Menopausal syndrome: illness or social role--a transcultural analysis.

In recent years the medical diagnosis and treatment of "menopausal syndrome" has come under a barrage of criticism. Critics of the conventional clinical approach claim that menopausal syndrome is largely a social role foisted on middle-aged women in this society. The physician plays a very active part (albeit an inadvertent one) in recruiting women into this role. This paper examines the evidence for this thesis, including cross-cultural and intracultural variation. The evidence examined suggests that the more psychological and psychosomatic symptoms do seem to vary with cultural role expectations. Research paradigms for further testing of this thesis are adapted from the study of mental disorders and described. In contrast, those organic changes directly associated with estrogen insufficiency do lead in some women to definite pathologies, e.g., osteoporosis and an increased rate of bone fractures. Whether these organic concomitants of aging in women should be viewed and treated medically is a moot question, and one which involves values and politics more than medical facts.