In the United States, generally speaking, it is not popular to look at the psychological and social factors of menopause. On the one hand, there is a sound reason to avoid the subject. Too many women have been victims of a health care system that has not taken their symptoms seriously — instead, they've had to deal with the negative consequences of the “it’s all in your head, dearie.” syndrome. However, in other parts of the world, such as Austrailia, looking at psychological and social contributors to menopausal symptoms does not seem to be anathema. It is part of a holistic, or "multidimensional," approach to women's health care. This does not mean that the biological aspects of the transition are ignored. It just means that the biological cannot be divorced from the woman's total psychological and social well-being. Menopause Across Cultures The type and prevalence of symptoms women exhibit during perimenopause and menopause are often related to cultural background. For instance, the hot flash is the most common symptom of Western city dwellers; however, hot flashes are so uncommon in Japan that there is no Japanese word for it.