Ambiguities of aging: Japanese experience and perceptions of menopause.

The initial findings of this study indicate that menopause is regarded as a natural life-cycle transition in Japan in which the biological marker of cessation of menstruation is not considered to be of great importance. Symptom reporting among all respondents is generally low regardless of menopausal status, and symptoms such as shoulder stiffness and headaches, which are reported frequently, are not linked specifically to menopausal status (even though individual informants may perceive them to be so). Symptoms of hot flashes and sudden perspiration are higher among peri- and post-menopausal women, but their prevalence appears to be much lower than research findings from other areas to date. Reports by Japanese gynecologists emphasize that menopausal women are liable to present with numerous non-specific somatic complaints. This may well be an accurate representation of a clinical population, but the findings of this present study indicate that such a picture is by no means representative of the average middle-aged female population in Japan. While occupational differences do not contribute to variation in reported symptomatology (with the exception of lumbago and shoulder stiffness), there are nevertheless considerable differences in the subjective meaning of menopause, many of which can be accounted for by class and occupational differences. Presentation of these differences awaits a future publication, but there is one topic which is of concern to the majority of the respondents from each of the sub-samples. The present generation of women entering their 50's are the first where the majority must face later middle age in a nuclear family, along with their husbands, although both they and their husbands have been socialized for the more distant male/female relationships of an extended family. Japanese women cannot look forward, as they did in the past, to the power and comforts derived from running an extended family; on the contrary many can expect a late middle age of looking after bed-ridden parents or parents-in-law, and a lonely, isolated and often poverty-stricken old age (Steslicke 1984), since many pension programs are by no means adequate. Some of their fears about aging are expressed in their views on menopause, but these fears do not appear to be manifested at all prominently as either psychological or somatic representations. When asked to compare their lives with that of their own mothers, stories of incredible hardships from pre- and immediately post-war Japan are vividly portrayed.(ABSTRACT TRUNCATED AT 250 WORDS)