Blog of the Society for Menstrual Cycle Research

What’s In A Name?

March 27th, 2014 by Heather Dillaway

This month an important Sage research journal, Menopause International, “the flagship journal of the British Menopause Society (BMS),” changes its name to Post Reproductive Health. The Co-Editors of this journal are quoted in talking about this name change:

“Women’s healthcare has been changing dramatically over the past decade. No longer do we see menopause management only about the alleviation of menopausal symptomatology, we also deal with an enormous breadth of life-changing medical issues. As Editors of Menopause International, we felt that now is the time for the name and scope of the journal to change; thus moving firmly into a new, exciting and dynamic area. We wish to cover Post Reproductive Health in all its glory – we even hope to include some articles on ageing in men. Our name change is a reflection of this development in scope and focus.”

This name change may seem very insignificant to most people but, for me, a change in name signifies major steps in conceptual thinking, research practice, and (potentially) everyday health care. While I have some problems with the new name (I’ll get to those in a minute), the idea that menopause researchers and practitioners are beginning to see menopause as part of a broader life course transition is phenomenal. It signifies the willingness of many in the business of studying and treating menopause to think more broadly about reproductive aging. It also indicates that many now understand that menopause is not necessarily the “endpoint” of or “final frontier” in one’s reproductive health care needs. Perhaps it also means that we might acknowledge that perimenopausal symptoms are more than single, isolated, “fixable” events and that they may be related to larger, long-term bodily changes. The very idea that “post reproductive health” is important is one that I support and advocate, and I see this as evidence of the realization that there is life after menstruating and having babies. What’s more, the re-branded journal seeks to include research on men’s health too, perhaps signifying that researchers and practitioners acknowledge the sometimes non-gendered aspects of “reproductive” or “post-reproductive” health. Everyone needs health attention, no matter what their life course stage.

What I can still critique about the name change, though, is that the new name of this journal suggests that menopause and other midlife or aging stages are thought of as “post”-reproductive. In my opinion, it is really that we live on a reproductive continuum, that we are never really “post” anything, that prior life stages always continue to affect us and that there are not strict endpoints to the menopausal transition in the way that the word “post-reproductive” might suggest. Reproductive aging as a transition could take as much as 30 years or more, and women report still having signs and symptoms of “menopause” into their 60s and beyond. According to existing research our “late” reproductive years begin in our 30s and don’t end until….what? our 60s? our 70s? The word “post-reproductive” suggests an “end” that maybe doesn’t really exist ever. Here is a link to an article I wrote on this idea of the elusive “end” to menopause, and I think it is important to think about how the word “post” may not be the best way to describe how we live our midlife and older years. We may still have “reproductive” health needs way into our 70s, 80s, and beyond, so how can we think of ourselves as “post” anything?

With this said, however, I still am very happy to see the current name change of the journal, Post Reproductive Health, because I believe it signifies a very important change in the right direction, and I hope to see many more moves like this as we contemplate what midlife and aging health really is.

  

12 Responses to “What’s In A Name?”

  1. Elizabeth Kissling says:

    Maybe post reproductive health is like post-feminist and post-racial, Heather!
    ;-)

  2. HeatherD says:

    You are so right, Liz. “Let’s talk about post-reproductive because we are so past reproduction….oh, wait, we’re not! Okay, so let’s just pretend we are…”
    What will be really interesting is whether this newly named journal will still focus on menopause or whether it will truly move on….then I will REALLY have a blog entry to write!

