The Challenge of Menopause – Daniel Miller
By Daniel Miller, on 3 August 2018
For a project concerned with health and mid-life, menopause is an obvious target. What specifically does an anthropological perspective add, first to understanding menopause and second to envisaging a positive digital intervention? One key anthropological component, which is the comparative perspective, will have to wait until the team completes its research, but from my Irish fieldsite there are many possible insights. The challenge is firstly that no two women have the same experience. Menopause can start in your 30s or 50s. It can be almost symptom-free or have dramatic effects, some of which may never end.
The anthropologist will focus on the way medical issues are inextricable from the social context. The effect can be on close relationships. As a pharmacist told me, “Sometimes they come and say ‘I’m ready to kill my husband I think I’m going crazy’ very reassured when you say it could be the menopause”. Or women report that vaginal dryness makes it too painful to have sex. Women have told me that their mothers never mentioned menopause to them, or that they do or do not feel they can discuss the topic with their sister or close friends. Mostly they report that menopause is a topic that can only be broached through jokes. The impact might also be on wider relationships, such as to one’s work: “You might say to your colleague `could you just take over for a moment’ and then not explain why you would disappear, because you had a flush and you needed to remove yourself”.
Then there is the relation to wider medical authorities. Concerns about HRT or addictive sleeping pills may mean they prefer to consult complementary medicine rather than doctors. Knowledge seems to be a complete lottery, where some are well aware of the potential effects on bone density while others have never had anyone suggest this is something they might look into. Listening to women, within an ethnography, also alerts one to the considerable differences in perspective. One woman will give a feminist perspective about the need to rethink menopause as a celebration of a natural process, rather than merely a medical problem. While another, who is undergoing IVF and is desperate to have children, sees nothing to celebrate.
For us, the ASSA team, it is important that this same alertness to the social and wider context should manifest itself as the anthropological contribution towards delivering that will be of genuine benefit. One of the lessons from this research is that we need to see smartphone apps less as autonomous interventions and more as potential hubs. Different women will respond to different levels of information. There are those who are turned off by text and just want visuals, contrasted to those who want to read the medical journals. In my research so far, women have split equally between those who would prefer a discussion forum based on complete anonymity, to those who would only want to discuss these issues with people they can identity and feel some sort of relation to. In making relevant information more accessible all these factors need to be taken into account, but first and foremost comes listening to what a broad range of women say.