Journal of Women & Aging

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How Women Experience Menopause: The

Importance of Social Context

Julie A. Winterich MA & Debra Umberson PhD

To cite this article: Julie A. Winterich MA & Debra Umberson PhD (1999) How Women
Experience Menopause: The Importance of Social Context, Journal of Women & Aging, 11:4,
57-73, DOI: 10.1300/J074v11n04_05

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Published online: 22 Oct 2008.

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 How Women Experience Menopause:
The Importance of Social Context
Julie A. Winterich, MA
Debra Umberson, PhD

ABSTRACT. This study analyzes personal accounts of women’s meno-

pausal experiences to understand why most women view menopause as
an insignificant event, despite negative cultural and medical construc-
tions of menopause as a time of ‘‘loss.’’ We analyze 16 in-depth inter-
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views with a diverse sample of women to examine how social contexts

affect women’s experiences with menopause and the meaning of those
experiences. We find that most women view menopause as inconsequen-
tial because other events of midlife are more important or stressful to
them. However, when cultural and medical contexts are examined, we
find that some women do not avoid others’ negative constructions of
menopause as a time of ‘‘loss.’’ [Article copies available for a fee from The
Haworth Document Delivery Service: 1-800-342-9678. E-mail address:
[email protected] <Website: http://www.haworthpressinc.com>]

KEYWORDS. Menopause, hormone replacement therapy, women and

health, women and aging, health and aging

Popular culture and medical practice construct menopause as a time

of ‘‘loss’’ (Coney, 1991; Love and Lindsay, 1997). Because our cul-
ture equates beauty with the young female body (Davis, 1995) the
menopausal body is, by definition, ‘‘past its prime.’’ Similarly, gyne-
cology textbooks routinely describe menopause as ‘‘reproductive fail-

Julie A. Winterich is a graduate student in Sociology, University of Texas.

Debra Umberson is Professor, Department of Sociology, 336 Burdine Hall, Uni-
versity of Texas, Austin, TX 78712-1088.
The authors would like to thank Kirsten Dellinger and John Knox for their helpful
comments on this article.
Journal of Women & Aging, Vol. 11(4) 1999
E 1999 by The Haworth Press, Inc. All rights reserved. 57
 58 JOURNAL OF WOMEN & AGING

ure’’ or ‘‘ovarian failure’’ (Love and Lindsey, 1997). However, recent

interdisciplinary studies suggest that women do not experience meno-
pause as a time of loss (Avis and McKinlay, 1991; Cate and Corbin,
1992; Kaufert et al., 1986). This study seeks to understand why most
women view menopause as a neutral or positive experience (Avis and
McKinlay, 1991), despite negative cultural and medical constructions,
by analyzing in-depth interviews with a diverse group of 16 postme-
nopausal women.
The scant research on women’s menopausal experiences suggests
that characterizing menopause from a medical perspective results in
more negative attitudes than presenting it from a life transition or
aging perspective (Gannon and Ekstrom, 1993; Kaufert et al., 1986).
Other research suggests that, among women, those who are postmeno-
pausal have the most positive attitudes about menopause while women
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who are premenopausal have the most negative attitudes (Avis and
McKinlay, 1991; Cate and Corbin, 1992).
The Massachusetts Women’s Health Study (MWHS), which includes
a random community sample of 2,570 women, shows that the majority
of women interviewed find the physical changes associated with meno-
pause to be unproblematic (Avis and McKinlay, 1991). Menopausal
women do not increase their health care visits (Avis and McKinlay,
1991) or experience increased depression (Avis et al., 1994). However,
most women interviewed agree with the perception that women be-
come depressed during menopause (Avis and McKinlay, 1991).
This qualitative study examines how social contexts influence
women’s accounts of their menopausal experiences. To understand the
ways women avoid negative constructions of menopause, we analyze
how other life events shape women’s menopausal experiences. We
also analyze how cultural and medical constructions of menopause
affect women through their accounts of how their family, colleagues,
and doctors define menopause.

