Abstract
Menopause is a discrete physiological event which is an integral and inevitable part of the reproductive life of women. lt is the final menstrual period and marks the end of the years of fertility which begin just after menarche. Menopause should be a straightforward passage to the next stage of women's development, but it has been subjected to diverse perspectives which have alienated it from the simple termination of a natural phase in the life continuum. Like other processes in women's physiology, it has undergone 'medicalisation', 'commercialisation' and has been generally politicised.
In order to investigate current attitudes and beliefs about menopause a random community survey of midlife women was conducted, utilising a population sample already canvassed in the Otago Women's Health Survey (1989). Responses from 236 women aged 40 - 65 years yielded information about socio-demographics, physical and mental health status including self-concept, and attitudes to midlife events including menopause, and its contingent effects.
Three instruments were used, two recognised, the General Health Questionnaire-12 (GHQ-12) to screen for minor psychiatric morbidity, and the Self Concept Questionnaire (SCQ) for assessing self-esteem, and one devised specifically for this survey, Current Attitudes to Menopause (CAM). Some data previously collected from the sample population in 1989 were available for comparison.
The primary objective was to evaluate the prevailing attitudes to menopause and its effects on social role functioning, personal beliefs about its impact and any morbidity, mental or physical that may be concomitant on the physiological changes. Any significant differences in individual GHQ and SCQ scores between 1989 and 1997 were expected to strengthen the assessment of midlife change.
No significant differences in mental health status or self concept in the interval between 1989 and 1997 were found, and good health in 1989 predicted positive attitudes to midlife and menopause. Previously prevailing theories of menopause that predict related difficulty and distress were not found to be accurate. The incidence of depression as a de novo illness, concomitant with menopause was not increased. This is a similar finding to studies in other countries. Symptoms were most prevalent in the perimenopausal group and the most common occurring were fatigue and anxiety. Premenopausal women were a little apprehensive as menopause approached, whereas postmenopausal women, with hindsight, considered their changing physiology to have had only transient and non-significant effects on their lives. In general menopause was welcome, or passed uneventfully for most women, though was not experienced so philosophically by women who had had a surgical menopause.
The findings suggest that despite the persistent social and clinical construction of menopause as a hurdle to be overcome, this was not women's actual experience. This seems to confirm the emerging theory of menopause as simply a transition to another stage in life development.