Blog of the Society for Menstrual Cycle Research

Feeling Uncertainty, Confusion, and Frustration about Menopause

November 10th, 2011 by Heather Dillaway

Last Friday I attended a conference on autoethnography and was privileged enough to listen to Carolyn Ellis give the keynote speech on this new and upcoming qualitative methodology.  Sitting there and listening to Ellis talk about the need for all of us to be reflexive and put ourselves into our research projects, I realized that I probably do need to acknowledge my own feelings of uncertainty and frustration as I study menopause and midlife. Therefore, this blog entry is for you, Carolyn Ellis, as I am inspired by you to be better from now on about acknowledging the connections between me and my work and trying to understand myself as a research instrument as I seek to understand menopause and midlife better.

The reasons I really started studying menopause are the very reasons why I’m still studying it but also frustrated by it. In the mid to late 1990s, my experiences as a birth control counselor at Planned Parenthood in Delaware and Michigan led me to realize that plenty of middle-aged women don’t understand what’s happening to them when they start to have irregular periods in perimenopause. I also watched my mother begin perimenopause in the mid 1990s and be confused and embarrassed to talk about the experience when she had always been the first one who always wanted to talk about pregnancy, childbirth, breastfeeding, and birth control (“What was so confusing about menopause?,” I thought).  I’ve now formally studied and written about women’s thoughts and experiences of menopause since 1999. All along, the terminology and definitions of menopause have been as problematic for me as for the women I’ve studied. I’ve listened to menopausal women who tell me that they are completely confused about biomedical terminology for their life stage and completely baffled about what they’re going through.  I’ve heard them talk about how doctors and other women they talk to are just as confused as they are. What is this thing they’re going through? I’ve talked to other feminist social scientists and humanities scholars who think we should call menopause “reproductive aging” or “the menopause transition” to signify that variation over time is really the only guaranteed experience at this time of life. Endocrinologists and biologists turn around and tell me that the term “reproductive aging” is faulty because all that term signifies is that we are all maturing from birth on – that it is an empty term signifying nothing. I listen to endocrinologists, epidemiologists, public health educators, women’s health advocates, menstrual activist researchers, biologists, and clinical/biomedical researchers who are all ready with their own take on what terminology and definition is “best” for describing this time of life. Some argue that there is a strict three-phase model of perimenopause, menopause, and postmenopause that we should follow. Some argue for a five or even seven stage model for “menopause,” parsing out pre, post, early and late stages of the menstrual life course (such as early and late  premenopause, early and late perimenopause, menopause, early and late postmenopause, etc.). Some argue that perimenopause is really the only “stage” of “menopause” or late reproductive life that women really want to know about because that is when all the (negative) symptoms come. I hear others argue that “menopause” and “postmenopause” are the same thing, or are that these are conflated terms that mean nothing, and that both of these terms should be scrapped. (Yet then I hear individual women I interview tell me that postmenopause is as frustrating as perimenopause.) I hear other researchers say that EVERY term associated with menopause or reproductive aging is faulty. If I listen to individual menopausal women, they tell me the same. Two months ago, I did a presentation on midlife in general, and a feminist humanities scholar (whom I respect quite a bit) told me I shouldn’t be using the term “midlife” at all, because it is a non-term itself, defined by nothing. If I think about all of the terms I associate with menopause – menopause, the climacteric, the change, the change of life, perimenopause, postmenopause, the late reproductive years, the menopause transition, women’s midlife transition, reproductive aging, etc. – I don’t even know what terms I should be using. Over time I have thought that the best case scenario is just to use the term that women themselves use (therefore I used the word “menopause” a lot to describe a whole transition, or adopted the term “reproductive aging” when urged by feminist scholars to do so in order to define a broader transition). But, now, I’ve been critiqued recently for not correcting individual women when they use the “wrong” term to describe what they’re going through.

The ‘Change of Life’ is More than Biology

July 7th, 2010 by Elizabeth Kissling
Photo by Ed Yourdon | CC 2.0

Photo by Ed Yourdon | CC 2.0

I hope my colleague Heather Dillaway feels at least at little vindicated when she reads this: A new study in the Journal of Health Psychology reports that social and psychological factors have the biggest influence upon women´s sexual behavior during menopause, rather than biological changes such as declining hormone levels. While most published research on menopause–especially about sex and sexuality with respect to menopause–is conducted within a biomedical framework, Sharron Hinchliff, Merryn Gott, and Christine Ingleton talked to women about their experiences. (Radical!)

They found that almost all of the women in their study had experienced changes in their sex lives, but they attributed these changes to external factors, such as caring for ill or elderly relatives, low sexual desire from their partners, issues of relationship quality, as well as to perceived changes in levels of hormones. (I appreciate the researchers’ qualifier of perceived changes, as most women never have their hormone levels measured.)

The researchers concluded that women go through many lifestyle changes at mid-life, only some of which are biological. Psychological and social factors, as well as the increasing medicalization of menopause, affect their sexuality just as powerfully.

Somehow, this study isn’t getting anywhere near the publicity of the ‘new blood test for menopause’ study received last week.


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Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.