WHAT IS MENOPAUSE?
Medically, menopause refers to the date when the menses cease,
which a woman can only determine in hindsight (Perry and O’Hanlan,
1992). As a woman’s reproductive system gradually changes, she may
experience hot flashes, vaginal dryness or irregular periods for a few
months to several years; doctors refer to this transitional period as
 Julie A. Winterich and Debra Umberson 59

perimenopause or the climacteric (Perry and O’Hanlan, 1992). Women

who experience menopause with their ovaries intact undergo ‘‘natural
menopause,’’ while those who have their ovaries removed experience
‘‘surgical menopause’’ (Perry and O’Hanlan, 1992). Women who do
not have a uterus but have ovaries also experience natural menopause
but cannot use lack of menstruation as an indicator of their menopause
status. They typically know menopause has begun because of hot
flashes (Utian and Jacobowitz, 1990) or because their doctors test their
hormone levels (Landau et al., 1994).

METHODS
The goal of this study is to explore how social contexts affect
women’s constructions of their menopausal experiences and the mean-
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ing of those experiences. To ensure a diverse sample by race, marital

status, and education, 16 women were selected for hour-long in-depth
interviews through purposive snowball sampling. Women were found
through friends’ and colleagues’ contacts and through referrals from a
local low-income medical clinic.
The sample consists of 16 women who experienced natural meno-
pause. Ten women are non-Hispanic whites, four are African-Ameri-
cans and two are Mexican-Americans. Their ages range from 46 to 65
with a mean age of 55. Fourteen of the women are heterosexual and two
are lesbian. Nine women are married, six are divorced and two have
never married. With respect to highest year of education, one woman
has an elementary degree, six have high school degrees, five graduated
from college and four obtained post-graduate degrees. The interviews
were conducted in a central Texas city with a population of 781,752.
The first author conducted the interviews. This study is part of a
larger project on women’s experiences with menopause and hormone
replacement therapy (HRT). The interviews are based on open-ended
questions about physical and psychological changes that occurred
during menopause; significant life events that affected women’s expe-
riences with menopause; how the reactions of family, colleagues, and
doctors affected women’s menopausal experiences; and women’s as-
sociations of menopause with aging.
We use grounded theory to analyze the meaning of women’s experi-
ences of menopause by interpreting various themes as they emerge
from the data (Glaser and Strauss, 1967). Grounded theory relies on
 60 JOURNAL OF WOMEN & AGING

inductive analysis and interpretation of the data to confirm existing

theory or to provide alternative explanations for understanding social
phenomena. Because we use qualitative methods, the findings from
this study are not generalizable. Yet the overall findings of our study
corroborate the MWHS findings and suggest why some women view
menopause as ‘‘no big deal.’’

FINDINGS
This article explores how different social contexts shape and influ-
ence the menopausal experiences of our respondents. We consider
social context in two ways. First, we examine how stressful life events
that often occur during midlife, such as health problems and marital
and family crises, are associated with the respondents’ menopausal
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experiences. Second, we analyze how cultural and medical construc-

tions of menopause affect the respondents’ menopausal experiences
through their accounts of how their family, colleagues, and doctors
define menopause. We examine the cultural context further by analyz-
ing women’s perspectives on menopause and aging.

STRESSFUL LIFE EVENTS AND LIFE CONTEXTS

Several respondents do not view menopause as a significant event
because health problems and marital and family crises are more im-
portant to them than are their menopausal experiences. Only one
woman reports that menopause affected her ability to cope with mari-
tal and family problems.

