Shea Jeanne L
Department of Anthropology, University of Vermont, 515 Williams Hall, 72 University Place, Burlington, VT 05405, USA.
Cult Med Psychiatry. 2006 Sep;30(3):331-62. doi: 10.1007/s11013-006-9020-4.
Drawing on ethnographic and survey research conducted by the author in a general population sample in mainland China, this article presents findings on Chinese women's midlife symptom reporting in comparison with pivotal studies conducted by Lock, Kaufert, and McKinlay in Japan, Canada, and the U.S. Analysis of the China survey data (N = 156 women, age 45-55) reveals for sixteen core symptoms a reporting frequency that is much lower than depicted in classic biomedical models of menopause. At the same time, however, the China data indicates problems with the popular extrapolation that midlife Asian women are virtually symptom-free compared to their North American peers. Finding the Chinese level of symptom-reporting low to moderate depending on the symptom, the article reveals important differences between Chinese and Japanese women in their level and pattern of symptom reporting, as well as substantial overlap with North American women in this regard. Referencing ethnographic materials on Chinese women and the cross-cultural literature on menopause, the article assesses potential explanations for the cross-cultural variation observed, including: local reproductive endocrinology, phytoestrogen consumption, aspects of East Asian culture, the nature of social change, the cultural acceptability of monitoring and voicing symptoms, and differences in dominant conceptions of midlife.
本文借鉴了作者在中国内地普通人群样本中进行的人种志和调查研究,呈现了中国女性中年症状报告的研究结果,并与洛克、考弗特和麦金利在日本、加拿大和美国进行的关键研究进行了比较。对中国调查数据(N = 156名年龄在45至55岁之间的女性)的分析显示,16种核心症状的报告频率远低于经典生物医学更年期模型所描述的频率。然而,与此同时,中国的数据表明,那种认为亚洲中年女性与北美同龄人相比几乎没有症状的普遍推断存在问题。根据症状不同,中国女性症状报告水平为低到中等,文章揭示了中国和日本女性在症状报告水平和模式上的重要差异,以及在这方面与北美女性的大量重叠。参考有关中国女性的人种志资料和关于更年期的跨文化文献,文章评估了观察到的跨文化差异的潜在解释,包括:当地生殖内分泌学、植物雌激素的摄入、东亚文化的各个方面、社会变革的性质、监测和表达症状的文化可接受性,以及中年主导观念的差异。