  3. Paula Derry says:

    Well, I believe that there is also a dark side to this change. The announcement says: “Initially the journal will concentrate on the key areas of menopause, sexual health, urogynaecology, metabolic bone disease, cancer diagnosis and treatment, recovering from cancer, cardiovascular disease, cognition, prescribing, use of new hormone therapies, psychology, the science of ageing, sociology, economics, and quality of life.”
    The idea that age-related changes are best defined by a woman’s reproductive state, is not an accurate idea and is related to the medicalization of menopause. Cognition, psychology, cancer, osteoporosis, heart disease–are related to development through the life cycle. Belief that heart disease, and even bone disease, are due to reproductive changes has been harmful in the past in defining large numbers of women as having pathologies and in narrowing ideas about good ways to prevent and treat these conditions.
    Post-reproductive really still means Post-menopausal. Most women are in fact post-reproductive after they finish having the children they are planning to have, with the exception or an accident or two.
    When the anthropologist Margaret Lock researched menopause in Japan, she found that in Japanese culture there was a broad psycho/social/physical developmental change in adult midlife called Konenki, of which the end of menstruation was a tiny part. Our focus on physical reproduction is a cultural idea, not a scientific fact.

    • HeatherD says:

      I completely agree, Paula. I’m actually critical of the change too, and I think Liz was trying to be critical too. I’m pretty sure that the editors and board members are not conceptualizing “post-reproductive” in the positive ways that I would like them to. What I’m wondering, though, is whether the focus of the journal will be less on menopause now. We should pay attention to the journal issues and see how the publications are defining “post-reproductive.” I agree that “post-reproductive” could just stand in for “post-menopausal” but I’m wondering if that won’t be the case.

      • HeatherD says:

        So, Paula, I’m curious, what type of name change would you advocate for in this case? If it’s dangerous to use reproductive in the title?

  4. Paula Derry says:

    What is significant to me is that a menopause society is naming a journal in a way that says that health problems like heart disease, cancer, and others, are (post) reproductive problems. Older women and their health are not defined by menopause status, there are many aging-related processes going on. Heart disease is not a disease of the ovaries. And try as people have done, evidence has not been found establishing that menopause is related to cognition, cancer, etc. If the Society is interested in general health issues associated with older adults or with aging, what would need to change is the name of the society and not of its journal.
    For a name of the journal, perhaps the name “Health in Midlife and Beyond”, or something like that, if the topic of the journal is general health issues. Perhaps the fact that there are few names for stages of development in older adulthood that are not derogatory or defined by menopause is what is significant–middle-aged, elderly, geriatric. Or, for that matter, that women who are not mothers are considered to be “post-reproductive”–what about grandmothers, etc.

    • HeatherD says:

      I understand your points even more clearly now. The conflation of these conditions and illnesses with menopause is really problematic, I agree. I’m really glad you clarified this and I don’t know why I wasn’t think about that initially. You’re absolutely right.
      The problem with a journal title about “midlife” is that, in my experience, no one quite knows what midlife really is or what should be included in it. But in theory I do like the idea of a midlife health journal.

  5. Paula Derry says:

    I actually did have one other thought, Heather, that the issues that you point to–experiences that really are related to reproduction and to the menopausal transition and to postmenopause–are not on the list of topics the journal says it will emphasize.

  6. Laura Wershler says:

    Great discussion Paula and Heather. I totally agree with Paula’s analysis on this, that the real problem with this name change and reframing is the implication that the health issues experienced by women who are aging are related to our being “post-reproductive” rather than aging in ways that relate to the way we’ve lived our lives (diet and exercise) the genes we’ve inherited or the environmental influences we’ve been exposed to.

    On the bright side, considering the plan for the renamed journal may include articles about men’s aging process, it could be this is just one transitional step on the way to disengaging research and discussion about aging in women from the menopause juggernaut.

    I wish the editors at the British Menopause Society would chime in on this discussion thread.

    • HeatherD says:

      Thanks, Laura, for chiming in. I’m enjoying this discussion too. Initially I was thinking along the lines of your “bright side” in writing the post and just the idea that “reproductive” includes more than menopause (or what becomes before menopause), but now I’m not sure why I wasn’t more critical to start with since Paula is completely right. I think the editors actually think they’re doing a great thing, but I wonder what/who truly instigated the change too. Who might have been the critic of the initial journal title? Perhaps there is a serious backstory within the British Medical Society that we are also missing here.

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