Health Issues
Two women report that menopause was not significant to them
because they were primarily concerned with serious health problems.
Pat, a 65-year-old married white woman, says:

I had a catastrophic illness (breast cancer which resulted in a

radical mastectomy) long before that. That was much more signif-
icant than menopause, so I think that had an influence on the way
I felt or thought about it, not felt physically, but mentally . . . just
glad to be around to have to go through menopause!
 Julie A. Winterich and Debra Umberson 61

She emphasizes that menopause ‘‘really and truly was not a great
significant event in my life!’’ Pat’s mother died from cancer at the age
of 49 and Pat feels very happy about her own successful recovery. As
a result of her battle with cancer, she views menopause as both a
symbol of time and her continuing successful recovery from cancer.
Joan, a 57-year-old married white woman, is postmenopausal but
does not feel that she experienced menopause because her doctor
prescribed HRT before her periods completely stopped and HRT
causes continued monthly bleeding. HRT has caused Joan’s uterine
fibroids to grow dramatically (Landau et al., 1991; Perry and O’Han-
lan, 1992; Utian and Jacobowitz, 1990). Her doctor now recom-
mends a hysterectomy because of the fibroids. Ironically, Joan’s doc-
tor prescribed HRT because of the hormonal changes of perimenopause,
but Joan does not associate her fibroid problems with her menopausal
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experience. Because she views menopause as the cessation of peri-

ods, she separates her HRT concerns from her menopausal experi-
ence.
Marital and Family Issues
Two women report that marital and family crises overshadowed
their experiences of menopause. Conversely, a third woman details
how menopause interfered with her ability to cope with family prob-
lems. A fourth woman positively describes menopause’s effect on her
marriage.
Mary, a 62-year-old divorced white woman, says menopause was
‘‘last on her list’’ of things to worry about because her divorce, her
son’s mental illness, and her daughters ‘‘acting out’’ were much more
important. Mary describes her reaction when menopause began:
. . . it began with an irregularity and . . . I just thought, ‘‘Hmm,
this must be it.’’ And as I say, this HUGE other thing was taking
precedence in my life, it’s a break-up after seventeen years, and
still having children in high school, and you know, struggling
with the things that come along with that. It was almost an aside,
it was like, ‘‘Oh, different, oh.’’
Similarly, Sue, a 55-year-old divorced white woman, lists various
crises that influence her view of menopause as ‘‘no big deal.’’ She
says: ‘‘I went through one divorce, the death of a child, the loss of all
my money, a marriage to a really weird guy, another divorce.’’
 62 JOURNAL OF WOMEN & AGING

Compared to her personal crises, Sue says that menopause was a

‘‘piddley thing.’’
Beth, a 47-year-old married African-American, positively describes
the effect on her marriage of dramatic mood swings that occurred
during menopause:

I decided that I was comfortable with myself. I made some deci-

sions like, oh, some things that I was tolerating that I would no
longer tolerate, and I communicated this to him (laughs). . . . It
made our relationship better because a lot of things I would
previously hold in, I don’t hold in anymore, and I share them
with him.
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Presumably, because the troubling aspects of Beth’s mood swings

have ended, she constructs menopause as a transition to greater self-
acceptance and a stronger relationship with her husband.
Conversely, Rosemary, a 53-year-old divorced white woman, views
menopause as an experience that impaired her ability to cope with
marital problems. When menopause began, her husband became con-
trolling and insisted she weighed too much. She gained weight as a
result of his pressure and she says that she entered a hospital for two
weeks because of emotional problems. Rosemary recognizes that her
life became difficult when menopause first started, but she says that:
‘‘Looking back on it, I think a lot of the problems in my life were real.
But I think my inability to handle them was directly affected by meno-
pause.’’ Rosemary explains that once she began taking HRT, she felt
better emotionally.
In sum, the accounts of the women in this study about how various
types of stress shaped their menopausal experiences suggest why
some women view menopause as a neutral or positive experience.
Several women report that stressful life events are more important
than menopause in shaping their emotional states. These findings are
especially important in light of evidence that shows stressors usually
make other stressors worse (Thoit, 1995). This study suggests that, for
some women, menopause is not a stressor but only a detail in the
background of other stressors. Only one woman says that menopause
interfered with her ability to cope with family problems.
 Julie A. Winterich and Debra Umberson 63

