Part 2 of an Interview with a Biological Anthropologist

Have you ever wondered if women around the world experience menopause the same way? We talked to biological anthropologist Dr. Lynnette Leidy Sievert about the similarities and differences among women of a variety of populations. Author of Menopause: A Biocultural Perspective, Dr. Sievert has been traveling all over the world since the 1980s, studying the menopausal experience, and hot flashes in women around the globe. Her travels for research include Hawaii, Slovenia, Bangladesh and Mexico. She shared with us some of her findings, including her thoughts on aging, and whether the topic of menopause is still taboo. Read on for Part 2 of our fascinating discussion.

Your work, and what you’ve found through your studies, is fascinating.

I think so! It is so hard to get young people interested in the study of menopause. They’ll study breastfeeding, childbirth and menstruation, but to get a 20-something-year old grad student interested in menopause is really hard.

It might just be a lack of awareness of what menopause is all about.

I agree. I ask women in the United States, “Do you talk to your daughters about this?” And women say, “Oh no, they’re not interested.” So even though we have this perception that, we can talk about anything and nothing is taboo, we’re still not telling the younger generation what it’s about or what it’s like.

Why do you think so few women want to talk about menopause?

I think it’s embarrassing. It’s part of aging. Women are self-conscious about the sweating, or about turning red when they have a hot flash. They feel a little bit out of control, especially women who feel irritable. However, that seems to be more common, or more commonly talked about, in the US than other countries. I talk about it all the time; everybody’s tired of hearing about my menopause.

You’ve studied the impact of marriage and family, religion and spiritual practices, and economics on symptom experience. Can you speak a little bit more about those factors and their effects?

From my preliminary research in Campeche, I’ve found that Catholics are more likely to report hot flashes than Protestants. We don’t know why. In Bangladesh, I told you about how we did find Muslim and Hindu differences in hot flashes in women. We also found hormonal differences. That could be because Hindus are vegetarians, which may affect their menopause experience. Hindus in Bangladesh are discriminated against, and I think their world is more difficult.

The family is so important. In Bangladesh, we expected to see that women who were living with their mothers-in-law would have more symptoms but we didn’t find that. What we found was that women who were living with their daughters-in-law had fewer symptoms. Maybe that’s because daughters-in-law are expected to do a lot of the work. Having a daughter-in-law was good for menopause, but having a mother-in-law didn’t make any difference. And that may just be because by the time a woman is 50, she’s kind of worked things out with her mother-in-law, and her mother-in-law has probably started to fail a little bit physically and is not as dominant as she had been. We had to look at that factor in Bangladesh because it’s a patrilocal society where the pattern of marriage calls for a couple to move into the husband’s home or community. Women live with their mothers-in-law.

Economics just makes everything harder. In Mexico, when you are walking along the street, you see signs advertising jobs that read, “Looking for a woman aged 18-35 with a good presentation.” It means they’re looking for a young, pretty woman. And in Mexico there’s no law against advertising that way. There’s no law to protect women who are 50 from ageism. We have it in the US, too; it’s just not as blatant because we do have a law.

In your research did you uncover any secrets for treating hot flashes in women?

Unfortunately, no. I thought maybe when I was working with the indigenous people in Paraguay I would find women using some really cool herb, but I didn’t. I found no secrets at all. Just the water, the fans, and women using hormones. Hormones are even available in small rural villages in Mexico because there are government health promoters who make them available. We were very surprised. We thought that by going to rural villages where there are no sewage systems or running water, we’d find women who were less exposed to modern medicine, but instead we found women taking hormone therapy for their hot flashes because a health promoter had come through and handed them out.

What are some of the limitations you encounter in doing your research?

The biggest limitation in all of my work is small sample sizes. We’ll never have the kind of sample sizes that epidemiologists have, studies of thousands of women or tens of thousands of women. Most of our work has been cross-sectional, and has involved hundreds, not thousands, of women. It’s hard. I talk as if I know about menopause in Mexico, but it’s really based on 755 women in one city. We’re going to have 600 more women in another city, and the Mexicans have carried out these studies in a couple of other cities, but all the sample sizes are rather small. It’s just a problem of logistics and funding.

Do you have any expectations for what you’re going to find?

Women in the rural communities in India actually had trouble talking about menopause because it was such a non-event for them. When we tried to talk about menopause, they would tell us stories about breastfeeding and menstruation, or about the deliveries of their babies. We would try to talk about menopause again and they just didn’t get it because to them it’s such a non-event. Women in the city had more exposure to the media and it was easier to talk about menopause with them.

When you say it was a non-event for rural women, do you mean physically or psychologically?

Psychologically it was a non-event for everybody we talked to in India. We asked if they had experienced any changes in mood, in thinking or in being themselves, and people just looked at us like we were asking crazy questions. They all said, “Of course not.” Their menstruation stopped, that’s all. They were familiar — some, not all — with hot flashes, but this idea of changes in mood or depression, none of that made any sense in either rural or urban communities. Keep in mind I’m talking only about 23 women in total, which is a very small sample size.

What research do you have planned for the future?

We still have a couple of years of work to do in Mexico. After that, I think the work in India will be the next project. We went to India to make contacts and find collaborators. We interviewed 10 women in the rural communities and 13 women in the city just to get an idea of how they talk about menopause and its symptoms and what their expectations are. One thing that was interesting to us is that Muslims can’t touch the Quran when they’re menstruating, and they’re not supposed to pray when they’re menstruating. The Hindus can’t do rituals at their shrines when they’re menstruating. The rural and urban differences in India will be interesting, and so will the Muslim/Hindu differences.

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