on menopause

– Perceptions and Social Stigma

Western cultures (North America, Europe and Australia) often view aging negatively.  We dread menopause instead of respecting it. Our worth becomes tied to our youth and fertility.  We spend millions of dollars each year to help us look younger, desirable and more attractive. We take painstaking efforts at the gym and undergo intensive treatments and surgeries to keep the hands-of-time in check.

So when we start experiencing the signs and symptoms of menopause, we often hide them or downplay their severity. And we suffer in silence.

Even worse, those of us brave enough to approach our doctors are often dismissed or under treated. Leaving us feeling ashamed, unheard and isolated. This only perpetuates the stigma and the cycle of neglect.

– Gender Roles
In Western cultures, women enjoy the same basic rights as men. We can vote, drive, own land, have access to education, and are protected from violence. Our mother’s and grandmother’s fought to get us these rights and told us that we could do it all.
What they didn’t tell us is that this meant that in addition to climbing to the top of the corporate ladder, we’d still be the primary caregivers.  And we’d be responsible for the household management and supporting our aging parents.
Incredibly, all this responsibility is likely one of the major factors impacting the intense menopause symptoms that we experience in North America.

– Common Symptoms

Western cultures commonly perceive menopause through a biomedical lens. Treating it as a disease. We agree on about 30 symptoms, such as menstrual irregularities, hot flashes, brain fog, night sweats, vaginal dryness, and weight gain. However, some Western researchers suggest that there could be almost 100 symptoms.

Interestingly, Western researchers apply varied menopause symptoms depending on ethnicity and socioeconomic status. In the US, menopause tends to occur earlier in Black and Latina women, and they experience more severe symptoms, such as hot flashes and a longer post-menopausal period.

Moreover, women of lower socioeconomic classes in America and Europe often face the greatest challenges with their symptoms. Conversely, the opposite is observed for Asian women. Those with higher socioeconomic status report more severe symptoms while experiencing menopause, rather than Asian women with a lower status.

– Tips and Management Tools

In Western cultures, many women turn to hormone replacement therapy (HRT) to treat their menopause symptoms. In fact, it’s estimated that 6 million women in the US use hormone replacement therapy (HRT) each year.

But HRT isn’t suitable for everyone. Instead, some women use supplements or even cognitive behaviour therapy (CBT) and mindfulness to alleviate hot flashes and other menopause symptoms.

– Celebrations, Tradition and Symbology

World Menopause Day is one of the few ways that Western cultures celebrate menopause. It started in 1984 by the World Health Organization. The goal of World Menopauses Day is to raise awareness of the menopause and the support options available to women. It’s a great step in the right direction to help reduce some of the stigma women experience around the world.

Menopause in Asia

Asian perspective on menopause

– Perceptions and Social Stigma

Japan, China, and India view menopause differently than the West. In Japan, menopause is a natural stage of life that is embraced. The Japanese word for menopause, konenki, roughly translates to renewal, season, and energy. China considers menopause as a “rebirth” and an energetic shift while India perceives it as a liberation for women.

Interestingly, India’s cultural studies conducted in the 70s and 80s discovered that women, who were traditionally veiled and isolated during their reproductive years, could interact with men once they hit menopause. Once women reach this stature, age-old societal norms no longer apply.

Despite the acceptance in these cultures, taboos about menopause still exist in rural parts, where the shame of menstruation silences women as they approach menopause.

– Common Symptoms

Japanese women seem to have cracked the mystery behind menopause. They report fewer symptoms compared to Western women, and astonishingly, around 25% of them experience no symptoms at all. It’s also worth noting that they have lower rates of typical diseases affecting postmenopausal women, such as breast cancer, osteoporosis, and heart disease.

In China, women commonly encounter shoulder pain and insomnia, although on a smaller scale than Western women. However, there is speculation that Chinese women tend to underreport their symptoms, in general.

Indian women experience usual menopause symptoms, notably heavy bleeding, joint aches, and fatigue. Worryingly, some women experience sight problems during this phase.

– Tips and Management Tools

Japanese women provide us with an important dietary tip: Include soy in your diet! Researchers have found that the high presence of soy in Japanese cuisine could explain reduced menopause symptoms in Japanese women. The isoflavones found in soy act like estrogen. This is exciting news since menopause symptoms like hot flashes worsen when our estrogen levels decrease.