ROLE OF OTHERS IN DEFINING MENOPAUSE

Several women discuss how their family, colleagues, and doctors
define menopause. These definitions, which tap into negative cultural
and medical constructions of menopause, often influence women’s
menopausal experiences. The examples in this section highlight both
the specific role of cultural and medical constructions of menopause in
shaping women’s menopausal experiences and the overall complexity
of social context and its effect on women’s constructions of the mean-
ing of their menopausal experiences.
Family and Colleagues
Some women describe how expectations about menopause by fami-
ly and colleagues affected their own expectations and experiences of
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menopause. Several women refer to negative old wives’ tales when

discussing their expectations about menopause. These references to
cultural tales about menopause reflect the impact of negative cultural
messages about the menopausal woman. For example, Sarah, a
50-year-old divorced white woman, mentions that as a girl she ‘‘heard
the rumors or stories about women being institutionalized.’’ Similarly,
two other women say that they remember their mothers and aunts
discussing ‘‘old wives’ tales’’ about irrational menopausal women.
Karla, a 53-year-old married African-American, says her advice to
younger women about menopause is to ignore old wives’ tales.
The fact that several women remember their relatives discussing old
wives’ tales suggests the strength of the negative cultural construction
of menopause and reflects the cultural backdrop against which women
experience menopause. These memories of old wives’ tales may ex-
plain why the majority of women believe that women become irritable
and depressed during menopause (Avis and McKinlay, 1991). If nega-
tive old wives’ tales affect women’s expectations about menopause,
this may partially explain why premenopausal women have more
negative attitudes about menopause than do postmenopausal women
(Avis and McKinlay, 1991).
Unlike childhood memories of relatives’ stories, some women’s
menopausal experiences are directly affected by others’ negative
views. As Mary began menopause, her husband asked: ‘‘Is it true that
after menopause you lose all sexual desire?’’ Mary says that if her
husband had not worried about menopause’s effect on her sexuality,
 64 JOURNAL OF WOMEN & AGING

she would not have thought about it. Mary’s account clearly illustrates
the complexity of social context. On the one hand, she associates
menopause with an emotionally difficult period with her husband. On
the other hand, because menopause occurred during other family
crises, she views the physical experience of menopause as ‘‘last on her
list of things to worry about.’’ This example highlights how various
aspects of context work together to shape the meaning of menopause
for any particular woman.
Linda, a 46-year-old married Mexican-American, provides a very
positive perspective about her male supervisors and ‘‘men on the
street’’ treating her differently; she explains:
You become more of a non-sexual being to others--not to your-
self--but others. I can walk down the street comfortably and not
feel . . . really concerned. When you’re younger, when . . . men
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whistle at you . . . you’re uncomfortable. As a middle-aged

woman you’re invisible. It’s wonderful because you can just be a
person.
Linda’s perspective informs our understanding of the transition meno-
pause can provide for women who felt sexually vulnerable in their
youth. Because, culturally, menopause means a loss of youth and
sexuality, women may experience this time as freedom from objectifi-
cation (Greer, 1991).
Doctors
The medicalization of menopause by doctors may profoundly affect
a woman’s menopausal experience. The three women in this study
who did not know perimenopause had begun until their doctors ex-
amined them all received recommendations to begin HRT, even
though two of them continued menstruating. A fourth woman reports
that her doctor frightened her into trying HRT even though she repeat-
edly told him she was not interested.
Olivia, a 54-year old married white woman, says that her doctor
tested her hormone levels because of her age. He recommended hor-
mone replacement therapy because:
. . . he’s a real proponent of preventive medicine . . . I think to
prevent having . . . vaginal dryness, the hot flashes, the mood
swings, all of these other things that go along with menopause,
 Julie A. Winterich and Debra Umberson 65

that, might as well go ahead and start the hormones, have a . . .

