The medicalization of female fertility--points of significance for the study of menopause.

This paper illustrates the need for human biologists to take into account the far-reaching influences of biomedicine in the study of reproductive aging. Data were drawn from western Massachusetts and Puebla, Mexico, to illustrate the effects of hysterectomy rates, tubal ligations and hormone replacement therapy (HRT) on studies of age and symptom experience at menopause. First, in examining age at natural menopause in relation to level of education, a country-specific, non-random pattern of participant exclusion due to hysterectomies was encountered. Second, in examining symptom frequency in relation to late childbearing, sample sizes were very small in part due to a high frequency of tubal ligations (43%) in Puebla, Mexico. Third, hot flash frequency during the two weeks prior to interview was, unexpectedly, not lower among women who used HRT. Human biologists who study the biological process of reproductive aging must also attend to the cultural influences of biomedicine.