Moreover, it’s worth mentioning that only 19% of Asian women use hormone replacement therapy (HRT) to alleviate their symptoms. Even fewer Chinese women, only 2.1%, use HRT to relieve their menopause side effects.

How do they cope? Around 37% of Asian women use natural or herbal remedies to ease their menopausal symptoms.

Menopause in the Middle East:

Not enough is known about the menopause experience for women in the Middle East.

– Perceptions and Social Stigma

The Middle East boasts a vast and rich myriad of religious and cultural diversity. So generalizing it is tricky. But in many places, reaching menopause means rejuvenation. Women get included more. And in many Middle Eastern nations, women climb to  higher position in society.

Women in the Middle East celebrate menopause as an potential opportunities and growth.

In Qatar, menopause is a source of freedom. According to a study, women reported being more socially active than before and participating in religious activities that were previously off-limits due to menstruation.

All of these positive attitudes. Despite the Arabic word for menopause roughly translating as ‘the hopeless age’ or ‘the age of desperation.’ However, the term refers more to the end of childbearing years than the actual menopause experience.

– Common Symptoms

Unfortunately, researchers have conducted very little research on menopause in the Middle East. However, a recent study revealed that Arab women experience natural menopause at an average age of 47.9 years, younger than the average age of 51 in Canada.

This same study showed that Arab women experience hot flashes and similar symptoms – muscle and joint problems, exhaustion, heart concerns, sleeping disorders, and irritability – with similar frequency and severity as Western women. Hmm…does that ring a bell?

– Tips and Management Tools

Sadly, there’s a lack of data on how women in the Middle East handle menopause symptoms. While natural remedies are believed to be their preference over HRT, this remains an assumption.

Menopause in African Cultures:

African perspective on menopause

– Perceptions and Social Stigma

Neglect has shrouded women’s health in Africa, leaving us with little knowledge of how menopause truly affects them. Cultural backgrounds, geography, and accessibility to knowledge all shape the diverse experiences women undergo during natural menopause.

In certain African countries, postmenopausal women are granted improved social freedom, though many continue to consider menopause a taboo topic. This silence leads to a severe knowledge gap, resulting in greater health problems.

It is time for women to unite and champion change. African women require comprehensive women’s health programs and accessible educational resources, supported and developed by properly trained care providers. They should also start an open, community-wide dialogue. Through the powerful tool of shared experience, our voices band together.

Menopause in Indigenous Cultures:

Indigenous women revere menopause and they take on leadership roles in their community.

– Perceptions and Sprituality

Indigenous women may experience menopause differently than their Caucasian counterparts, with some groups simply defining it as the cessation of periods and not even having a word for it. Instead, menopause is celebrated as a source of wisdom.

In shamanic cultures, menstrual blood holds great wisdom. When menopause arrives, women are believed to begin ‘retaining their wise blood.’ It is at this moment that women can emerge as community leaders and shamans.

– Common Symptoms

Indigenous women globally experience menopause symptoms with similar frequency and severity as non-Indigenous women in the same regions. These symptoms include hot flashes, night sweats, brain fog, and mood changes.

Unfortunately, Indigenous women are less likely to seek support for these symptoms, with some speculating that this is due to the taboo nature of menopause among these women. Rather than share their experiences, they suffer in silence. Shockingly, a study of Australian Indigenous women found that almost 60% of them didn’t know that their periods would stop.

We need to stop this lack of knowledge and communication.

The take away

Half of the world’s population will go through menopause. And there’s so much we need to do to improve this experience for women around the world.

It is great to see that some cultures manage to transition with little to no symptoms. It is even more inspiring to know that in many cultures women celebrate their menopause. It’s a time of rebirth and renewal. A time when they can shrug off some of their societal boundaries. And even become leaders and healers in their community.

But the reality is that in far too many countries in this world, menopause is still a taboo topic that is ignored and under supported.

They say that menopause is having its moment. Yes! Amazing! Fabulous!

But let’s not stop here. Let’s keep pushing the conversation. Normalizing the narrative. Smashing the taboo.

We need to keep talking. And we need to talk louder. We need to share our stories with women in our communities and around the world. Even though every woman’s menopause transition is wildly different, our shared experiences provide support. And they help to normalize this stage of our lives.

Because now more than ever, women need to push the boundaries. We need to get bold. To understand our bodies and our health.

We need to become the heroes of our own health journeys.