(laughs), I guess, drug-induced, natural existence!
However, Olivia questions whether her doctor prescribed HRT too
soon. She says that she was ‘‘toying with the idea’’ of stopping it for
awhile to ‘‘just kind of see where I was, and see if they really made me
feel any different.’’ When she suggested to her doctor that she stop
taking HRT, he convinced her to continue taking it because of the
advantages he associated with it, including vaginal lubrication and the
prevention of osteoporosis and heart disease.
Olivia feels ambivalent about her doctor’s advice to continue HRT.
Despite her doctor’s strong recommendations, she disagrees with his
definition of menopause as a time to begin life-long medication; she
says she feels opposed to ‘‘taking a drug the rest of your life.’’ Howev-
er, she worries about discontinuing HRT because she remembers her
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mother discussing her discomfort with vaginal dryness and intercourse

and Olivia enjoys an active sex life.
Olivia’s doctor’s steadfast recommendation to continue HRT shapes
the social context in which she must reconcile her ambivalence. Olivia
describes menopause like puberty, as a ‘‘normal part of life,’’ but her
doctor’s advice to take HRT for the rest of her life conflicts with this
perspective. In addition, she questions whether she needs the protec-
tive effects of HRT for her heart and bones because she leads a very
healthy and active life. Yet Olivia cannot ignore her doctor’s strong
advice about the benefits of HRT, which she says he pitches as ‘‘the
magic drug!’’
Similarly, Joan says that her doctor tested her hormone levels even
though she continued menstruating because he believed that, given her
age, menopause had probably started. Joan’s doctor also prescribed
HRT to prevent heart disease and osteoporosis. However, as discussed
earlier, HRT increased the size of Joan’s uterine fibroids and now her
doctor recommends a hysterectomy because of the fibroids. Joan dis-
agrees with her doctor’s narrow approach and wishes that ‘‘he offered
more alternatives because I really don’t think he’s offered me much.’’
Like Olivia, Joan feels conflicted about her doctor’s definition of
menopause as a time to begin HRT. Because her doctor adamantly
believes in the preventative effects of HRT, Joan says she feels fright-
ened to stop taking it. She wonders whether she needs those preventa-
tive effects, however, when she comments: ‘‘I do a lot of weight-bear-
ing exercises to begin with. So I don’t think that’s a problem, and my
 66 JOURNAL OF WOMEN & AGING

mother is 83 . . . but she doesn’t have osteoporosis, she doesn’t have

heart disease, and she’s never taken hormones.’’ Joan then says she
may try a compromise by cutting her pills in half to test whether a
reduced amount of estrogen would decrease her fibroids.
Grace, a 58-year-old married white woman, had her uterus removed
at 27 and says that during an annual exam her doctor ‘‘ . . . looked at
my calendar (chart) and decided I was over 50 and it was time to start
estrogen replacement.’’ Obviously, Grace no longer menstruated and
because she did not have hot flashes or mood swings, she did not
suspect menopause had started. But, based on her age, her doctor
advised her to begin estrogen replacement therapy (ERT).
Grace tried ERT and after nine months decided she ‘‘hated it’’
because she gained weight. She describes her doctor’s reaction when
she tells him this:
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He (her doctor) . . . swore to me was not the problem of the

