Perimenopause vs. Menopause: What's the difference?

By: Dr. Vanda

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 β€” instead, they've had to deal with the negative consequences of the β€œit’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.


Japanese Women: Symptom Free?

Various writers and researchers have speculated as to why Japanese women do not have hot flashes. One hypothesis is the Japanese diet, which is replete with vegetables and soy, provides some measure of prevention. Another hypothesis is that Japan's cultural respect for older people makes the menopausal transition more comfortable for women; the menopausal woman, then, is moving into a place of honor, rather than being pushed aside into a place of invisibility as frequently occurs in Western youth-oriented cultures. Research has found that when women hold roles that they consider important, they have fewer symptoms of menopause. This latter hypothesis might look good at first glance, but it is not the case, as claimed wiidely over the Internet, that Japanese women have no symptoms of menopause. Their symptoms are merely different.

The most common symptom of menopause experienced in Japan is frozen shoulders. This is a condition in which shoulder movement is severely restricted and painful. Nigerian women also experience this symptom more frequently than hot flashes (i.e., 40 percent, vs. 30 percent). Given these facts, it seems that the most fruitful research for attempting to understand why there are these differences in symptoms would be to look at diet, genes and environmental factors.


Cultural Fears

Women's fears and concerns about menopause also vary by culture. Muslim Arab women fear a loss of their spouses' sexual interest when they can no longer have children. Near Eastern Jews worry about a loss of physical health; European women worry about their mental health. American women fear losing control of their emotions and becoming emotional wrecks.

Regardless of culture and country of origin, all women the world over will experience menopause should they live to that point in their lives. It is interesting to consider the differences in menopausal symptoms, and to glean information from the research that might help any woman manage this transition in a life-affirming way.