estrogen, it was the problem of the mouth. And so we went
through that for a period of time, and finally I went, ‘‘I just can’t,
this is just stupid, it’s ridiculous. There’s no difference in feeling.
I’m quitting the dang things.’’ He said, ‘‘Then I am writing it on
your chart.’’ That’s like, you know, the highest authority in the
world, it’s on your chart.
During the time when Grace stopped taking ERT, she began having
difficult night sweats. She returned to her doctor and told him, ‘‘I
surrender,’’ and started ERT again. Grace is interested in alternatives
to ERT but when she asked her doctor about the vitamin therapy her
friend in Sweden takes, her doctor dismissed her by telling her ‘‘it’s
not done.’’
Even though Grace describes menopause as a ‘‘part of life’’ overall,
she dislikes the interactions with her doctor. He shapes the context in
which she thinks about her postmenopausal health by limiting the type
of information he provides. His medical authority is not lost on Grace
when he warns that he will record her decision to stopping taking ERT
on her chart. Grace’s education stopped at high school and she refers
to her education level as a reason why she ultimately follows his
advice: ‘‘Truthfully, being of my generation and not any more educa-
tion than what I have, I didn’t expect more. You know . . . it’s whatever
Dr. Whatever says and it’s what I’d hear my entire life. Why else
would I have consented to a hysterectomy at 27?’’
 Julie A. Winterich and Debra Umberson 67

A fourth woman in this study recounts how a doctor she consulted

in a low-income clinic pressured her to try HRT. Opposed to taking
medication, Sarah told her doctor that she managed her mood swings
with meditation and took care of her bones by drinking milk and
exercising. Sarah said her doctor ‘‘didn’t respond.’’ Instead, he asked
her if there was anything about menopause she did not like. She told
him that, as a beautician, she looks at herself in the mirror for 50 hours
a week and does not like how quickly her face is aging. She describes
his reaction:
And, um, he, he just lit up, and he kind of raised up off the stool
and pulled the stool close to me and got right in my face and said,
‘‘Your face is aging rapidly. How rapidly?’’ And I said, ‘‘Oh, you
know, three years to one in the last few years . . . ’’ And, he said,
‘‘Sarah, your face is, is composed of skin and musculature.’’ He
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said, ‘‘That’s body tissue.’’ He said, ‘‘Those are cells of body

tissue.’’ And he said, ‘‘As, as rapidly as that tissue is deteriorating,
all of the tissue in your body is deteriorating at the same speed.
Your heart, your lungs, your kidney, your liver, your brain tissue is
deteriorating at the same speed.’’ And I went, ‘‘Oops, not the
brain!’’ (Laughs.) You know, I mean my brain, you know?
Sarah says he frightened her into trying HRT which she stopped
taking after three months because she did not like it. Her account of
her doctor’s pressure provides the most dramatic example in this study
of a doctor resorting to extreme tactics to persuade a woman to con-
form to the medical model’s definition of menopause. While the aging
process inevitably causes women’s bodies to change, estrogen should
not be viewed as an elixir for aging (Coney, 1992; Landau et al., 1994;
Perry and O’Hanlan, 1992; Utian and Jacobowitz, 1990). On the other
hand, because Sarah consulted this doctor in a low-income clinic, the
doctor may have used class assumptions to rationalize his character-
ization of HRT as the best option to maintain health (Strauss, 1979).
Past research shows that middle-class doctors treat lower-income pa-
tients differently and with more authority than they treat middle-class
patients (Miller, 1973; Strauss, 1979).
Clearly Sarah’s doctor shaped the social context in which she expe-
rienced menopause by frightening her into trying a drug in which she
had no interest. After three months of taking HRT, she stopped be-
cause ‘‘in spite of the benefits, the controversies are so great. There’s
 68 JOURNAL OF WOMEN & AGING

just no way to know.’’ Even though ultimately Sarah resisted her

doctor’s definition of menopause as a time to begin HRT, his pressure
greatly affected her decision-making process.
Some doctors’ definition of menopause as a time to begin HRT can
profoundly shape the social context in which women experience
menopause and the meaning of those experiences. The findings from
this study suggest that some doctors’ strong recommendations to take
HRT to maintain postmenopausal health not only conflict with some
women’s definitions of menopause, but also can cause ambivalence,
confusion, and fear about how to resolve their different perspectives.
Sometimes, as in the case of Joan, this conflict results in dramatic
consequences for women’s health. The findings from this study sug-
gest that doctors are uniquely positioned to influence women’s per-
spectives and decisions about HRT and their postmenopausal health.
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In sum, others’ expectations and definitions of menopause affect

women’s menopausal experiences in various ways. In some cases,
women do not avoid the negative cultural and medical constructions
of menopause. Our results illustrate the complexity of social context
and some ways that women’s constructions of menopause can shift
based on different contexts.

AGING ISSUES
Women discuss their views of menopause and aging in various
ways. For example, one woman who became menopausal at a young
age did not associate it with aging. Other women who became meno-
pausal in their 50s and experienced typical life events of midlife view
menopause as a symbol of aging. Finally, two women describe the
effect of menopause and aging on their sexuality in positive ways.
Because Karen, a 58-year-old married white woman, began meno-
pause in her early 40s, she does not think of it as a marker of aging.
She explains:
. . . I think the reason is probably because I did it so early, and so,
consequently, I didn’t have all of the misgivings about entering
into a new phase of my life. . . . (A friend) who is about six or
seven years older than I am, was going through menopause about
the time when I was . . . and I saw it much more, interestingly
enough, as a demarcation in her life than I did in mine because
she was significantly older than I was. And yet we were going
 Julie A. Winterich and Debra Umberson 69

through the same experience, but my own perception was that

she was going through a change of life that I wasn’t going
through. Her kids were grown up. . . . And I still had wild little
kids running around.

Later in the interview Karen says that ‘‘all of the things that one
associates with menopause really happened to me after that point.’’ In
her 50s, her father died and for the past several years Karen and her
husband have provided care for their mothers. She says: ‘‘If I had
waited to go through menopause until I was in my early 50s, you see,
that would have all come together. But really at the time I did . . . we
didn’t have those normal burdens.’’
Karen clearly distinguishes between the experience of menopause and
the experience of aging. While Karen and her friend share the same
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physical experience of menopause, their age difference and their different

roles affect how Karen views the meaning of those physical changes.
Conversely, Sarah experienced menopause in her 50s and weaves
several contextual issues together as she discusses her menopausal
experience. She says, as a beautician, ‘‘I stay in front of a mirror all
day. And I am aging rapidly. . . . And there, that’s distressing in a
culture where physical attractiveness is our most valuable asset.’’ This
quote illustrates the work and cultural contexts in which Sarah dislikes
the effect of aging on her face. As a beautician, where physical appear-
ance is the commodity, she cannot help but reflect on her changing
appearance. Sarah also feels distressed about her aging face in the
context of our youth-oriented, heterosexual culture in which she has
internalized the importance of physical beauty for attracting men.
At the end of the interview, Sarah ambivalently discusses meno-
pause as a marker of aging. She explains that during menopause she
went through ‘‘a divorce, the death of both of my parents, and becom-
ing a grandmother.’’ Sarah associates menopause with a number of
aging issues, her changing appearance, her new role as a grandmother,
her divorce, and the loss of her parents.
Rosemary also feels ambivalent about menopause and aging. She
enjoys menopause because, now that her divorce is over, she feels
serene and happy with herself. But she is also sad about the end of her
child-bearing years because her identity is ‘‘tied up with motherhood.’’
Dorothy, a 59-year-old white lesbian, positively discusses meno-
pause and aging:
 70 JOURNAL OF WOMEN & AGING

Now when you start to look older it’s really nice because before
. . . you sort of have to prove yourself, now, people say, ‘‘Gosh!
You know, that person is older so they’re liable to probably know
more’’ and so, you just get a lot better reaction from people.

Dorothy does not say in what context people treat her with a ‘‘better
reaction,’’ but as a female professor, she may feel that students and
colleagues treat her more respectfully as she ages.
Two women discuss the effect of menopause and aging on their
sexuality in positive ways. Dorothy describes menopause as a time
characterized by a calmer sex drive. She says:

It was absolutely wonderful because finally you get to a point of

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life where . . . your sex drive that drives you to distraction and it’s
just sort of like, you finally get to a point where you’re really
satisfied . . . you don’t have to be distracted with other people
(laughs)!

Similarly, Sarah says in her younger years she had ‘‘lusty hor-
mones.’’ However, during menopause, her libido relaxed, which she
enjoys. As she recounts how her doctor talked her into trying HRT, she
says: ‘‘And the thing they all talk about is how it really increases your
sexual interest. It brings it back . . . and I just laughed, I said, ‘Well,
that’s not a plus!’ (laughs).’’
These two quotes suggest that reframing menopause’s possible ef-
fect on women’s libidos from their perspectives refutes the cultural
myth that women ‘‘lose’’ their sexuality. According to Dorothy and
Sarah, menopause brought a welcome gain of a more controllable sex
drive.
In sum, the accounts in this section suggest that women’s association
of menopause with aging vary and depend on the timing of the onset of
menopause. For younger women immersed in the mothering role,
menopause may not hold the same meaning as it does for older women
with grown children. Also, because women’s feelings toward aging
vary within individual women, these accounts again illustrate the com-
plexity of the meanings women attach to menopause. Finally, the two
positive accounts on menopause, aging, and sexuality highlight the
importance of reframing these issues from women’s perspectives.
 Julie A. Winterich and Debra Umberson 71

CONCLUSION
This study analyzed women’s accounts of their menopausal experi-
ences and the meaning of those experiences to examine why most
women characterize menopause as ‘‘no big deal.’’ By exploring the
role of social context, we suggest that one reason women describe
menopause as inconsequential is because, compared to more impor-
tant life events and contexts, menopause is not a significant event.
Furthermore, when women describe menopause as a neutral or posi-
tive experience, they generally view it as a physical event, the cessa-
tion of menses.
However, the complexity of meanings women link with menopause
became evident when we explored how others define menopause and
when we discussed aging issues. These accounts reveal the complexity
of social context and the different meanings women associate with
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menopause depending on the context. For example, one woman views

menopause as both insignificant in relation to physical changes and
difficult in relation to marital and family crises.
Furthermore, this study suggests that the medical context most sig-
nificantly affects women’s menopausal experiences. Some women
who describe menopause as a ‘‘part of life’’ in general, describe their
doctors’ advice to take HRT as confusing and frightening. Past re-
search shows that women are often dissatisfied with the information
their doctors provide on menopause and HRT (McKinlay, 1991). The
accounts from this study provide detailed descriptions of why women
may feel negative about menopause in the medical context (Cate and
Corbin, 1992; Kaufert, 1986).
Our study highlights the importance of the social meaning of meno-
pause: Menopause cannot be viewed as a monolithic experience de-
fined in the same way by all women or by the same woman in all
contexts. Indeed, the scant cross-cultural research shows that Japanese
women do not even have a word for hot flash and Canadian women
report fewer problems with menopause than do American women
(Lock, 1993; McKinlay et al., 1993). Not only is menopause histori-
cally and socially constructed, but individual women’s constructions
of their menopausal experiences depend on an array of interrelated
social contexts.
In future research, researchers should examine the complexity of
social context rather than study menopause as an isolated event. This
research may be particularly important as baby boomers age; the num-
 72 JOURNAL OF WOMEN & AGING

ber of women entering menopause is expected to increase by 73 per-

cent between 1990 and 2010 (‘‘American Demographics,’’ 1993). The
increasing proportion of menopausal women may affect cultural atti-
tudes toward aging women. These changing attitudes, in turn, may
affect women’s menopausal experiences.
Perhaps most importantly, systematic research is needed on the
relationship between the medical context and women’s menopausal
experiences because past research and this study suggest that this
context negatively affects women’s views on menopause (Cate and
Corbin, 1992). Such research could produce important guidelines for
health care professionals to provide satisfactory care for menopausal
women.

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